Office Ally Enrollment and Account Set-up Process

Office Ally Enrollment and Account Set-up Process

What you'll learn in this guide

In this guide, we will show you how to set-up your Office Ally (OA) account. You'll learn how to integrate your zHealth account with the OA account, what you need exactly to do that, and a few different set-ups in zHealth to get you started with insurance billing. Our Customer Success Specialists will help you understand the OA set-up process and what you need to do to integrate OA to our zHealth Software. We don’t manage your OA account or claims unless you have hired our Managed Billing Services.

What is Office Ally?

Office Ally is a full-service, free*, and cloud-based clearinghouse that helps you to submit claims to over 5,000 insurance payers. zHealth Software uses Office Ally as our clearinghouse partner.

*Note: There is no charge if over 50% of the claims submitted to the ‘partner’ payers via Office Ally. If not, there is a $39.95 flat fee (effective 2/1/2024). The $39.95 rate is per Billing NPI and Tax ID combination. If your clinic has different NPI and Tax ID combinations, you will pay $39.95 each for Office Ally. Each provider on HCFA form 24J would be $39.95 a month.

Participating and Non-Participating Payers

There are two types of insurance payers in Office Ally. Participating Payers (Par or “P”) pay a fee to Office Ally for pre-processing claims submitted to the payer. Non-Participating Payers (Non-Par or “NP”), on the other hand, do not pay this fee, so the fee is incurred upon the provider instead. 


You can search who is a Participating or Non-Participating Payer by searching the insurance name in this link and checking the type (P or NP) as shown below.


Integrating zHealth Software and Office Ally for New Users

Integrating zHealth Software with Office Ally (OA) will allow you to submit claims to insurance payers without leaving your zHealth account. The claim statuses will automatically update within your zHealth account as information is received from Office Ally for a seamless and automated tracking process. Additionally, zHealth will capture the EOB (Explanation of Benefits) from your payers as they become available and automatically allocate insurance payments to claims and appointments.


If you need a brand new Office Ally account, our Customer Success Team will do it for you. Here is what we need from you to get started:


Office Ally Enrollment Process - Video


Office Ally Enrollment Process - Read Steps

Step 1 - Sign up for Office Ally

a. Visit the official website of Office Ally. Click here: https://cms.officeally.com/. On the Office Ally website, click the "Sign up" button on the top right corner.



b. On the sign up page, enter your email address and click on "Create an Account".

On the next screen, you will get a message from Office Ally - "We have sent you a secure link to continue creating your account." 

Check your email account. You will get an email from Office Ally. Click on the "Verify my email" link/button to verify your email address.





c. Once you click "Verify my email", you will be taken to the next screen where you need to enter the following details:

(i) Enter the name of your clinic or practice
(ii) Enter your first and last name
(iii) Select username* from the drop-down
(iv) Set your password** and enter it again in the "Confirm password" box
(v) Click "Continue"
*Note: Save this username in a notepad as you will need this to login to your Office Ally account later on.

**Note: Read the Office Ally instructions to set a password. The password must contain 10-30 characters. It must contain three of the four following character classes - English Upper Case Characters, English  Lower Case Characters, Numeric, and Punctuation.
Save this password in a notepad as you will need this to login to your Office Ally account later on.



d. On the next screen, enter the following details:

(i) Enter your clinic's phone number
(ii) Enter your mailing address (Street Address 1 and 2, City, State, and Zip Code)
(iii) Click the check box to accept the Office Ally Terms and Conditions.
(iv) Click "Continue" 



e. On the next screen, you will get a Business Associate Agreement. To sign it, click "I'am authorized to sign".




f. Next, you will see the Business Associate Agreement. Read the agreement carefully. Once you've read the agreement, scroll down to Page 6.
  1. Enter your name in "Covered Entity".
  2. Enter the title as "Owner" if you're the clinic owner
  3. Click "Sign"
Once these details are filled and signed. Click "Confirm" to proceed.

You will be redirected automatically to the login page.




g. On the Office Ally login page, enter the username and password. Click "Continue".



h. Once you login, you will get a few options. Check the features/services Office Ally gives you and click "Next".
Note: Depending on whether you want paper claims or not, you have option to turn the button on and off.




i. On the next screen, click "Create claims using my current system". A pop-up screen will appear.

On the pop-up screen, start typing zHealth in the box. Select zHealthEHR from the auto-populated result.

On the next screen, click on "Professional Claims" as you will be submitting professional claims. Click "Done".

Next, you will receive a message saying that Office Ally will email your SFTP login credentials once your SFTP account is created. It might take 2-3 business days. Click "Done"









Step 2 - Enter the SFTP credentials in zHealth

Once you receive the SFTP username and password in your registered email address, enter those details in zHealth.

Login to your zHealth account. Hover the cursor over your name at the top right corner. Click Update Info > Provider > Provider Details.

Scroll down to the bottom of the page to the section "FTP credentials for the Office Ally".

Enter the login credentials you received in your email. Click "Update".



Step 3 - Enroll for Electronic Remittance Advice (ERA) and Electronic Data Interchange (EDI)

While you wait for your OA account to be activated, we encourage you to get a head start on enrolling for Electronic Remittance Advice (ERA) and Electronic Data Interchange (EDI).

EDI Enrollment - The enrollment forms you fill out for Office Ally allows you to electronically submit claims to most commercial insurance companies. However, some state specific and federal payers require pre-enrollment before permitting the provider to submit electronic claims to them. Typically payers such as Medicare, Medicaid, Tricare/VA, Blue Cross, Blue Shield, and some smaller state specific payers require pre-enrollment. Payers that require pre-enrollment are indicated on Office Ally's Payer Lists (ENR column). Office Ally provides these agreements and forms at the link provided, pre-filled with Office Ally’s information where ever required. Click here for a list of all Pre-Enrollment forms available
 (sorted by state). This is required in order to submit claims electronically to these specific payers.

ERA Enrollment - All payers require pre-enrollment in order to activate Electronic Remittance Advice (ERA/835) and avoid paper EOBs. Office Ally provides these forms at the link provided, pre-filled with Office Ally’s information where ever required. Click here for a list of all electronic remittance advice (ERA/835) forms available (sorted alphabetically by payer).

It is our recommendation to ask Office Ally to split ERAs by check so each will be sent in a separate file into zHealth. Here are their ERA splitting options:

 

  • No Splitting (OA default)

  • By Provider

  • By Payer

  • Both Provider and Payer

  • By Check (our recommendation)

  • By Payer (with TRN03 in ERA Filename)


Office Ally's default is no splitting which can make it more difficult to post payments. When OA receives the ERAs, they are sent to zHealth so that may include one or more. If they are received at the same time as other check/payer’s ERAs, then they’ll all go into one file to zHealth.



a. Add Insurances to your zHealth Account: Login to your zHealth account and go to Update Info > Insurances. Add the insurances one by one to your account. Click the help link here to learn how to add insurances to your insurance master list. You must enter the Insurance Name, Payor ID, and the Claim Filling Indicator Code for each insurance company you want to submit claims to (other fields are optional). Insurance Name and Payor ID are required and can be found here.



b. EDI Enrollment: Some payers require pre-enrollment before permitting the provider to submit electronic claims to them. Click this link to check the payers that require pre-enrollment. Click on any state name to view the insurance payers. Check their EDI enrollment form. Read the instructions carefully to know how to fill the form, where to send the form, how to check the status of EDI enrollment, and what is the turnaround time.



c. ERA Enrollment: ERA enrollment is MUST for each insurance company you want to submit claims electronically and avoid paper EOBs (posted payments will come directly into the software). You will need to use this link to get details for each insurance company for ERA enrollment. Read the instructions carefully to know how to fill the form, where to send the form, how to check the status of ERA enrollment, and what is the turnaround time.


d. Medicare Enrollment: It is based on the state you want to submit claims electronically. If you want to accept Medicare patients, please use this link to search for Medicare pre-enrollment forms in your state. Be sure to complete the form(s) as indicated on the Instructions Cover Page to ensure applications are not denied for incorrect/missing information.

IMPORTANT: Please note the 'turnaround time" indicated on the forms. Once enrollment has been approved, you MUST contact Office Ally at (360) 975-7000 Option 1 and notify them of the approval BEFORE submitting claims electronically or it won't be connected.


e. VA Enrollment: Click the following links to enroll yourself for EDI and ERA:

  1. EDI enrollment link
  2. ERA enrollment link


Integrating zHealth Software and Office Ally for Existing OA Users

Step 1: If you already have an existing Office Ally account, we need to verify a date that you would like to start submitting claims through zHealth as you can’t have two different EHRs connected to Office Ally at the same time.


Once we have a date, we need your Office Ally SFTP credentials so we can connect zHealth and your Office Ally accounts.


Here's a template email you can send to Office Ally to get SFTP credentials. Please copy the below information and paste it into your email and send the email* to Office Ally at Support@officeally.com.

*Note:  Please make sure to send this email to from the email address registered with Office Ally otherwise they will not process your request.
--------------------------------------- Email to Office Ally -------------------------------------------

 

Dear Office Ally Support,

 

I would like to have SFTP enabled on my account in order to submit HCFA claims via zHealth Electronic Health Records. Here are the details needed:

 

  • Office Ally Username: XXXXXXX

  • Contact Name: Dr. Your Name

  • Contact Email: Your Email Address

  • Software Name: zHealth Electronic Health Records

  • Form Type Submitted (HCFA/UB/ADA): HCFA

  • Turn on ANSI reports (999 & 277CA): Yes

 

Please let me know when SFTP access has been enabled.

 

Thank you,

 

--------------------------------------- Email to Office Ally -------------------------------------------


Step 2: If you followed the instructions in the section above, you will receive an email from Office Ally containing your SFTP username and password. Please forward those to support@zhealthehr.com and will add them to your portal in order to integrate Office Ally. Once the accounts have been connected, you will be ready to submit your claims electronically via zHealth.


Frequently Asked Questions
Q: What is the general claim submission process?
A: Here is the process to follow to submit electronic claims:
  • You submit the claims on zHealth, zHealth electronically sends them over to the clearing house (Office Ally - 837 EDI). 
  • OA validates the claim and forwards it to the respective payer for adjudication but if there is an error (277ca), OA shares that with zHealth.
  • The payer/insurance also validates the claim and might send any error back (277) to Office Ally electronically and that gets shared with zHealth.
  • The payer then processes the claim and if approved or denied - sends the ERA (electronic remittance advice) back to Office-Ally and OA shares it with zHealth.
  • When zHealth receives the ERA, it processes it and keeps it in the billing center for you to post payments for the respective claims.

We have seen the ERA files can take from 1 week to 4 weeks to be shared with zHealth (Payer to Office Ally to zHealth) although you might have received payment and acknowledgement from payer by then.

Q: My clinic has insurance (medicare, VA, or any other) with another clearinghouse, do I simply need to let Office Ally know or do I have to go through the full enrollment process via OA forms?
A: New form need to be filled out UNLESS they are existing Office Ally users

Q: Does Office Ally offer verification of benefits?
A: Office Ally offers 3 options for eligibility verification (a free and 2 paid versions). 
  1. Service Center Eligibility Request Tool (or Real-Time Eligibility Verification tool) - This is a free tool that allows you to confirm, in real time, the eligibility status of a patient prior to submitting their claim electronically. All admin accounts have this free tool activated automatically. Here is how you can get started with the Real-Time Eligibility Verification tool.
  2. Practice Mate Eligibility Verification Service - This is a paid tool that costs $10/month for the first 100 transactions and $.10 for each additional transactions. Once you have completed the Eligibility Verification User Agreement and Office Ally has linked your account you must complete the Eligibility Settings in Manage Office.
  3. Real-Time 270/271 Transactions - With this paid tool, you can send multiple 270 requests simultaneously. Charges based on a volume tier system. Here are the links to Real Time 270/271 User Agreement, Real Time Eligibility Companion Guide, and CORE Phase II (270) Connectivity Rules.

Q: Can I start filling out all the EDI/ERA Enrollment forms prior to getting/having my Office Ally account set-up?
A: Yes, you can.

Q: How do I pre-enroll with insurance companies that require pre-enrollment?
A: To get started on the pre-enrollment for those payers who require pre-enrollment, go to Office Ally’s Payer EDI Enrollment Forms page here. Find the state and respective insurance company that you need to pre-enroll with. Click on the link and follow the instructions provided and complete all required forms referenced in the instructions. There is no cost for pre-enrollment.

Q: How long does the pre-enrollment process take?
A: Pre-enrollment for most commercial payers is usually complete within one week. Pre-enrollment for Medicare, Medi-Cal, and CHAMPUS/TriWest varies from 1 to 6 weeks.

Q: Do I need to purchase Office Ally to send claims?
A: No, the Office Ally website interfaces with our zHealth Practice Management Software. All you need to do is to create your Office Ally account if you don’t have an account and integrate zHealth and Office Ally with the help of our Office Ally Set-up and Integration Guide.

Q: How much time does it take to set-up my Office Ally account?
A: It can take anywhere from 1-4 weeks to set up Office Ally and start submitting claims.

Q: How much time does it take to make the switch to OA if I am filing to Medicare and VA?
A: If you’re currently filing to Medicare or VA prior to making the switch to OA, this may take up to 4-6 weeks to make the transition.

Q: How to find claim ID (or Filing ID or Number) in my Office Ally account?
A: Login to your Office Ally account and follow the steps below to find your claim through the Office Ally inventory reporting tool:
  1. On the left hand side of the page, you will see a list of blue links. Under the category of ‘Reports’ you will see ‘Inventory Reporting’. Click that link.
  2. Once on the page, make sure the correct ‘Form Type’ is selected for the kind of claim you are searching for.
  3. Change the ‘Date Type’ to ‘DOS’.
  4. Change the ‘From Date’ and ‘To Date’ to the date of service that you are looking for.
  5. In the ‘Patient Last Name’ field, enter in the patient's last name, then click ‘Search’
  6. After the page refreshes, scroll down the page and you should see a list of claims.
  7. There is a column for Claim ID for each claim; this is the Office Ally Claim ID.
Claims and Billing Guides
For more information on how to submit claims and manage billing in zHealth Software, check these links:

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