Update on Clearinghouse Switch

 

 

We just wanted to give everyone an update on our clearinghouse switch.  Just a quick recap:  We had been using Office Ally as a clearinghouse for the past ten + years but they announced a change in their pricing effective February 1, 2019 that would have created an increase of over 10000%.  Instead of $20 per month we would be paying $2000 per month.  Obviously that wasn’t going to work for us so we found a new clearinghouse.  We switched to Claim.MD and our monthly fee is only about $200.  We currently are billing for about 50 providers all across the US.

 

We switched to Claim MD on February 1st and we’ve had many people asking us how it’s going.  Well it’s only been just under three months but so far we are thrilled!  Quite honestly I do not like change so I was not looking forward to this.  However, the change was really not that bad.  Considering we have 50 + providers that’s huge.  I’m not going to lie, for that many providers the EDI enrollments for Medicare and Medicaid got a bit intense.  But Claim MD makes it as easy as possible.  We made it through without too many bumps.  Once we got over the initial shock of the change and started looking around we were pleasantly surprised.

 

Claim MD has many features that we really like.  The rejected claim section is awesome.  They have a dashboard that tells you how many claims are out there, and then you can go in and make corrections and resubmit.  Initial rejections as well as ERA rejections are all in the same place and easy to access.  The ERA section works great.  It’s so easy to retrieve an ERA when needed.  Signing up for ERAs is very simple.  Really everything is totally simplified.  We have 8 people who upload claims into the system and ClaimMD makes it very easy for me as the owner to see a good overview of what everyone is doing.

 

There is also a feature that allows us to check eligibility right from the rejected claim by simply clicking on the patient.  It saves us from having to log into another website and reenter the patient information.  We are still learning about the system and I’m sure we haven’t taken advantage of all that they offer, but right now we are thoroughly happy with our switch!

 

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!