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DoctorHelper posted on 10-17-2009 12:43 AM

I'm a computer person and knows very little about healthcare software but am trying to help a doctor friend find a billing clearinghouse.

Another doctor friend showed us how Office Ally works. The #1 feature that my friend wants is to check status of the claims. But according to the other doctor, once the claim is accepted by the payer (accepted does not mean it will be paid), office ally does no further tracking. In other words, we cannot tell if the claim is paid, pending approval, or denied by the payer using office ally web site. Is this true?

If this is true, then is there an alternate billing clearinghouse that would track the status of the claims?

I found a list of billing clearing house but don't know which one provides this feature.

http://www.medicalbillingsoftwarepro.com/Medical%20Billing%20Clearinghouses.html

Excuse me if I'm not using the correct terminologies.

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My understanding is that Office Ally provides a free service. It's tough to compete with that, but you also get what you pay for. I'd look into GatewayEDI, ZirMed, or MDOnline (who recently bought Medical Claim Corp., a company many of the clinic we service raved about). I have clients using these and others, and I believe they offer better interfaces that provide the kind of interaction and reporting you are interested in. I've also heard good things about a newer clearing house called TKSolutions. You generally see these types of solutions in the $80-100 per provider range, but their pricing structures vary. Hope this helps.

http://www.gatewayedi.com/

https://public.zirmed.com/

https://www.mdon-line.com

 

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One of the feature listed in gatewayEDI is a feature called "claims status". Is this the feature I mentioned, i.e. the ability to see if the claim is being process, paid, or rejected? Is this feature only available in paid service?

We're not necessarily looking for a free clearinghouse. If we pick a paid service it would have to address all our needs. Utimately, it needs to save time.

Another thing that bothered us with office ally, is that according to the friend who gave us the demo, different fields need to be filled in for different payer. The example given to us is that medicare require a facility code (NPI or something). Having to fill in different fields for different payers kind of defeats the purpose of using a computer. This is something the computer should help us do. Does any clearinghouse allow us to enter claims the same way for all payer? If so, what would this feature be called, and is it only avaialble in paid service?

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We (3 physician, single specialty group) are very happy users of Gateway EDI (best customer service of any vendor we have used in 25 years, giving credit where credit is due), but I'd investigate the others mentioned above as well.  The Gateway folks have a nice demo process that will show you what they provide.

Robert

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DoctorHelper,

I'm not sure what state you are in, but one thing to be careful about is that Office Ally does not have Medicare connectivity in all 50 states.

If I had to pick between the two, and I have no interest in either, I would pick Gateway EDI even though it is not free.

Margalit Gur-Arie

My brand new Blog: On Healthcare Technology

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Unless I am mistaken,  the Ansi specification does have a Claim Status which will return the information you seek.  Ask the Clearinghouse if they support that Spec(I could be corrected on this). 

 

I have found in my workings that many times it is better to enroll online with the individual large payers that you work with.  You can login for free, and usually get your eligibility, claim status and other things right from the payer. 

This might be time consuming, but many of the Clearinghouses will charge a per provider fee, or a transaction fee each time you utilize them.

Now that Medicare has the Medicare Info site, you can get that status for free as well. 

This might be another option to consider if you want to save money, and in some cases you can actually correct the claim on the site of the Payer and fix it right there.

Just my 2 cents.

Norv

 

 

David B. Norvell

CEO Paradise Medical Billing and Consulting

www.medicalbillinginparadise.com

 

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One of the feature listed in gateway EDI is a feature called "claims status".

  I am not sue that this feature I mentioned,  is being process, paid, or rejected?

Please give some more information.

Thanks.

 

Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Medical billing companies

 

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Hello, I work for a company that has a mental health EMR and we are getting our client signed up with a clearing house named gateway. They do a wonderful presentation and are really on top of it. you can check them out at. http://www.gatewayedi.com  Also www.public.zirmed.com looks like a good one and is price a little less than gateway. Hope this helps.

Judy

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Good questions. Call Office Ally and ask.

Ph: (866) 575-4120  
Fax: (360) 896-2151  
Email:
info@officeally.com

 

Chris Wilkerson, D.C.
Carson Doctors Group
TabletPCs in Medicine
Editor-in-Chief www.MedicalTabletPC.com
Home: www.Digital-Doc.com

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