tracelogoRBInnovative electronic solutions to improve efficiencies.

 

HNS is an industry leader in leveraging technologies to provide solutions that increase efficiencies, improve communications and reduce costs - resulting in a more efficient healthcare delivery system for everyone!

HNS offers complete Electronic Data Interchange (EDI) services.  If you have any questions regarding our electronic solutions, please contact our EDI Service Representatives at (877) 426-2411, extension 122.

Click here for ICD-10 information, timelines and new HNS claim filing requirements.

 

EDI QUICK LINKS:

HNS Electronic Claim Filing

HNSConnect® (Electronic Claims Submission)

HNSConnect®  Requirements

How to Register for HNSConnect®

 

HNSConnect® User Manual

HNSConnect® FAQ

Office AllyTM and HNS

How to Enroll

HNS Payor ID Numbers

Office AllyTM FAQ

Electronic Fund Transfers (EFT)

EFT FAQ

ERA Delivery (Automatic Payment-Posting)

 

  

 

Electronic Claim Filing

With few exceptions, all primary claims must be filed electronically to HNS.  Primary claims with office notes attached may be sent by paper using the CMS 1500 claim form.

HNS will accept electronic claims via the following methods:

1.  HNSConnect®

HNS accepts HIPAA compliant ANSI 5010 837p claim files submitted directly from the physician's practice management software to HNSConnect®HNS cannot accept 837p claim files submitted in version 4010.

 

For assistance with submitting your 5010 837p files to HNS via direct submission from your practice management software, please contact HNS' EDI Department at (877) 426-2411, extension 122.

2.  Office AllyTM

The submission of claim files to HNS through Office AllyTM is allowed only by HNS contracted providers whose software cannot produce a HIPAA compliant 837 file.  With few exceptions, HNS does not accept claim files from any other clearinghouse.

For information about filing claims through Office AllyTM, click here.

3.  Manual Entry via HNSConnect®

You may file primary claims to HNS by manually entering claim data in HNSConnect®.

HNSConnect®

HNSConnect® is a state-of-the-art web-based application that allows you to electronically send claims directly to HNS, via a HIPAA compliant 837 file.  HNSConnect® streamlines electronic claims processing and is provided at no charge to HNS healthcare professionals. 

 

HNSConnect® includes advanced data validations (edits) to facilitate the submission of  “clean claims”, resulting in reduced administrative costs, fewer denials and improved cash flow.  Customized edits identify claims with certain missing or incorrect information, allowing you to quickly correct the errors and resubmit the claim.   

 

HNSConnect® can ONLY accept electronic claim files submitted in the HIPAA compliant 837p (5010) claim file format. 

 

With HNSConnect® you can reduce or eliminate the need for clearinghouses since you no longer need to “drop your claims to paper” or pay to electronically transmit your HNS claims. 

 

HNSConnect® is easy to use and includes management reporting tools to help you manage your practice more efficiently. The HNSConnect® User Manual guides you through this easy-to-use system and EDI Representatives are available to assist you with any of your questions.

Features and Benefits:

  • HIPAA compliant

  • Full-service support team to assist with set-up

  •  Advanced validations facilitate “clean claims” improving efficiencies, reducing costs and improving cash flow

  • Designed to work with all practice management software systems (capable of generating the 837p HIPAA file) 

  

HNSConnect® Requirements  

 

Requirements for HNSConnect® (What you must have in order to use the HNSConnect® system)

  • Internet Connection (28K bps or higher)
  • Internet Browser
  • Windows 98 or higher (NT, 2000, XP, or Vista), Mac OS 10 or higher
  • A practice management system that can create an 837p (HIPAA compliant) electronic claim file.

Recommendations for HNSConnect® (What we recommend for use with HNSConnect®)

  • Broadband Internet connection with 500K bps or greater speed (DSL, CABLE, or T1)
  • Internet Explorer 6.0, Firefox 1.0 or higher, or Google Chrome
  • Windows XP with service pack 2, Mac OS 10.4 or higher

 

How to Register for HNSConnect®  

 

Once your HNS Service Representative has contacted you to introduce you to HNS, an EDI Representative will contact your office to start the HNSConnect® setup process.

Here is an overview of the setup process: 

  • An EDI Service Representative contacts your office and, if necessary, schedules a time for a conference call.  We recommend that all billing persons, including the provider, if available, be present on the conference call.
  • If a conference call is scheduled, an EDI Service Representative will connect to your office computer to assist with creating and transmitting a test file to HNS.  
  • A test file is generated from your practice management software and uploaded to the HNSConnect® system.
  • HNS then uses your test file to build a custom account for HNSConnect®.  This process usually takes 3-5 business days.
  • HNS will contact your office with testing results and/or confirmation that you are ready to file all HNS claims electronically through HNSConnect®.

 

NOTE:  During your HNSConnect® testing phase, you may continue to provide care to your HNS patients, but you will need to hold your claims until your HNSConnect® account is ready. Once your testing has been completed, your HNS EDI Representative will contact you so that you may begin submitting your HNS claims. 

Office AllyTM and HNS

Background

In 2009, HIPAA mandated that the healthcare industry use standard formats for electronic health care transactions.

Because the standard claim file format (837p, version 4010) could not support the upcoming ICD-10 code set changes, the Department of Health and Human Services mandated the conversion of all electronic health care transactions to the HIPAA-compliant 837p 5010 version by January 1, 2012.

The 837p 5010 claim file format provides for the expanded ICD-10 code length, and allows two different computers to speak the same billing/coding language.

As a result of this federal mandate, payors (and HNS) can no longer accept print image files (test files), or 837 files in the 4010 format.

HNS strongly encourages all physicians to submit their electronic files to HNS in the required HIPAA compliant 837p 5010 format, directly from their practice management software system.  However, HNS is providing an alternative for those physicians who are not yet ready to do so.

HNS can only accept electronic claim files in the required 837p 5010 format, submitted in one of the following ways:

  1. Directly to HNSConnect® from your practice management software;
  2. Directly to HNS from Office AllyTM (HNS cannot accept claims from other clearinghouses)

 

To assist those of you who are not submitting your claim files in the required 837p 5010 format, HNS has contracted with Office AllyTM.  Office AllyTM will convert your non-standard (print image claim and 837p 4010) claim files to the required 837p 5010 file format and transmit your files to HNS.  There is no cost to you for this service.

If you choose to submit your claims via Office AllyTM, at any time in the future you may discontinue the services of Office AllyTM and submit your electronic claim files to HNS directly from your practice management software system in the required 837p 5010 format.  This option will always be available to you.  For information regarding transitioning to an 837p 5010 claim file format, please contact your software vendor.

Please note:

HNS cannot accept claim files from Office AllyTM from those physicians currently submitting the required 837p 5010 claim file format.

About Office AllyTM

The decision to contract with Office AllyTM was made, in part, because many HNS practices already utilize Office AllyTM as their clearinghouse, and also because of Office Ally'sTM commitment to transmit your other commercial claim files at no cost to you.  Office Ally'sTM business model is based on charging the payor (or in this case, HNS), versus charging the physician for their services.  Additionally, Office Ally'sTM system is user-friendly; Office AllyTM does not require you to sign a contract, there is no setup fee and they offer 24/7 customer support.  Moreover, Office AllyTM offers physicians additional electronic solutions, including Electronic Health Records (EHR) at minimal or no cost to the physician.  You can learn more about Office AllyTM by visiting their website at www.OfficeAlly.com.

The Office AllyTM website interfaces with all practice management software packages; all that is required is internet access.  Office Ally'sTM Online Claim Entry allows you to submit your claims electronically to HNS (and to other payors), in just a few easy steps using your existing software.  You simply send the claims to a file and then log into the Office AllyTM website and upload your claim file(s).  You will receive an immediate e-mail confirmation from Office AllyTM, and approximately one hour later, Office AllyTM will notify you that your file has completed processing.

To help reduce denials, Office AllyTM utilizes numerous edits to pre-scrub all fields on the claim and will notify you of any rejected claims.  You will have the ability to correct any rejected claims right on the Office AllyTM website.

Enrolling with Office AllyTM

How to Enroll

Enrolling is fast and easy!  You can enroll online at http://www.officeally.com/register/enrollment.aspx.

Important Notes Regarding the Enrollment Process:

  1. As part of the enrollment process, you will be asked to provide "billing information".  You must complete this part of your enrollment with your practice information.  As previously noted, HNS has contracted with Office AllyTM for the conversion and transmission of your print image and 837p 4010 claim files to HNS.  There will be no cost to you for this service, but your practice billing information must be entered on this part of the enrollment form.
  2. On the enrollment form, under "System Information", you must tell Office AllyTM how you will submit your claims.  If you will be submitting your claim file from your practice management software, please check the option indicated below, and be prepared to enter the name of your billing software and which version of the software you are using.

"We will be using billing software."

After you have completed the enrollment form, you must print, sign and fax the 'Provider Authorization Signature Page' to Office AllyTM.  The Office AllyTM fax number is (360) 314-2184.

It takes approximately 48 hours to complete the setup process with Office AllyTM.  When the enrollment process is complete, you will receive a user name and password for the Office AllyTM website and an Office AllyTM enrollment specialist will contact you to set up an appointment with one of Office Ally'sTM technical staff to submit a test file to ensure the file will process correctly.

HNS Payor ID Numbers

To ensure that Office AllyTM transmits your HNS claim files to HNS, you must include the appropriate HNS payor ID number in each claim file.

Please contact your software vendor directly if you need assistance in adding the HNS Payor IDs to your claim files.

 

HNS Payer IDs for Office Ally

 

 

 

Office AllyTM FAQ

 

1. Am I required to send my electronic files to HNS via Office AllyTM ?

No.

 

HNS encourages all physicians to submit their electronic files to HNS directly from their practice management software system in the required HIPAA compliant 837p 5010 format.

If, at any time, you wish to discontinue the services of Office AllyTM and submit your electronic claim file to HNS in the required 837p 5010 format directly from your practice management software system, this option will always be available to you.

For information regarding transitioning to an 837p 5010 claim file format, please contact your software vendor.

2. Will my practice management software work with Office AllyTM?

Yes, the Office AllyTM website will interface with all practice management software packages. All you need is internet access (and even dial-up internet access will work).

3. How will Office AllyTM identify me as an HNS physician?

HNS has provided Office AllyTM with an "Office AllyTM HNS Eligibility File" which Office AllyTM will use to determine if your claim files are to be sent to HNS. When contacting Office AllyTM to enroll, it is not necessary to identify yourself as a HNS physician.

4. When do I start submitting my HNS files to Office AllyTM?

You may begin sending your HNS claim files to Office AllyTM as soon as you have registerd with Office Ally and completed your testing.

5. How will Office AllyTM know which claim files to send to HNS?

Office AllyTM identifies claim files to be transmitted to HNS by the HNS Payor ID. The specific HNS payor ID number for each HNS contracted payor must be included in the claim file you submit to Office AllyTM. The use of these payor ID numbers will ensure your HNS claims are transmitted directly to HNS.

6. How do I add Payor IDs to my print image claim files?

Your software vendor will need to assist you with adding the HNS payor IDs to your claim files, so please contact your software vendor directly.

7. Who do I contact about tracing claims sent to HNS through Office AllyTM?

Contact your HNS Service Representative with questions regarding claims submitted to HNS through Office AllyTM.

8. Does Office AllyTM provide customer support?

Yes, Office Ally'sTM customer service number is (360) 975-7000, Option 1.

9. After I enroll with Office AllyTM, how do I submit paper claims to HNS?

Office AllyTM will only accept electronic claim files from HNS physicians. You will continue to submit secondary and corrected claims, and claims with attachments, directly to HNS, via the CMS 1500 claim form, version 02/12.

10. What if I need to resubmit a claim to Office AllyTM?

Just like HNSConnect®, the Office AllyTM system includes edits to prevent the submission of previously submitted claims, so claims previously submitted through Office AllyTM will error back to you and will not be forwarded to HNS. If you need to make changes to a previously submitted claim, you must file the claim directly to HNS as a "corrected" claim using the CMS 1500 claim form (and be sure to mark the claims as "corrected").

11. If I am already using Office AllyTM as my clearinghouse, is there anything I need to do?

If you are already using Office AllyTM, you do not need to do anything at this time. Once HNS notifies you of the effective date for transmitting your HNS claims to Office AllyTM, you will begin using the specific HNS payor ID numbers in those claims. You will need to contact your software vendor for assistance in adding the HNS payor IDs to your HNS claim files.

You will continue to send claim files to Office AllyTM for non-HNS payors just as you currently do.

12. What if I want to use Office AllyTM to send my claim files to ALL payors?

Office AllyTM will not charge you for sending claim files to other payors, such as United Healthcare, Aetna, etc. Once you have enrolled with Office AllyTM, if you wish to use Office AllyTM as your clearinghouse for some, or all of your other (non-HNS) payors, you should first check the Office AllyTM website to verify that Office AllyTM transmits to those payors, obtain the appropriate payor IDs and include them in your files, then send those claim files to Office AllyTM.

13. Will HNS accept claims from any other clearinghouse?

No, HNS has contracted exclusively with Office AllyTM to convert your non-standard claim files to the required 837p 5010 format and to transmit those claim files to HNS.

14. How long will HNS allow me to submit my claims through Office AllyTM?

HNS will only accept claims from Office AllyTM while you are participating in the HNS Network. If you have claims that must be submitted to HNS after the effective date of the termination of your participation, those claims must be filed to HNS via "paper" claims on the revised CMS 1500 claim form.

 

Electronic Fund Transfers (EFT)

EFTs are the most efficient method of remitting payment to our network providers and improve your cash flow.

 

HNS systems are extremely secure so your personal and banking information is always protected. We have redundant security measures in place, including

  • McAfee SECURE™ -  The McAfee SECURE™ Trust mark only appears when the website has passed an intensive, daily security scan. McAfee tests for possible personal information access, links to dangerous sites, phishing, and other online dangers. 

  • HNS encryption – HNS transfers all important information, such as your bank routing and checking account number, in an encrypted format.

  • Blocking of Bank & Routing numbers – HNS staff, including management, has neither authorization nor access to see bank routing and account numbers. The EFT file is auto-generated from our accounting software and is then immediately sent to our bank. HNS does not have access to the connection between the accounting software and the bank.

 

 

 

ERA Delivery (Automatic Payment-Posting)

To help you stay ahead of the curve, HNS delivers Electronic Remittance Advice (ERA)! 

This HIPAA compliant  ANSI 835' file is an electronic version of the paper EOB that you are accustomed to receiving, which includes all information necessary to post payments to your patient accounts.  

 

ERAs can be imported from the secure HNS website portal directly into your billing software and automatically post payments to your patient accounts. All information received on the paper EOB,
including remark codes, is included in the ERA file. Utilizing ERAs saves valuable staff time, increases efficiency and reduces the costs of healthcare administration.  

 

Most practice management software systems have the ability to import an ERA auto-posting file. Contact your software vendor to inquire if your software version has the ability to import an auto-posting ERA/835 file and to assist you with the initial set-up. Your software vendor will "map" the information in this file so it can be correctly imported to your software.