Clearinghouse Fees Up 1000% February 1

I write this article with a heavy heart. We’ve been using Office Ally as a clearinghouse for over 10 years. For most of that time we didn’t pay anything. In most recent years we paid a monthly fee of $19.95. But as of February 1st their pricing has changed. They are now charging $35 per month per NPI/EIN combination. $35 is a reasonable monthly fee for a provider’s office. But for a billing service it can prove to be pretty steep.

For the providers that we bill for we will end up being charged over $1800 per month. That’s almost a 1000% increase. For our larger accounts the fees are fine, but we bill for several smaller providers. Some work only part time and we only charge them between $200-400 per month. With the other costs of doing business it isn’t profitable for us to spend $35 just on claim submissions.

I can hear Linda Walker now: “That’s why I use the provider’s software. I don’t incur any costs for clearinghouse fees.” Love you Linda! We do have some clients that we have that set up with. But the majority of our clients we use our system so the clearinghouse fees fall on us. That hasn’t been a problem until now.

So it is with a heavy heart that we are telling everyone that after 10 years we are being forced to switch clearinghouses. We have found another one that the fees are much more reasonable. We have begun the switch but haven’t actually used it yet. It looks like a pretty good system so far so we are actually excited about giving it a try. We were very happy with Office Ally. Their system and their support were great. But as with everything else in life, change is inevitable. We will keep you posted!

10 Responses to “Clearinghouse Fees Up 1000% February 1”

  1. Melody Valier Says:

    Which clearinghouse are you switching to? I would really like to know are we are already being charged $35 a month for OA for billing more than 50% non-par. As a small office, we can’t afford more. Thank you!

    • SolutionsMedicalBilling Says:

      If you are only a one provider office you probably won’t find less than $35 a month. We switched to Claim.MD. I do not know their pricing. I only know that for us as a billing service with 50+ providers it is going to be about $200 for us, which is better than $2000!

  2. Lisa Marshall Says:

    I also own a billing service, have used Office Ally for over 15 years. I was astonished at the increase, it is such bad business, i contacted them to see if they would be open to negotiate and was told “no”, so they don’t even value their loyal customers.The $35.00 applies if more than 50% of claims are non par, for us most of our over 60 clients will fall into this category so we will also be hit with a bill of $1500-$2000. The work involved with switching clearing houses is a lot of work, but we will have to do it. Luckily for us if we first just switch over our BC/BS of Mass. claims we shouldn’t be hit with a huge bill and it will give us time to switch everyone over. I have been checking fees and didn’t have Claim.MD listed but thanks for the info, will check them out.
    Lisa / SRTS

    • SolutionsMedicalBilling Says:

      Hey Lisa,
      We kind of were in denial at first and we waited a bit before looking into it. Claim.MD has been great so far! The switch was not nearly as involved as we thought it would be. Yeah, I’m not sure what Office Ally is thinking. They went from being a “free” clearinghouse to being one of the most expensive! We have raved about them and referred a lot of people over the years. We were resistant to changing, but so far we like what we see! Good luck!

  3. Teresa Says:

    I called and asked about negotiating a flat monthly rate as well and they wouldn’t do it. They did tell me that as long as the monthly claims submitted is 11 or less per NPI/TAX they won’t charge for par/non-par. I wrote down the person’s name who told me this and I’m going to see what happens next month. Most of my clients only bill out 1 claim a few months out of the year. In the meantime, I’m going to contact Claim.MD for a quote. I only bill out a handful of codes and need something very simple and easy to use. I would have been willing to pay office ally $200 per month since I have used them as well for over 10 years. They lost potential revenue by not doing this and forcing their long term clients to go elsewhere.

  4. Jessica Mojica Says:

    I am in the same boat, I have a small billing practice serving about 12 providers. The $35/provider is a huge hit for me and I will be looking for alternatives. Thanks for bringing this up, it helps to know that I can turn to this group for help and information

    • SolutionsMedicalBilling Says:

      That is why we have the forum and our newsletter! We do not have to be competitive. We can help each other out. 🙂 You might want to check out Claim.MD. I can’t say too much because we just started but so far we are happy.

  5. Lisa Marshall Says:

    Does anyone know if you can split the process? Our biggest payer we submit to is BC/BS of Ma, they are on the non par list of Office Ally. I am wondering if i can set up just EDI to bill BC directly and leave my ERA’s with Office Ally? If I am only receiving BC ERA files via Office Ally would they still charge me the non par fee? I do not know enough about the workings of clearing houses but they base billing us on claims submitted, correct?
    Any info would be appreciated.

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