Providers/CA - EDI

What if my software isn't HIPAA compliant?

Your claims will be converted to the required format by OA before they are sent to the payor. It is not necessary to upgrade or purchase new software.

How do I enroll in EDI?

To enroll, complete the enrollment paperwork.

Mail the original signed documents to:

    ActivHealthCare, Inc
    1926 Northlake Parkway, Suite 100
    Tucker, GA 30084

What formats does Office Ally accept?

Office Ally does accept the HIPAA compliant ANSI 837 format. However, if your software does not produce this format, text files, print-image files and NSF format files are also accepted.

How do I send claims to Office Ally?

Most users send claims to OA as follows:
1. Create a claim file using your current billing software.
2. Log into and click UPLOAD HCFA1500.
4. Find your file and click OPEN.
5. Click UPLOAD.

Office Ally also supports FTP transfers and offers an online entry tool. They will walk you through this process step-by-step during your set-up appointment.

How do I pre-enroll for insurance companies that require pre-enrollment?

To get started on the pre-enrollment for those payers who require pre-enrollment, when you are filling out the OA Enrollment Form, list any of the listed payers that you would like to pre-enroll for. OA will start the pre-enrollment process for the companies you've selected and get any necessary paperwork to you. There is no cost for pre-enrollment.

What if I don't have billing software?

For providers without billing software, Office Ally (OA) offers a free, online entry tool. This tool allows you access to a blank, electronic HCFA on the OA website. You type data into it the same way you would a paper HCFA. Additionally, this tool allows you to store patient, facility and provider information so you do not have to re-type the same information over and over.

What insurance companies am I able to send to electronically?

By enrolling with Office Ally, you are automatically set-up to send to all payers on the OA Payer List except those with asterisks next to their name. Those payers require you to go through a pre-enrollment process before we can send your claims electronically to them.

Is Office Ally HIPAA compliant?

Yes, OA is certified HIPAA compliant. The Trading Partner's Agreement details the HIPAA policies and procedures that are followed to protect your private health information as well the security measures used in the computer systems to ensure privacy.

Do I have to submit in a HIPAA compliant format?

No, the law allows providers to submit in a non-HIPAA compliant format to a clearinghouse. The clearinghouse must convert the claims into the 837 HIPAA compliant format prior to transmission to the insurance company or claims payer. It is against the law for a provider to submit directly to an insurance company in a non-compliant format.

Do I need to purchase software?

No, the Office Ally website will interface with all practice management software packages. All you need is Internet access. The OA technicians will assist and train your office staff on set-up and the use of the Office Ally tools.