Office Ally & Healthie: Direct Claims Submission
Healthie's sync with Office Ally 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. Subsequently, claim statuses will automatically update within your Healthie account as ERA (Electronic Remittance Advice) file data is received from Office Ally, for a seamless and automated tracking process.
IN THIS ARTICLE:
Create an Office Ally Account
If you're interested in using Office Ally's software and clearinghouse to verify patient insurance, submit claims, accept payments, and manage your business online, explore the various Office Ally solutions here and choose the one that's right for you.
Connect Your Healthie Account with Office Ally
If you use Office Ally to submit claims to insurance companies, you can enable an auto-claim submission from Healthie into Office Ally, and enable claim statuses to be updated automatically.
To set this up, e-mail firstname.lastname@example.org. Use the email subject: "SFTP Support (Healthie & Office Ally)"
Include the following content in the email:
- Your Office Ally username
- The name of the Office Ally account holder
- The email address of the Office Ally account holder
- Software: Healthie
- Form Type Submitted: HFCA
Once you receive the information back from Office Ally, Navigate to Billing > CMS 1500 > Connect to Office Ally. Press the button "I have the SFTP Data" and enter the information you received from Office Ally.
After you have set up this integration between Healthie <> Office Ally, when you navigate to Billing > CMS 1500s:
- Select the claim (or multiple claims) you’d like to send by checking the box to the left of the client name or picture
- On the top right of your screen, you will now see a BLUE “Send to Office Ally” button
- When you click this button, your CMS 1500 will automatically send to Office Ally, and a green banner confirming it was sent will appear. When you send a claim from Healthie to OfficeAlly, you'll receive an email shortly after confirming that OfficeAlly received the claims.
- Claim statuses and reimbursement details automatically updated daily (at approximately 6:00am EST)
- Payment reimbursement for insurance will happen outside of Healthie. If you have ERAs set up in OfficeAlly, we will automatically pull in reimbursement data in Healthie.
- The first time you use this integration, you'll need to submit 5 claims.
- This direct integration is available on our Practice Plus membership plan and above. To upgrade your membership plan to Practice Plus, you can email our team at email@example.com
- If you are receiving an error message when attempting to set up Healthie <> Office Ally, here are the most common reasons for errors:
- Credentials are invalid: If you see that credentials are invalid, you will likely need to request new credentials since we cannot validate the old ones
- Please e-mail firstname.lastname@example.org with details on any Error message that you are receiving, so we can provide details to resolve this connection.
- Depending on your mix of insurance claims, Office Ally may charge you a fee for utilization of their platform. This fee is separate from Healthie's membership fees, and Healthie membership does not cover this charge. We recommend reaching out to Office Ally's support for more information about your account and fees. From their website, *Non-Par Claim Fee applies when 50% or more of monthly claim volume is to Non-Par Payers. Here is some more information.
Batch and export claims for manual upload into Office Ally
If you do not have the SFTP integration between Healthie and Office Ally, you can download and re-upload CMS 1500 claims from Healthie into Office Ally, for electronic claims submission.
Within your Healthie account:
- Select the claims you are seeking to export (by checking the checkbox to the left of each) and press the "Export as TXT" button
- Download the export file to your computer
- Upload the export file into the Office Ally Service Center within your Office Ally account
Additional instructions on sending batched claims can be found here, particularly in the "How do I send claims to Office Ally" section. Be sure to include your TIN, or else your files may not be readable by Office Ally when submitted.
Note: the first time you upload files to Office Ally from Healthie, you will need to have at least 3 claims to submit.
Automatic Updates to Claim Status
The status details for each claim will automatically update within Healthie as ERA (Electronic Remittance Advice) file data is received from Office Ally. This information originates from Office Ally and is pushed into Healthie. This prevents you from having to log into Office Ally directly to reconcile claims status, saving time in your billing workflows. If Office Ally rejects your claim, Healthie will not update the status. Please note that though Office Ally rejection may come over, it is not the standard for now, and you should not expect it to.
You can review your claims statuses by going to Billing > CMS 1500. All insurance claims will be listed, and you may filter accordingly.
You can find a detailed list of Healthie's claim statuses here.
Note: If you do NOT see reimbursement details automatically updating within Healthie, we suggest that you go to Office Ally to each payer page and request to send the remittance report to Healthie.
Office Ally FAQs & Troubleshooting
Refer to our Insurance Claims Troubleshooting Guide for common claim errors & resolution tips.
Why am I being charged by Office Ally?
While there are no fees to use the Healthie + Office Ally integration, fees may apply from Office Ally. We recommend reaching out to Office Ally to better understand pricing and fees associated with claims submission.
New to insurance billing? Join our Live Class " Deep Dive: Insurance Billing" here for a walkthrough of the Healthie billing platform and open Q+A.