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 health care delivery system for everyone!

 

HNS offers complete Electronic Data Interchange (EDI) services.  If you have any questions regarding our electronic solutions, please contact your HNS Service Representative or email us at This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it..

 

  

EDI QUICK LINKS:

   

HNS Electronic Claim Filing

  

HNSConnect® (Electronic Claims Submission)

 

Features and Benefits

 

HNSConnect® Requirements

 

HNSConnect® User Manual

 

HNSConnect® FAQ

  

Office Ally™ and HNS

 

How to Enroll

 

HNS Payor ID Numbers

 

Office Ally 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 your HNS Service Representative or email us at This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it..

     

  2. Office Ally™

    The submission of claim files to HNS through Office Ally™ 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 Ally™, click here.

     

  3. Manual Entry via HNSConnect®

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

 

 

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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 health care 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 HNS Service Representatives are available to assist with any 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 HIPAA compliant ANSI 5010 837p claim 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 a HIPAA compliant ANSI 5010 837p 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

    

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Office Ally™ and HNS

    

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 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 Ally™ (HNS cannot accept claims from other clearinghouses)

     

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

     

    If you choose to submit claims via Office Ally™, at any time in the future you may discontinue the services of Office Ally™ and submit 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 Ally™ from those physicians currently submitting the required 837p 5010 claim file format.

  

About Office Ally™

 

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

 

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

 

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

   

Enrolling with Office Ally™

 

How to Enroll

 

Enrolling is fast and easy!  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 Ally™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 Ally™ how you will submit claims. If you will be submitting your claim file from your practice management software, please check the option, "We will be using billing software.", and be prepared to enter the name of your billing software and which version of the software you are using.

 

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

 

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

  

HNS Payor ID Numbers

 

To ensure that Office Ally™ transmits your HNS claim files to HNS, the appropriate HNS payor ID number must be included in each claim file.

 

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

  

North Carolina Physicians
HNS NC Payor IDs for Office Ally™


HNS NC Payor HNS NC Payor ID
BCBS NC HBC01
CIGNA NC HCI01
CIGNA Medicare Advantage NC HHS01
Focus Plan NC HFP01
HealthTeam Advantage NC HCC01
Liberty Advantage NC HLA01
MedCost NC HMC01
PruittHealth NC HPH01

  

 

South Carolina Physicians
HNS SC Payor IDs for Office Ally™

HNS SC Payor HNS SC Payor ID
ATC SC(Medicaid &
Medicare - Allwell)
HAT02
CIGNA SC HCI02
CIGNA Medicare Advantage SC HHS02
MedCost SC HMC02
PruittHealth SC HPH02
Select Health SC HSH02

 

 

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Office Ally™  FAQ  

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

    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 Ally™ and submit electronic claim files 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 Ally™?

    Yes, the Office Ally™ website will interface with all practice management software packages.  All you need is internet access.

     

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

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

     

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

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

     

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

    Office Ally™ 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 Ally™.  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 Ally™?

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

     

  8. Does Office Ally™ provide customer support?

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

     

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

    Office Ally™ 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 Ally™?

    Just like HNSConnect®, the Office Ally™ system includes edits to prevent the submission of previously submitted claims, so claims previously submitted through Office Ally™ 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 Ally™ as my clearinghouse, is there anything I need to do?

    If you are already using Office Ally™, 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 Ally™, you will begin using the specific HNS payor ID numbers in those claims.  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 Ally™ for non-HNS payors just as you currently do.

     

  12. What if I want to use Office Ally™ 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 Ally™?

    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.

 

 

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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.

 

 

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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 will automatically post payments to your patient accounts.  All information received on the paper EOBincluding remark codes, is included in the ERA file.  Utilizing ERAs saves valuable staff time, increases efficiency, and reduces the costs of health care 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 with the initial set-up.  Your software vendor will "map" the information in this file so it can be correctly imported to your software.

 

 

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