Clearing House in OpenEMR

Day-to-Day Users
1

arbemr wrote on Tuesday, October 15, 2013:

Am new to OpenEMR like to know -

What are clearing house that OpenEMR will support directly without making much customization and manual submission.

ARB

2

visolveemr wrote on Tuesday, October 15, 2013:

Hi,

At present OpenEMR supports manual submission, furthur customizations are required for electronic submission.

openEMR Supports clearing houses such as Office Ally, MedAvant, ZirMED, etc.

You can also refer to this Thread for similar discussion.

Thanks
OpenEMR Customization/Support provider,
ViSolve,Inc
services@visolve.com

3

fsgl wrote on Tuesday, October 15, 2013:

I would suggest Office Ally because of ease of setup, ease of use, knowledgeable support, cost effectiveness (no bill from them in over one year) and extensive payor list.

Consult this Wiki page for details of how to prepare for electronic submission. The video tutorial on Billing and Claim Generation is excellent. Paper submission will be required occasionally for the problematic claim or for the obscure insurance carrier that does not accept electronic claims.

4

tmccormi wrote on Tuesday, October 15, 2013:

We like gateway EDI, they do charge a small fee but their tools are great. We’ve also used Availity which is free but the customer support is very slow.
–Tony

5

cverk wrote on Wednesday, October 16, 2013:

I’ll give a second vote for Office Ally, with more than 2 years of use it has worked very smoothly. When I originally was getting set up with their tech folks, they were very complimentary of OpenEmr even though they sell their own emr online product. It has been very rare for us to have to resort to paper, so I have never had to use any of the paid services.

6

fsgl wrote on Wednesday, October 16, 2013:

Office Ally charges 40 cents per paper claim. It’s cheaper to send a batch of paper claims ourselves.

Occasionally our local Blue Shield carrier will have a problem processing the electronic claim. They usually ask us to fax the CMS 1500 to a specific customer service representative, who then will re-process the claim.

For the single claim to the obscure insurer, it would less expensive to have Office Ally send that claim. The payor list will indicate which claims have to be submitted by paper.

7

dkdipak1 wrote on Thursday, March 06, 2014:

Hello Tony,

We are also shifting to Openemr from eclinical. Our CH is Gateway EDI. Would you mind sharing the API for direct submission of claims? or is it only possible manually? Would appreciate your help.

8

tmccormi wrote on Friday, March 07, 2014:

DKD,
Gateway EDI just works, nothing is needed beyond what is already in OpenEMR
–Tony

Hello Tony,
We are also shifting to Openemr from eclinical. Our CH is Gateway EDI. Would      you mind sharing the API for direct submission of claims? or is it only possible manually? Would appreciate your help.
9

yehster wrote on Friday, March 07, 2014:

Generating the X12 files from OpenEMR and uploading them to clearing houses is a manual step in the process.

10

cmswest wrote on Friday, March 07, 2014:

hi kevin, it would be pretty cool to set this up as a background service.