Office Ally setup

billing

(system) #21

fsgl wrote on Friday, April 22, 2016:

Unfortunately it is not quite as simple as reporting breaches.

Our local Blue Shield’s web site was hacked. The only reason they found out was because with Anthem being hacked previously, realizing that they may have targeted as well; they hired a security company, who confirmed that the hack occurred 2 years previously.

Then it’s a matter whether the breaches were reported in a timely fashion & in compliance with HIPAA guidelines.

It’s not merely notifying the feds. All patients will have to be notified as well. Our local Blue Shield was required to send letters to everyone who was ever covered by them, including spouses & dependent children. I received 5 different letters, despite being the same insured, because I had 5 different policies over the years with them.

Physicians in small practices don’t have the same resources as insurers. Their best defense is to limit the online traffic as much as possible.

Why talk about what to do after the horse is out of the barn? Better to be certain that the barn door has been closed in the first place. In this case, a good defense is just that.


(system) #22

fsgl wrote on Friday, April 22, 2016:

Regarding malpractice & the standard of care; we, physicians, are presumed innocent until proven guilty in state courts.

With federal mandates & often with federal laws affecting the practice of Medicine; in reality, we are presumed guilty until proven otherwise. Please be extra careful when dealing with the feds.


(system) #23

ptalerico wrote on Wednesday, October 26, 2016:

As a followup on my 4/21/16 post (above), I finally verified with Office Ally that they do not offer automatic transfer via SFTP wth OpenEMR. Both fsgl and Harley were correct.


(Jeremiah Ocasio) #24

I just went through the config and setup review with Office Ally on a new client and found that the automated batch submissions while passing the review and config setup tests are not showing diagnostic links in the cpt lines. Is there a setting I might have missed or does someone know of a modification that could be needed for those?


(Jeremiah Ocasio) #25

I just got in a test with Office ally where they ‘picked up’ the batch submissions from an SFTP folder when I have a job on my server side that publishes to that folder. It does the same process as if it was submitted via the Office Ally portal but is a lot cleaner for the billing manager on the administration side. It works in the same way for denials and claim corrections however where you still have to log into the portal to get the feedback sadly.


(Stephen Waite) #26

hi, that’s pretty cool, which version of OpenEMR are you running?


(Jeremiah Ocasio) #27

Hello,

We are running version 5.0.0 on the server we have that tested out with.


(Stephen Waite) #28

ok, so the batches failed due to missing dxs?


(Jeremiah Ocasio) #29

Just through with another Office Ally session and they pointed me in the direction that the Pointers for the Procedure codes (in our setup set as CPT codes) to the diagnostic codes that are auto submitted in batches are not there. For a correction to the submissions they say they have no documentation on what they are expecting but instead pointed me to this page for my own use http://www.nucc.org/index.php/1500-claim-form-mainmenu-35 . So guess Im digging into that unless someone out there has already gotten the formatting for procedure pointers to diagnostic codes in the cms 1500 txt report submissions for office ally.


(Stephen Waite) #30

hi @Jeremiah_Ocasio, did you justify the procedure codes on the fee sheet?


(Jeremiah Ocasio) #31

Hi @stephenwaite, That was indeed the case. We did a modification to the GUI display formatting and our data entry technician was not justifying the procedure codes on new tests.