FAQs - Switching from Office Ally to Apex EDI clearinghouse

FAQs - Electronic Billing with Apex Clearinghouse

Why do I want to convert my existing My Clients Plus account from using Office Ally to Apex?

As you may know, our current clearinghouse, Office Ally, has unexpectedly announced they will be raising prices by up to $35/month per provider (effective for claims submitted on or following 2/1).  By moving to Apex clearinghouse, My Clients Plus can continue to provide you the same billing support you have come to depend on and you can avoid the $35/month Office Ally surcharge.

How do I convert my EDI Enrollment from Office Ally to Apex?
My Clients Plus and Apex have teamed up to give you a seamless process to completed your enrollment forms.
  1. Log into your account in MCP 2.0 and click on "IMPORTANT!"  Steps to avoid upcoming Office Ally surcharges"
  2. Click on the blue "Go To Pre-enrollment" button.
  3. Select your state and click Go.  A list of applicable payers for your state and all states will be displayed.
  4. Complete the required fields and Submit.
  5. Check your email for the follow up email from Apex clearinghouse.  You will be notified if any additional information is required.

How will I know if my Apex EDI Enrollment has been approved?

You will receive an email notification if your EDI Enrollment has been approved or you may check directly with the payer (some payers may notify you directly or be enrollments that you complete directly in the payer system and be considered instant enrollments).  If you have questions about the status of your EDI Enrollment, you can contact the payer directly to confirm that your enrollment request has been completed.

How will I know if my Apex EDI Enrollment was rejected and how do I fix it?

You will receive an email notification if any EDI enrollments were rejected.  Included in that email will be the cause of the error and instructions on how to make a correction.

To correct a rejected EDI Enrollment, simply go to the Apex Payer Enrollment button in your account and complete Fix an Enrollment.

Do I have to switch to Apex if I have been using Office Ally?
No, you do not have to switch your clearinghouse from Office Ally to Apex, but you may incur a $35/month Office Ally surcharge each month if 50% of the claims submitted are to non-participating payers.
If I am an existing subscriber, I choose to stay with Office Ally and possibly have to pay a $35/month Office Ally surcharge, and I want to add an EDI or ERA enrollment, how do I do that?
You must go to the Office Ally website to find the appropriate enrollment forms:  www.officeally.com
What happens once I complete the EDI enrollment in my account for Apex clearinghouse?

Apex will forward the enrollments to Madaket.

Madaket takes your enrollment information, complete the forms with your data in it and give you additional instructions as to what needs to be done.  Every enrollment is different based on the payer requirements.

Madaket will typically give you the following types of  instructions:

  • Payer websites - some payers require that EDI or ERA enrollments be completed in their websites.  In this case, Madaket will give you the instructions you need to navigate the payer website.
  • Payer enrollment forms - for other payers, they may have a specific form that needs to be completed.  Madaket will pre-fill this form with all your information from the enrollment information you completed on-line.  There may be additional fields you need to complete.
  • ERAs - for some ERAs, Madaket will simply send the enrollment information directly to the payer and you will get an email letting you know you are enrolled.  There are some ERAs where you may need to take additional action but that will be included in the information you receive from Madaket.
Do I need to do anything if I do not submit electronic claims?
No, you are not impacted by any changes in clearinghouses.  There is no action for you to take.
Do I need to complete EDI enrollment for all of my payers if I want to switch to Apex?
Not all payers require EDI enrollment.  Only certain payers require the enrollment process for EDI submission, so you should completed EDI enrollment for only those payers that require it.
Do I need to complete the ERA enrollment for my payers?
If you currently receive your ERAs through a different clearinghouse, then we recommend you go through the ERA enrollment process for Apex if you are switching to claims submissions through Apex.
If you do not receive ERAs currently and would like to, then you should complete the ERA enrollment process.
What does Par or Non-Par mean?

Non-Par or Non-participating means that the payer does not pay the clearinghouse to submit claims to payer.
Par or Participating means that the payer does pay the clearinghouse when they submit claims to the payer.

In the past, Office Ally has been paid by a number of payers for claims submissions.  There is a trend in the industry for payers to no longer pay for claims submissions, so Office Ally is turning to another source of revenue, which is to charge those rendering providers who submit 50% or more non-par claims per month.

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