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US Insurance Billing Using Online Clearing House Office Ally

September 19 2018 - Update: While the integration development took a little unexpected pause while Jane started a big move to newer and larger infrastructure, Jane has now returned to actively working on direct billing to Office Ally as a top priority project. While we are so looking forward to being able to offer direct billing straight through Jane, the following options are the temporary solution for submitting claims. As with all renovations our actual timeline is twice as long and twice the price as the original estimate. Anyone mid-reno out there? Thanks for your continued patience and we have many clinics working to submit successfully with the following solutions:

Office Ally is a free online clearing house and/or billing software through which you can submit insurance claims to thousands of insurers across the Country. You can work with either their “Clearinghouse” option, which is screenshotted below, or also with their “Practice Mate” option if you want to store patient specific treatment and diagnostic codes. Both of these solutions are free to use.

If you do a significant amount of insurance billing Practice Mate can be a quicker option for repeat billing.

Either way, within Jane this would then be managed using our Portal Billing Workflow

Jane will record the information about the patient’s insurance coverage, and can manually track what you are billing to and receiving payment for from the insurance companies (through the Office Ally portal), but it is a manual process at this time and there is no DIRECT LINK between the two systems.

Within Office Ally claims, patients, and templates can be built manually and favourites can be stored for faster billing on subsequent visits.

Let’s take a look at how that work.

Option 1: Clearinghouse

You can Launch the Office Ally Portal from within Jane’s Claim Screen.

First you can add the login URL to all of your insurers that bill through Office Ally, this way Jane will launch the portal for you.

The log in for the portal is: https://www.officeally.com/slogin.aspx

Once an insurer has a portal address, you can launch the portal from the claim screen.

Once in Office Ally you can use the online claim builder to submit a claim.

Here you can create “one off” type claims and just plug all of the patient’s information into an online CMS-1500 form, but the real time saver is in using their Stored Info features.

It’s here that you would create a shortlist of your patient profiles, payor information, and even full templates of typical billing templates (initial visit, subsequent visit, diagnosis, or even build them specifically for individual clients.

To populate the CMS-1500 and bill a visit, or a week, or month of visits you would hop into the portal and start with these favourites.

Choose an existing option from the drop down list or use the “Add” option to enter a new Payer, Patient, Provider, or Billing Template.

Once all the fields are ready to go, click the Create New Claim button.

The relevant information will then populate on fillable and editable online form:

Just the dates need to be added - and you will be warned before completing the form if you are missing any required fields.

Office Ally has some very helpful training videos that walk through the process of billing within their portal.

Option 2: Practice Mate

Note: We have heard positive feedback about how this option is working for current clients managing fairly large amounts of insurance claims. This would likely be the best option for you if you do work regularly with insured patients.

Practice Mate is also a free service within the Office Ally suite of products and can be used if you work with more unique codes on a client by client basis.

Other Jane users who work with significant amounts of insurance billing are opting to work with “Practice Mate” as they can set up diagnostic and treatment codes for a patient just once and that will be saved as a custom template specifically for that patient (instead of creating generalized billing templates that need to be updated patient by patient).

The paid claims are also nicely categorized in the Accounting_Autopost Area instead of on a calendar, which can be easier to review.

Once all the patient demographics have been entered for the first time re-billing for future visits can be quite quick.

You can learn more about Practice Mate from their downloadable help guides on the various topics. Most relevant are:

Adding Patients and Setting up Claim Templates

Creating Patient Claims to be Billed

Submitting Claims

Tracking the Claim within Jane

At this point you can mark the claim as submitted. This can be done at the time of sale, or Jane has an insurer billing area where you can work with your claims in one view and that will show which visits have not been sent through and which are submitted but waiting for payment.

Learning More

And here’s some further reading about Insurance Billing Set Up within Jane!

Setting up Insurers

Creating a Patient Claim

Creating Custom Billing

Receiving an Insurer Payment

If you have any further questions do let us know, and we’re so excited to work towards completely simplifying this process in the very near future.