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#31032
05/31/2011 9:53 PM
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Does anyone know what Dr Bertman meant when he said that it should only cost an AC user $150 to use a Clearinghouse once the AC PM module comes out.
Did he mean $150 a MONTH or a quarter or a year (I hope) or what? I'm afraid it is $150/mo but hopefully at least, it is only $150 per office per month and not per provider.
My incentive money is dwindling rapidly! ;(
Thanks for any info.
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I currently use Medisoft - the clearinghouse charges 110-140 per month per office. That is the going rate if you are doing electronic. You can still e print to something like Office Ally and it will be cheaper or free.
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I am currently outsourcing at much more than that per month.
I tried EZClaim in the past, they charge $99-$139 per month. My suspicion is this is per month.
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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Funny. I read that and just assumed it was $150/year as everything else in AC is on a per year basis.
If it's per month, I may just keep my current PM system and not rock the boat in the office.
Travis
General Surgeon
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If it's per month, I may just keep my current PM system and not rock the boat in the office. Out of curiousity are you doing electronic filing of all bills and if so how much are they charging you ? You would still be able to use AC's PM and export to a different clearing house or print bills - it is just that the clearinghouse they supply would be 150 per month. I pay around that much for Medisoft and get horrible support as I don't pay several hundred yearly for support. I also don't get real time checking of insurance, etc.
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Well, hopefully the pm can export or import with other formats. OA is fine for the clearinghouse and I pay about $4/month for those pesky companies like Empire BCBS who wont contract with them. No other fees.But I'd like to get my eobs electronically and downloaded into a pm.
Wayne
New York, NY
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I don't know about the other connectivity - as an aside my office manager worked with AC as they developed this PM and they showed her a sample with some screens about eligibility checking, and other features and was really impressed. She feels like if it works as well as the demo showed that it was very impressive.
Since I pay 130-140 dollars now for a lot less functionality I am more than willing to pay 150 for what is promised.
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I use EZ claims and presently that cost me $100 per month.
$150 per year would be a bargain but that is most likely monthly charge.
Dariusz
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I pay $200/month for my PM system. It's all electronic and even sends to Medicaid which is a bonus in Arkansas. Checks eligibility, ERA, electronic EOBs, etc. We don't do anything with paper unless forced billing-wise.
I would look at AC's but my office manager, aka, my wife, isn't big on change when things work well and they do. And it's her choice on PM systems. Saving $600/year isn't that advantageous if my wife isn't happy!
Travis
General Surgeon
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The thing I like about AC's PM is that it is integrated in one program which will make it easy for my staff to check balances - know when pt are delinquent, etc. If you don't mind entering patients in AC for charting and a PM for billing then it doesn't matter (I have been doing this for 10 years).
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I am not sure why whould any body pay a clearing house a 100-200 dollars a month if other clearing houses charge nothing . Two example 1) Office ally (whether you use parctice mate or uploading the file from your current PM softwere) 2) avility.
I have an exellant experiance with office ally I am using their practice mate as a PM softwere. They have excellant support service and training. always some one answere your phone in a 1-2 minute and also at no charge and unlimited.
I have been using office ally since January 1, 2011.
That is my personal opinion. A $ 150 /month is a lot of money in comparison to the big zero.
Mohamed Salem MD, FACS
General Surgery
Northwest Ohio
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Could Jon please respond to this and clear up the confusion?
We sent an email to Claire yesterday to see if we could get an answer to this.
Frank J. Paiano, DO, FACOI
Internal Medicine of Central Florida, PA
The Villages, FL
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I will bring the issue up at ACUC
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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Must I use the charting program?
Harriet James, NP
Rio Rancho, NM
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The PM system was demoed at the meeting, tenatively called V7. They are hoping for 4th quarter but in software world that might not hold. It looked good.
It was based on the current program and allowed you to check in the patient, verify eligibility, send email reminders, also screen for MA to imput vitals.
On the financial side, it would connect to the clearinghouse by 837 and be able to receive 835 remittance info. It could keep a running balance as well as tell you expected charges by insurance and paid charges by insurances. Overall looks good.
Apparently working off of a dummy database, and has not been connected to a live provider. They have contracts with 2 clearinghouses at this time.
It will be smooth if it works, you should be able to choose what clearinghouse you would like if it is just submit and receive (837/835) but eligibility might require their databases, I suspect.
Oh well, more details in the future.
The conference has been a blast so far.
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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If I may chime in: I would advise not skimping out on having a good clearing house. A good clearing house, such as RealMed, can be very advantageous but yes it will cost anywhere between $100 - $200 per month depending on your volume, etc. Things such as checking eligibility, recieving remits electronically for auto-payment posting, sending claims electronically to get rid of all that annoying paper, and the reports clearing houses can provide can easily make up for that pesky $100 - $200 a month and then some. Here is a screenshot of the performance report of the custom made payment posting program we use. We could not do this without a good Clearinghouse backing us up. JamesNT
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I vote HOORAY!
Last edited by Dr_B; 06/08/2011 4:34 PM.
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I use practicemate and officeally as the clearing house.
It is total free except for stamps.
Is there a bigger advantage to using an integrated practice module for 150 dollars a month per provider? I have me and Pa so it will cost me 3000 dollars a year.
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I believe the PM with clearinghouse will be 150 per month for the Practice, not per provider. As long as you have all the features that the PM will have you don;t need it, but the checking of eligibility and the other features are great. You may be able to use the PM program and just export to Office Ally or continue to use what you are doing - just having one program to do everything would be advantageous for many of us so that what patients owe and the other information will be great.
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We use Office Ally as well and it has worked flawlessly. I have been a big advocate of the PM module but if I am forced to cough up $150/provider as was stated in Jon's email, I probably will pass on it. Hopefully, it will be set up so we can use the PM module with any clearing house we choose. If not, as far as I am concerned, the PM will be much ado about nothing.
Bill Leeson, M.D.
Solo Family Medicine
Santa Fe, NM
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We don't pay $200/year for a clearing house now.....why the big jump in price????
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I think that price is an estimate. Clearinghouses charge based on number of claims per month and number of providers. You should call a clearinghouse and ask for a quote.
We have been very happy with RealMed. I would start there.
JamesNT
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Sounds like the fee is for use of AC's contracted clearinghouses, not the module itself. I would think this "835" format is something standard and so any clearinghouse can send you the remittance notifications this way for the module.
Wayne
New York, NY
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We use Availity and Office Ally.
I don't think I spend over a$100.00/ year with Office Ally?
I'm not sure why $150.00 per month per provider?
I need someone to educate me on what is being provided to justify the monthly fee?
Thanks
Frank J. Paiano, DO, FACOI
Internal Medicine of Central Florida, PA
The Villages, FL
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ANSI 837 (for sending claims), ANSI 835 (for recieving remittance), and ANSI 270/271 (for eligibility inquiries) are all government standards of data interchange. The issue is that it takes a lot of work to send what all the different insurance companies are looking for. Many of the fields in the 837, for example, are situational so carrier A may need one or two of the fields but carrier B may not. In fact, if you include the fields carrier B does not want to see, carrier B will reject the claim even though it sounds like all they would have to do is ignore the field - but they don't. A good clearinghouse takes care of all this for you through custom overrides and edits to make your claims go through. The reason Office Ally is free is because the carriers pay Office Ally so they pass the total savings over to you. I keep hearing rumors that the carriers are going to stop paying clearinghouses, but those rumors thus far remain unfounded. Furthermore, the farther east you move, the more useless Office Ally becomes as they are based in CA and just don't have the relationships with the far east carriers. Here is an example of what an 835 file looks like (the 837 is far, far more complicated than this): ISA*00* *00* *ZZ*REALMED *ZZ*3884 *110608*1240*U*00401*023539370*0*P*>~
GS*HP*REALMED*3884*20110608*124057*651*X*004010X091A1~ST*835*651001~BPR*I*486.7*C*CHK************11111111~TRN*1*10020177*1560894904~
REF*EV*352091331~REF*F2*CLMA278DF1~DTM*405*20110606~N1*PR*BLUE CROSS BLUE SHIELD OF NORTH CAROLINA~N3*PO BOX 5555~N4*CITY*NC*277072219~
PER*CX*FEDERAL EMPLOYEE PROGRAM*TE*8002224739~N1*PE*CAPE MEDICAL *XX*1316999527~N3*ADDRESS ONE ~N4*CITY*NC*ZIP~
REF*TJ*561245721~LX*1~CLP*194011000811P*1*140*0*0*12*050511979660PM~NM1*QC*1*LASTNAME*FIRSTNAME*M***MI*R01613770~DTM*050*20110505~
DTM*232*20110328~DTM*233*20110328~SVC*HC>99202>25*80*0**1~DTM*472*20110328~CAS*OA*18*80~
REF*HPI*111111111~REF*6R*0001457~LQ*HE*M87~SVC*HC>11721*60*0**1~DTM*472*11111111~CAS*OA*18*60~REF*HPI*1124079256~REF*6R*0001458~
LQ*HE*M87~LX*2~CLP*109153003772S*1*40*0*40*12*060211931658PM~NM1*QC*1*LASTNAME*FIRSTNAME*M***MI*R01613945~DTM*050*20110602~
DTM*232*20110428~DTM*233*20110428~SVC*HC>11719>GY*40*0**1~DTM*472*20110428~CAS*PR*96*40~REF*HPI*1780634535~REF*6R*0015715~LQ*HE*N174~
LX*3~CLP*139268004802P*2*175*19.87*60*12*060311979076PM~NM1*QC*1*LASTNAME*FIRSTNAME*R***MI*R11690939~DTM*050*20110603~
DTM*232*20110509~DTM*233*20110509~SVC*HC>99203>25*115*19.87**1~DTM*472*20110509~CAS*CO*45*15.65**23*79.48~REF*HPI*1124079256~REF*6R*0024902~
AMT*B6*99.35~LQ*HE*MA04~LQ*HE*N381~SVC*HC>11721*60*0**1~DTM*472*20110509~CAS*PR*96*60~REF*HPI*1124079256~REF*6R*0024903~LQ*HE*N174~
LX*4~GE*3*651~IEA*1*023539370~ JamesNT
Last edited by JamesNT; 06/09/2011 6:27 PM.
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The ability to do real time insurance verification is usually an add on service, but would be part of the service as shown in ACUC. It is not uncommon for clearinghouses to charge in the range of 100-150 per month.
Jon knows about Office Ally. There must be a good reason for choosing a vendor other than them beside the fact that I don't think you can do real time verification with them.
Another question would be if this system can be used with other clearinghouses such as OA, which they did not discuss at ACUC.
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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Every time you change clearing house, Don't you have to wait21-28 days for Medicare to accept the transmissions?
Yeah!200th post.
Frank J. Paiano, DO, FACOI
Internal Medicine of Central Florida, PA
The Villages, FL
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It can take that long or longer - sometimes shorter but that's rare. So, yes, changing clearinghouses is something some thought should be given to, not something you do on a whim.
JamesNT
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Thanks for all the input. Ouch, $150 per month per provider. Maybe it's costing me $150/mo or more in paper, ink, etc and I don't know it. I wouldn't mind paying $50/mo for the PM module though. I'll look into Office Ally tough before the PM module comes out. Maybe it will suffice.
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Remember, it's per provider and based on volume. Depending on the clearinghouse, you could be below $150 per month.
Again, you should call and ask.
JamesNT
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Looks like Jon B. updated his "Status Update" on 6/11. It is hard to know how it changed, but it now says "less than $150/month". I am not sure, but I think the "less than" is added. It is still unclear if you can use another clearinghouse.
Jon
GI
Baltimore
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Clearinghouses get paid to submit electronically that's why clearinghouses like Office Ally are FREE! why would we pay $150 per month per office or per provider for a service that is FREE??? Doesnt make sense....
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1. Those clearinghouses that are not free offer more advanced services that are not covered by the money they receive from the carriers.
2. Those clearinghouses that are not free very often can submit to insurances that Office Ally cannot.
JamesNT
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OA only charges 0.35$ to automatically mail the claim for you.That is less than the cost of a stamp. I believe that they will raise this price soon. But for now...
Wayne
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Office ally now offer eligability check online $10/months for first 100. Then ten cents for each additional.
Last edited by msalem; 06/14/2011 12:15 AM.
Mohamed Salem MD, FACS
General Surgery
Northwest Ohio
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initially, they did not charge for it at all
Wayne
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I think the issue is whether you can use the new AC PM program to export files to any clearinghouse and Jon has not said - I think he will - then the question is moot about cost as you can do whatever you want. On the other hand for all the features I think his price is reasonable - I spend almost this much without electronic EOBs, eligibility, etc. Unless Office Ally has changed I was not eligible to do this as My MEDICARE/MEDICAID was too high and it would not be free to me.
The funny thing is that everyone is worried about 150 / month and nobody has commented that as far as we know Jon is going to give the PM interface to all users at no cost over support now.....that is a great deal and even if you do cash or print CMS 1500's it will be great for anyone checking in anyone to be able to see acct. balance and notes, etc.
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At the ACUC, Jon indicated one would be able to continue using any clearing house. If you are not already using one, there will be several options available through AC
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
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As I read it, the $150/month is only when you use full integration with one of the clearinghouses that AC is reaching an agreement with. No other details at this time. We may need to just wait and see.
Wayne
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