The Billing Reports ElderSuite Downloads and What Each One Means

📝 Overview

When you submit one batch of claims, several different reports come back over the following days and weeks. They are not duplicates and they do not disagree with each other. Each one reports on a different stage of the claim's journey, and each one is silent about the stages before and after it.

The earlier the stage, the less it proves. “Accepted” never means paid. Only the 835 remittance advice tells you what a claim was worth.

ElderSuite serves adult day care centers nationwide. Pull the files from Claim Center → View Reports, then use Auto Reconcile or Reconcile Claims to record outcomes. For how to open and print the list, see How to View and Print Billing Reports in ElderSuite. The path from attendance through claims is on Adult Day Care Billing Software.

⚙ How It Works

1. Know the Stages in Order

1. Did the file get in the door? — TA1, 999
2. Did the clearinghouse accept each claim? — Immediate batch responses (IBT, 277IBR, 277IBRP), Electronic Batch Report (EBT)
3. Did the payer accept each claim for review? — 277CA
4. Is the payer still holding the claim? — Delayed Payer Report (DPT, DPR)
5. What was paid, denied, or adjusted? — 835 remittance advice (ERA)

2. Download Reports From the Claim Center

Reports do not arrive on their own and they are not emailed. You pull them in:

1. Open Claim Center and click View Reports. The Billing Reports window opens.
2. Click Download Reports.
3. Choose your clearinghouse, Availity or TMHP, in the Select Clearing House prompt.

ElderSuite signs in with the credentials saved for that clearinghouse, downloads every report that is waiting, stores each one in your ElderSuite account, and adds it to the list. Double-click a report in the list to open it.

If you see The billing reports are not available to download at this time, nothing new was waiting. That is normal, not an error.

Availity removes its copy of a report once ElderSuite has stored it, so a report cannot be downloaded a second time. Every report stays in the Billing Reports list, and opening it again fetches it from your ElderSuite account.

3. Read What Each Stage Means

Stage 1 — TA1 and 999. These check the structure of the file you sent. They say nothing about any individual claim. ACCEPTED means the file could be opened or passed syntax checks and the claims move on. REJECTED means the file failed and the claims will not be processed until the batch is corrected and resubmitted.

Stage 2 — Immediate batch responses and EBT. Within moments of an upload, Availity can send IBT, 277IBR, and 277IBRP checks of each claim before the payer has seen anything. Accepted here means the claim passed Availity's checks and is queued to be forwarded—not payer acceptance and not payment. The Electronic Batch Report (EBT) summarizes how many claims were accepted or rejected for the batch. A claim rejected here should be corrected, set back to Pending, scrubbed, and resubmitted. See How to Process Claims in ElderSuite.

Stage 3 — 277CA. The first report that speaks for the payer, claim by claim. Accepted means the claim passed front-end checks and entered adjudication. Rejected means it will not be reviewed or paid and must be corrected and resubmitted. Accepted on a 277CA is still unpaid.

Stage 4 — Delayed Payer Report (DPT / DPR). Availity reports that the payer has acknowledged the claims but has not yet entered them into adjudication. Claims here are not rejected and not approved or denied. No action is needed while a claim is genuinely pending. If a claim stays unresolved for around 30 days with no further status, contact the payer with the patient name, dates of service, and total charges.

Stage 5 — 835 / ERA. The payer's report of what happened to the money, claim by claim and line by line. This is the only report in the family that carries payment information. Nothing is applied automatically: download the 835, open it from the Billing Reports list, and reconcile with Auto Reconcile after confirmation. Until then, every claim keeps its previous status. ElderSuite can split a multi-day claim line by attendance day when sharing payment, which is why a paid claim can show Denied rows inside it.

4. Know Which Reports Auto Reconcile Can Use

ElderSuite chooses the viewer from the report type. Auto Reconcile only exists in the grid viewer.

• Yes (grid): 835 / ERA; 277, 277CA, 277IBR, 277IBRP and other claim status files; DPT / DPR; IBT; EBT with claim detail
• No: EBT summary only; TA1; 999; PDF reports; Batch ID file (BID)

If you open a report and there is no Auto Reconcile button, you have opened a TA1, a 999, or a summary-only EBT. Those reports carry no claim rows, so there is nothing to reconcile.

A BID file contains only the batch identifier for a TMHP submission. Opening it shows the batch ID and the TMHP phone number rather than a report.

✅ Important Limitations

Print is the only way out of either viewer. There is no export.

The copy of a report on the computer is temporary. Reports are stored in your ElderSuite account. Opening a report from the Billing Reports list fetches it again.

Questions about why a claim was rejected or priced a certain way belong with the payer or the clearinghouse. ElderSuite receives and displays the same information on the report. Availity is at 1-800-282-4548 and TMHP at 1-888-863-3638.

Claim status codes and EOB codes are a separate subject from these report types. The report still opens even when a code has no plain-language explanation in ElderSuite.

⚠ Accepted Never Means Paid

Accepted on a TA1, 999, immediate batch response, EBT, or 277CA is not payment. Only the 835 remittance advice carries what was paid, denied, or adjusted—and only after you download it and run Auto Reconcile (or update statuses another supported way).

💡 Need More Help?

For step-by-step instructions, click Ask Eddie from within ElderSuite.