Setting up and navigating insurance billing in your practice can be a confusing process but it does not mean you can’t do it without help. While it can be a tedious and time consuming process, it plays an important role in the financial health of a practice which is largely dependent on translating patient visits into actual reimbursements. For this reason, having an EHR and telehealth platform that also integrates with insurance billing features will reduce billing errors, high reimbursement and streamline the overall insurance billing workflow within your practice. Healthie’s Telehealth & EHR platform was created with nutrition professionals in mind.

What is Office Ally and what does it do?

Office Ally is a full-service, cloud-based clearinghouse employed by health and wellness professionals who accept insurance for their services.  Office Ally software allows providers to create, submit, and track insurance claims, as well as run reports, check eligibility, and verify codes. 

• Documentation: clients can complete forms online
• Billing & invoicing: through their web based system
• Scheduling: users can create appointments, manage calendar, and use color coding
• Client portal (Patient Ally)

What makes Office Ally different?

Office Ally is well-known for being one of the lower-cost clearinghouses on the market.  They do not incur any set-up fees, general monthly fees, or per-claim fees for electronic claims submission to Participating Payers.  Other clearinghouses can range anywhere from $39 to $95 a month for practitioners.  

• Time saving
• Best for small to mid-sized medical practices
• Affordable
• Simple and uncomplicated

There are two types of payers providers can submit to through Office Ally software.  Participating Payers (Par) pay a fee to Office Ally for pre-processing claims submitted to the payer; this is how Office Ally is able to generate their income.  Non-Participating Payers (Non-Par), on the other hand, do not pay this fee; therefore, the fee is incurred upon the provider instead.  The payer itself chooses which category they fall into, based on whether they want to pay the fee and benefit from Office Ally’s pre-processing services. 

Is Office Ally HIPAA-compliant?

Office Ally is ONC-ATCB certified and HIPAA-compliant. ONC-ATCB certified EHR systems have been thoroughly tested and approved to securely store and maintain patient health information. HIPAA IT sets the standard for sensitive patient data protection. HIPAA Privacy Rule provides federal protections for Personal Health Information (PHI) held by covered entities and gives patients an array of rights with respect to that information. In addition, the Privacy Rule is balanced so that it permits the disclosure of PHI needed for patient care and other important purposes. The HIPAA Security Rule specifies a series of administrative, physical, and technical safeguards for covered entities to use to assure the confidentiality, integrity and availability of electronic Protected Health Information (ePHI). With Healthie, you can conduct HIPAA-compliant virtual sessions from your computer or any mobile device, to reach your clients on-the-go. Beyond virtual calls, the Healthie platform also provides secure ways to send messages, emails, documents, forms and faxes virtually, to support your wellness practice.

Office Ally offers many different medical software products:

Office Ally Clearinghouse

What is Office Ally Clearinghouse? 

Free clearinghouse with access to more than 5,000 payers

Features: 

• Submit to over 5,000 payers
• No contracts to sign
• Free set up and training
• Use your existing Practice Management Software
• Free Customer Support
• Free online Claim Entry - No Software to Purchase
• Detailed Summary Reports
• Practice Management Software Package
• Order Labs Online
• Online Patient Eligibility Checking

Pricing: 

Free

Office Ally Practice Mate

What is Office Ally Practice Mate? 

Free software full of useful features and benefits that will help organize & grow your practice.

Features

• Submit to over 5,000 payers
• No contracts to sign
• Free set up and training
• Use your existing Practice Management Software
• Free Customer Support
• Free Online Claim Entry - No Software to Purchase
• Detailed SUmmary Reports
• Practice Management Software Package
• Online Patient Elig

Pricing

Free

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Office Ally EHR 24/7

What is Office Ally EHR 24/7? 

A Comprehensive EHR program that allows healthcare providers to spend more time with patients and less time on paperwork.

Features

• Customizable Design & Fast Implementation
• Free set up and training
• Customizable for all specialties
• Increase your HEDIS Numbers
• Capture Pay-for-Performance Monies
• Real Time Results Reporting
• ePrescribing (Electronic Prescribing)
• Order and Receive Lab Results online
• Fully integrated with Office Ally’s Practice Mate™ systems
• Customizable SOAP notes guidelines

Pricing

$29.95 per month/provider

Patient Ally

What is Patient Ally? 

No cost patient portal that enables providers to connect with their patients and includes a variety of tools for patients to access and manage their personal health records.

Features

• Notifications for appointment reminders and new content
• Schedule and manage appointments with multiple providers
• Online secure messaging to and from patients
• Online Bill Pay and payment history
• Viewable/printable Clinical Summaries for each visit
• Lab and Test results
• Intake Documents for clinical paperwork before a visit
• Vital signs charting
• Free sign up for health care vouchers

Pricing

Free

Intake Pro

What is Intake Pro? 

1. Patient checks in with Front Desk Staff and is given a Sync Code.
2. Patient is given access to the tablet to enter the Sync Code and complete their forms.
3. Information from the intake and agreement forms can be reviewed and automatically populated into the patient’s chart.

Information from the intake and agreement forms can be reviewed and automatically populated into the patient’s chart.

Features

• Compatible with today’s hand held tablets
• Easy to use interface
• Custom electronic documents
• Automatic upload to Practice Mate, EHR 24/7 and Patient Ally

Pricing

$1.00 per device for startup fee for users who meet all requirements of service as outlined in the Electronic Agreement form

Price surcharge & non-par payer update

Office Ally has recently made a few updates to their monthly fees for claims to Non-Par payers, as well as their list of Non-Par Payers.  Previously, if more than 50% of a provider’s claim volume was made to Non-Par Payers, providers were required to pay a monthly Office Ally fee of $19.95 per rendering NPI/TIN.  As of February 1st, 2019, this monthly fee was raised to $35 per month. 

Additionally, the list of Non-Par Payers is expanding rapidly, as insurance payers choose to not pay for Office Ally’s services.  The table below shows the latest round of payers that have switched as of July 1st, 2019. You can find an updated list of Par Payers here. 

There are a few reasons why these switches and the surcharge are occurring.  Office Ally has seen a significant decrease in insurance companies that are willing to pay for their services.  This is due to the fact that the Affordable Care Act requires that between 80-85% of premium dollars are spent on medical care.  Therefore, insurance payers are becoming warier of the money spent on processing claims, Office Ally fees are consistently not making the cut.  

Originally, insurance companies were looking to encourage providers to submit claims electronically and were willing to concur with clearinghouse fees to bolster electronic submission. However, electronic submission is usually employed by providers anyway , so insurance companies are less willing to pay for the incentive.  

In addition, most insurance payers currently offer their own portals for electronic claim submission. For providers who are in-network with several insurance payers, it can be inconvenient to utilize multiple portals for claim submissions, a large factor when choosing to utilize a single clearinghouse. However, from a payer perspective, a free way to submit claims is available to their in-network providers, and the provider’s choice to use an alternative clearinghouse as such is an independent decision. 

How do I create an Office Ally account?

To enroll with Office Ally, fill out the Online Enrollment Form. After completing the enrollment form, there is a Provider Authorization Signature Page and the Business Associate Agreement that must be printed, signed, and faxed to Office Ally at (360) 314-2184. 

Office Ally EHR & Healthie

Healthie is a practice management platform, designed for nutrition and wellness professionals. As an all-in-one solution, Healthie provides the back-office tools that providers need (charting, billing, scheduling) alongside modern client engagement tools (client portal, journaling, chat, telehealth, and more). 

Healthie's sync with Office Ally EHR enables you to electronically submit CMS 1500 claims from Healthie to Office Ally. This eliminates the need to manually export claims from Healthie and upload them to Office Ally. Moreover, claim statuses will automatically update within your Healthie account as information is received from Office Ally, for a seamless and automated tracking process. 

It’s important as a provider who accepts insurance to run through the list of your insurance payers and identify any that have switched over to the Non-Par Payer list.  You may have payers that have switched, but unless 50% of your claims are Non-Par payers, you are still exempt from the monthly fee.   However, these updates very well may have pushed your Non-Par Payer claims submission rate over 50%, and you will need to begin paying the $35 a month.  Be sure to evaluate your income and overall budget to ensure you can accommodate this cost.  

You can see your clients insurance plans straight from the Billing > CMS-1500 tab on Healthie. You can easily verify any payers that have switched to the Non-Par Payer category and prepared yourself appropriately.     

Read more on syncing your Office Ally account with Healthie here. Get started with Healthie, the all-in-one practice management solution for wellness professionals.