Important Changes to Office Ally Clearinghouse
Over the years we have submitted some claims to the Office Ally clearinghouse rather than to the primary clearinghouse we use, Availity.
There was one main reason why we have submitted some claims to Office Ally:
- The particular payer was not on Availity's Sponsored Payer List and thus we would not have had an electronic connection to the payer unless we submitted to Office Ally.
For the most part Office Ally has not charged a fee for submission of claims for commercial payers.
HOWEVER, as of September 1, 2017, Office Ally is going to be changing the status of MANY claims from Par to Non-Par.
Office Ally's policy is that if more than 50% of claims submitted during a month are submitted to Non-Par payers a fee of $19.95 is charged. Therefore, with the changes to their payer list as of September 1st, we will be submitting very, very few claims to Office Ally.
Office Ally Payer List Changes As of September 1, 2017
- To see a list of payers whose status is changing for Office Ally from Par to Non-Par, check out: https://www.mbpros.com/officeallynonparpayerchanges0917.pdf.
- It is important to understand that this list is only for payers changing their status as of September 1, 2017. Office Ally has many other payers that already have a status of Non-Par. To see the current list of payers for Office Ally, you can visit: https://cms.officeally.com/Pages/ResourceCenter/PayerLists/PayerList.aspx.
Medisoft Network Basic Service Providers
- For our Medisoft Network Basic Service providers, you should review all payers on your payer list to see which EDI Receiver the payer is set for. If the Receiver is Office Ally, you will want to review the Office Ally Payer List Changes PDF referenced above.
- Providers will also want to review the Availity Sponsored Payer List at http://www.mbpros.com/availitysponsoredpayerlist0817.pdf.
- If a payer on your payer list is currently set to Office Ally AND is also on the Availity Sponsored Payer List, you should change the EDI Receiver to Availity. In addition, you should double check the EDI Payer Number on the Availity Payer List as it may be different than the EDI Payer Number on the Office Ally Payer List.
- If a payer appears on the Office Ally Non-Par Payer List (whether as of now or on the change list effective 9/1/17 as indicated at http://www.mbpros.com/officeallynonparpayerchanges0917.pdf AND the payer does NOT appear on the Availity Sponsored Payer List, you should change the default billing method for the payer to PAPER. You then will have to print and mail claims for that payer.
- EFFECTIVE WITH INVOICES BEING SENT October 1st and later, if 50% or more of your claims are sent to Non-Par Payers on Office Ally's Payer List, we will be passing on to you the $19.95/month fee assessed by Office Ally. It will be your responsibility to ensure that you do not incur this $19.95/month fee from Office Ally. This is ONLY for our Medisoft Network Basic Service providers.
FOR OUR PREMIUM, PREMIUMPLUS AND PLATINUM SERVICE PROVIDERS.
- The above fee does NOT apply to our Premium, PremiumPlus and Platinum Service providers as we will ensure that non-par claims will not be submitted to Office Ally.
- There may be some payers for which we can submit electronically but which as of September 1st we will submit claims on paper. If your office wants us to continue to submit any claims electronically on the Office Ally Non-Par Payer List (and which are not available on the Availity Payer List) AND you want to pay the resulting $19.95/month fee, let us know. Otherwise, for payers for which there is no connection via Availity and for which the payer has a status of Non-Par with Office Ally, we will send those claims on paper.