Providers/CA - EDI

How do I identify AHC claims?

Review the list of Network Affiliates, or PPOs, found on this website. If the patient is covered by a benefit plan or carrier that uses one of the Network Affiliates, and the instructions on the corresponding Term Summary Sheet says to submit claims to AHC or I-AHC, then you should identify the claims to OA by placing the AHCØ1 (for AHC) or AHCØ2 (for I-AHC) prefix in front of the payer name on the CMS-1500.

How long until claim payments are received?

If there are no processing delays, a typical claim may be paid as early as 10 business days.

Who do I contact if I have a problem uploading my claims?

Call the customer support team for OA at (949) 464-9129 or send an e-mail to support@officeally.com. Customer service or technical support is available 24 hours a day, 7 days a week, at no additional charge.

How long does the pre-enrollment process take?

Pre-enrollment for most commercial payers is usually complete within one week. Pre-enrollment for Medicare and CHAMPUS varies from 1 to 6 weeks.

What tools and features are available on officeally.com?

Office Ally offers many features including tools for tracking claims, running reports based on your own specifications, checking eligibility, verifying codes (ICD9, CPT, POS, Modifiers), fixing claims right on the website, entering claims online, and sending attachments electronically. OA continually adds new features and upgrades existing services to meet your EDI needs.

Is my software compatible?

OA's ability to accept a print-image file means that we are compatible with nearly every practice management system. Essentially, if your software allows you to print claims in your office, you can send claims to Office Ally.

Can I file Medicare claims electronically?

You are welcome to file Medicare claims through Office Ally, but it is not required. AHC is NOT responsible for your relationship with Office Ally and the processing of Medicare, BCBS, Medicaid, and other non-AHC claims. You should contact OA with any questions regarding non-AHC claims.

Can all claims be submitted electronically or just AHC claims?

You may submit all of your medical claims through Office Ally. This includes AHC payors, I-AHC payors, Medicare, and other claims that would not involve AHC or I-AHC. AHC is NOT responsible for your relationship with Office Ally and the processing of Medicare, BCBS, Medicaid, and other out-of-network claims. You should contact OA with any questions regarding non-AHC claims.

I am already enrolled with Office Ally, what do I need to do to process claims with AHC?

You must notify AHC so that we may contact OA to indicate AHC on your enrollment. This is important so your AHC claims are not processed out-of-network. You will also need to submit a check for the set-up fee along with the two AHC enrollment forms.

How long does it take to get started after I send my enrollment form?

Please allow up to 30 days for us to process your enrollment. Once we submit the enrollment form to OA, OA will email a user name and password for uploading claim files. An OA enrollment specialist will contact you to set up an appointment with one of their technical staff for training

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