Office Ally

NOTE:  
The numbers provided in this configuration guide are subject to change without notice. It is your responsibility to maintain the accuracy of these numbers in your system.

Electronic Document Interchange (EDI) is a way to exchange data using a standard format and communication protocol. ChiroTouch supports a subset of EDI standards for Health Care that is mandated by HIPAA. This standard is created and maintained by the ANSI X12 committee. The current version of ChiroTouch includes support for the 837 (claim) and 835 (remittance advice) EDI transactions. The process of exchanging the EDI documents is called “document trading” and the parties involved in that process are called “trading partners”.

Before you can start trading EDI documents with Office Ally, you must complete the following tasks:

These tasks are described in greater detail later on in this document.

NOTE:  
If you are currently submitting HCFA claim images to Office Ally™, then you must contact their support department and switch the claims format for your user account from HCFA to ANSI X12 837. Office Ally does not support the submission of mixed claim formats. To minimize the downtime of your billing process, please ensure that your system is fully configured for EDI and that it has a low volume of unbilled charges before you switch from HCFA to ANSI claims.

ClosedEnrollment

To enroll with Office Ally™, please contact their sales department at:

URL: http://www.officeally.com

Phone: 1-866-575-4120

ClosedConfiguration

EDI makes use of several data identifiers that define key entities included on the exchanged documents. These include site, doctors, patients, payers, and trading partners. Using identifiers instead of names greatly reduces data entry mistakes and removes naming discrepancies between different organizations. The following section describes all data elements that need to be configured for successful EDI. Please refer to the ChiroTouch Manual for more information on how to use the EDI configuration screens.

Trading Partner Configuration

Office Ally is considered an electronic document trading partner for your organization. A trading partner in ChiroTouch is defined by few data elements that are specified on the Trading Partners screen.

The table below shows all data elements that need to be specified for Office Ally. It does not show any elements that can be left with their default values.

Partner Name and Identifier:

Organization Name

Office Ally

Identifier Qualifier

Federal Tax ID [30]

Identifier Value

330897513

ETIN

330897513

Application Code

OA

Site Name and Identifiers

Organization Name

Site name is used automatically and it cannot be changed here

Identifier Qualifier

Federal Tax ID [30]

Identifier Value

Practice Tax ID

ETIN

Practice Tax ID (same as above)

Application Code

Practice Tax ID (same as above)

Transaction Options

Usage Indicator Set to “Test” initially, before creating first test claims file. Set to “Production” after that

835 File Name Mask

*.835

Registered Payers

Primary Identifier

Use Payer ID from the Payer List available at http://officeally.com/payerList.aspx

Claim Filing Indicator

Selected the value that matches the payer type. It is important to use “Medicare B” for Medicare and “Blue Cross/Blue Shield” for BCBS. Other payers may use “Commercial Insurance” or whatever matches their type.

Designated Partner

Office Ally

Site Configuration

Your site in many cases will be used as the EDI Billing Provider and Pay-To Provider for claims and remits. The table below shows all the data elements that need to be specified on the Site screen. It does not show any elements that can be left with their default values.

Billing Name and Address

Name

You site billing name (same as in ChiroTouch Maintenance)

Address Line 1

You site billing address line 1 (same as in ChiroTouch Maintenance)

Note: PO box is no longer accepted as a valid billing address

Address Line 2

You site billing address line 2 (same as in ChiroTouch Maintenance)

City, State, and Zip

You site billing address city, state, and zip code
Note: a 9-digit code is required in all provider or facility addresses

NPI (type 2)

A type 2 (organization) NPI assigned to your practice / site

Employer Number / Tax ID

A Tax ID assigned to your practice / site

Taxonomy Code

A specialty code for you practice / site
The default taxonomy code for Chiropractor specialty is 111N00000X. Other codes are available at http://www.wpc-edi.com/codes/taxonomy

EDI Administrative Contact

Name

The name of the contact person in your office for EDI transmissions

E-Mail

The e-mail of the contact person in your office for EDI transmissions
Use valid e-mail format (ex: john@doe.com)

Phone

The phone of the contact person in your office for EDI transmissions

Omit punctuation (ex: 2061231234)

Fax

The fax of the contact person in your office for EDI transmissions

Omit punctuation (ex: 2061231234)

Provider Configuration

Each provider that appears on the claim must be configured for EDI using the Providers screen. Other practitioners do not need to be configured. The table below shows common data elements that need to be specified for each provider. It does not show any elements that can be left with their default values.

EDI Rendering Provider

Last Name

Provider last name

First Name

Provider first name

Middle Name

Provider middle name (optional)

Suffix

Provider suffix
Omit punctuation (ex: DC)

NPI (type 1)

A type 1 (personal) NPI assigned to the provider

SSN

Social Security Number of the provider

Taxonomy Code

A specialty code
The default taxonomy code for the chiropractic specialty is 111N00000X

Other codes are available at http://www.wpc-edi.com/codes/taxonomy

Upload and Download File Locations

Office Ally provides several ways to upload claim files and download ERA files. For more information please refer to the Office Ally User Manual listed on the Resource Center page (http://officeally.com/resourcecenter.aspx).

When uploading claim files, pick them from the path specified below (replace “servername” with the actual server name):

\\yourservername\CTData\EDI\OfficeAlly\OUT

When downloading ERA files, place them in path specified below (replace “servername” with the actual server name):

\\yourservername\CTData\EDI\OfficeAlly \IN

Please ask your IT professional if you don’t know your ChiroTouch server name.

ClosedTesting

There is no need to create and validate any test claim files with Office Ally as a site. ChiroTouch has already been tested with Office Ally and has been approved as a vendor.

Closed5010 Readiness

Once Office Ally announces that they are accepting 5010 claims live into production, you may switch the version of claims from 4010 to 5010 under the “Trading Partner” screen. Please do not submit 5010 claims until this time.

ChiroTouch has already been tested and approved to use 5010 claims.