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US Insurance Billing Using Online Clearinghouse Office Ally

Phase 1 of Jane’s Office Ally Integration is ready!!

As mentioned in our guide on Creating an EDI File to Submit to a Clearinghouse, phase 1 of the integration allows you to generate an EDI text file of your claims to download from Jane and then upload to Office Ally (or other clearinghouses).

If you are not yet signed up for Office Ally, Office Ally is an online clearinghouse 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.

Signing up for Office Ally can be done here: Office Ally Enrolment

You can then follow our guide document on Creating an EDI File to Submit to a Clearinghouse.

Important Note

If you are still opting to submit claims manually in Office Ally or use the Practice Mate Option, these options are listed below:

Option 1: Office Ally 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.

Once you receive the Explanation of Benefits (EOB), you can follow the steps on Receiving an Insurer Payment (EOB)

Learning More

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

Setting up Insurers (US)

Creating a Patient Claim (US)

Creating Billing Codes (US)

Receiving an Insurer Payment (EOB)

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.