Support Center

Insurance Company Information and Electronic Billing

Last Updated: Jun 12, 2015 12:56PM EST

Most therapists work with a limited number of insurance companies. Insurance company information is stored in a separate database so that addresses, etc. do not need to be entered repeatedly for each new patient.

You enter new insurance company information by pressing the "Edit Insurance" button and selecting "(new insurance company)" from the pull-down list. The most critical information to be entered is the mailing address. You also need to select the Type of Claim Submission.

If you use electronic billing for this company, select "Electronic Billing" from the list. Note that you must have an active account with Office Ally to use this option; see below.

If you do online billing through the insurance company web site, or have to fill in special forms for EAP sessions, choose "simple claim list" as the type of claim. This will cause a page to print on your local printer with a list of claims that need this sort of manual processing.

If you submit paper claims to this insurance company, select this option. See the notes above on how to set up your printer to print out these claims correctly.

A strong suggestion: make it easy on yourself. Set up an account with Office Ally, our preferred claims clearinghouse, and then select "Electronic Billing" for each and every insurance company. This will simplify your life remarkably. If a particular company doesn't accept electronic claims submissions, Office Ally will print out a paper claim for that company and mail it for you. They charge just $0.35 for each paper claim; the electronic claims are all free (unless your practice is more than 50% government claims). You end up saving money on stamps, and save a great deal of time.

One minor hassle: you need to make arrangements for acceptance of electronic claims with a small number of insurance carriers, most notably Medicare and Champus (Tricare). Copies of all the forms you need to fill out and submit are on the Office Ally web site; click on "Payer lists/forms" on their home page. The time expended on this will be returned to you many times over! While you wait for approval of electronic billing, just select "paper claims" for these carriers, then switch it to electronic when they notify you of the approval.

If you submit electronic claims, you receive a message whenever claims are accepted or rejected by the clearinghouse or insurance company. If claims are rejected, they must be resubmitted with the corrected information (e.g. an incorrect ID number or an invalid diagnosis code). Here is how to do this: display the patient's information, click on "edit info," and correct the invalid information. (If the invalid information is an insurance company address, you click on "edit insurance" on the left instead.)

So, that corrects the problem for future claims--but you still have the claim that was just rejected to resubmit. There are two ways to do this. The fastest and most reliable is to go through the Office Ally website and correct the claim that they have on file. Visit "www.officeally.com", log in with your password, and you will see an option on the left for correcting claims that you have already submitted.

Can't figure out how to do it there? Then try this option. Within TherapyAppointment.com, display the patient's information, and click on the "Posting" button. Find the problematic date of service, and click the little button labeled "B" to include that claim in the next electronic claims batch. But see the note a few paragraphs above about turning off the "duplicate claims filter" in Office Ally before you try this.

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