tracelogoRBPartnering for ICD-10 Compliance

Office Ally and HNS image

Background

In 2009, HIPAA mandated that the health care 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 changes associated with ICD-10, HNS can no longer accept print image files (text files), or 837 files in the 4010 format.

Effective April 1, 2014, 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)

If your software can produce the required 837p 5010 format, you must submit your files to HNS in this format. If your software can only produce the print image files, you may submit your claim files to HNS via Office AllyTM. Office AllyTM will convert your non-standard (print image and 837p 4010) claim files to the required 837p 5010 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 or from those offices who are manually filing claims via HNSConnect.

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 set-up 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 save 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

When to Submit HNS Claims to Office AllyTM

You may not begin submitting claims to HNS via Office AllyTM prior to April 1, 2014.

When to Enroll with Office AllyTM 

You should enroll with Office AllyTM as soon as possible and complete the claim file testing so that you are ready to begin submitting your electronic claim files to HNS via Office AllyTM on April 1, 2014.

Remember, effective April 1, 2014, HNS cannot accept non-standard electronic claim files (print image or 837p 4010 claim files).

How to Enroll

Enrolling is fast and easy!  You can enroll online at http://www.officeally.com/register/enrollment.aspxIf you have questions regarding the enrollment form, please contact Office AllyTM at (360) 975-7000, option 3.

It is not necessary to identify yourself as a HNS physician when enrolling.  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.

Remember, you may not begin submitting claims to HNS via Office AllyTM prior to April 1, 2014.

 

Important Note:

Remittances associated with claims submitted via Office AllyTM will be sent to you from HNS, and EOPs for those payments will be available through your HNSConnect account.

 

HNS Payor ID Numbers

To ensure that Office AllyTM transmits your HNS claim files to HNS, your file must include BOTH:

"HNS" and the name of the payor  (Example: HNS/BCBSNC)

The HNS Payor ID number.

Example:  HNS/BCBSNC

HBC01

PO Box 2368

Cornelius, NC 28031

Without both of these identifiers, your claim file will not be transmitted to HNS, so be sure you include both in each claim file.

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

Please make sure that in addition to the Payor ID number, the claim file includes "HNS" and the name of the payor.

Example:  HNS/BCBSNC    HBC01

 

North Carolina Physicians
HNS NC Payor IDs for Office AllyTM

 

HNS NC Payor HNS NC Payor ID
BCBS NC HBC01
CIGNA NC HCI01
MedCost NC HMC01
HealthSpring NC HHS01
HealthTeam Advantage NC HCC01

 


 

South Carolina Physicians
HNS SC Payor IDs for Office AllyTM

 

HNS SC Payor HNS SC Payor ID
CIGNA SC HCI02
MedCost SC HMC02
HealthSpring SC HHS02
Select Health SC HSH02
Absolute Total Care SC HAT02

Frequently Asked Questions:

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

You may begin sending your HNS claim files to Office AllyTM on April 1, 2014.  HNS cannot accept your claim files from Office AllyTM prior to that date.  However, to ensure that you are ready for the 04/01/14 effective date, you need to enroll as soon as possible and complete your claim file testing with Office AllyTM.

3.  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).

4.  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.

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 and by your inclusion of "HNS and the name of the payor, in the claim file.  Both "HNS", the name of the payor AND the specific HNS payor ID number for each HNS contracted payor must be included in the claim file you submit to Office AllyTM.  Without this information your claim file will not be transmitted to HNS.  Example:  HNS/BCBSNC    HBC01

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 adjudicated 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" and follow the directions for submission of corrected claims on the HNS Claims Checklist).

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

13.  Will HNS accept claims from any other clearinghouse?

No, HNS has contracted exclusively with Office Ally 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 Ally 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.