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I need info on a clearing house that works well with EZ claims. Thank you

Try Office Ally. It's free and all you need to do is to upload a image file of claims and they will scrub it to meet HIPPA compliance. www.officeally.com (If you are in the State of Washington, you need to register through www.onehealthport.com.

Roy, I assume that you use OfficeAlly. Have you tried their insurance eligibility verification service that is supposed to verify eligibility before your visits? How does it work? Do you upload your schedule or something?

Wayne

Roy,
There is only one problem with OfficeAlly for us east coast folks, they just aren't up and running with those proper relations for a lot of our carriers here. I'd love to get established with them, they seem so provider friendly. That's probably why our local BC/BS, Excellus, won't get set-up with them. Have a great weekend everyone.

Paul

Paul, it could be that they are currently concentrating on the insurers that are active in the largest metros. I think over 90% (prob. closer to 100%) of the patients we see in NYC would have plans that have a relationship with OA. Assuming of course they can file through the Blue Card program. We do have alot of out-of-state Blues patients.

Aren't we all who "PAR" with all blues via our local blue (you Empire, me Excellus for example) have to file all our Blues claims thru the local Blue that we contract with??? That we are not allowed to file via the clearing house with the various individual blue plans??? For Example if I see a patient with Down State Empire Blue up here, we will be paid our cheaper Upstate Excellus fee schedule not your better Down State Empire fee schedule and visa versa. So if you saw a patient with Upstate Blue you would be paid your Better Down State fees instead of the Upstate fee that are in effect up here.

So once again, if we must file thru our local Blue for any and all Blue, then for us who have our Blue over controlling 50-75% of our local market, then we must have a clearing house who is up and running with our local Blue among others, correct? Or risk having very slow, dropped to paper claims and the extra charges that go with them, defeating the the entire purpose of using a provider friendly outfit like OfficeAlly, right?

This whole need a clearing house and their associated parasitic loses and charges just piss me off to no end. It seems that everybody from the Carriers, to Big Pharma, High Tech and Software Firms (except little guys like AC), to Clearing Houses and Collection agencies all get to make good money off of the food chain that is Medicine, that always starts with Primary Care, except the folks who are providing the care. When was the last time GE or Welch-Allyn in our area of town lost money selling scopes, ECG's, MRI's and CAT Scan machines, right? There are no price controls on Big Pharma the way the Medicare Fees Schedule holds us all back.... Especially the PCP's who went thru Med School and Residency programs, then fighting against market trends to open a small practice, aquiring debt all the way.

We were just at a fancy anniversary lunch for our collection agency. Some guy who is but a businessman with an MBA (what else?) is now a Millionaire off of the loses we providers of care suffer every day... Meanwhile, Nancy and I can't afford to replace our rusting out old Jeep (180K salty miles), fix our falling down old fence or repair our roof....The present system is so out of wack it really is like a bad Monty Python skit, you just can't make this stuff up.
As I've said before; "Beware of the Medical Industrial Complex".

Paul

Oh, I see what you mean and why you wouldn't be able to use OA. They have Empire, but I don't think I saw Excellus on that list. So they would have to file a paper file They'd charge you probably .25$ (I think thats the rate) but then you'd have to wait an obnoxious amount of time for Excellus to process the paper claim as opposed to the quick turnaround they give to electronic claims.

Sai,
Have you found a Clearinghouse yet? We have EZ claims and we are working great with Navicure.

Does anyone have experience with a clearinghouse named ZirMed?

I have a question for anyone using Gateway clearinghouse.

I know that Gateway offers eligibility verification with batch processing. Do you use this? Does it work well? How do you send them the data for a "batch process?" Can you just export and email the daily or weekly schedule to them and then they can do the eligibility verification?

I'd appreciate any info on this. Thanks.

Wayne,
Who is this Gateway clearing house, how did you hear about them, what do you know about them, and how would one contact them??? Obviously gateway.com is the computer company that many of us use... Thanks much.

Oh, I first heard about them on this website. But when I tried to search for the message to see who it was that said they used it, it didnt show up.

Their website is gatewayedi.com

I dont' know too much about them and was trying to avoid the long drawn-out sale pitch by getting this info from someone that already uses them. But I might be stuck with calling them myself.

Wayne,
Thanks for that and good luck. Let us all know what you find out.