Office Ally

The Supervisor of Customer Service was assigned to this case and has been in contact with the complaintant today and is clearing up any confusion that was had in the past between the complainant and our staff The complainant is satisfied with the situation being looked intoBelow is the Supervisor's notes on the situation: The issue stems back to: [redacted] giving the provider information that was confusing to him The user not sharing all of the information with the past reps One rep that didn’t contact him back when she should have (she has now been spoken to) I am helping him nowThe full resolution is that he needed to add a site id that is assigned by [redacted] to differentiate between the different offices that a rendering provider practices atWithout this number the claim is processed under the default ID, causing a denial due to conflicting address vssite idCurrently I am in contact with [redacted] via email, with the user cc’d, confirming the information that was givenThey are stating that the provider needs to send the facility with the site id assigned by [redacted] , the issue is that the facility is the same as the billing, and their ANSI guidelines clearly state to only send the facility when it is different than the billingSo I am confirming that they will allow thisOtherwise he will be putting this site id in 33b, which I will assist him with in Practice MateHe is satisfied that the situation is being looked into fullyHis true frustration is due to the apparent lack of communication and the feeling of frustration that he could not seem to get his issue rectified by [redacted] (knowing full well that [redacted] was the cause, but wanted Office Ally’s assistance to get a resolution)

Complaint: [redacted] I am rejecting this response because: As of today (9/13/1:49pm), I have not received the refundI will accept your response as soon as I received it Sincerely, [redacted] ***

The customer was contacted and credit was issued to their account for charges that were accumulated before the account was officially cancelled. Refund for amounts already paid will be issued. Customer was happy with the resolution. Last email from customer below:
"From: "***
***" Sent: Friday, September 09, 10:AMTo: ***Subject: Re: cancellation /form
MsW***,
Good morning
Yes, please proceed to refund the amountsI haven’t paid the Sep/Oct invoices
Thank you for the update
Very truly yours,
*** *** *** ***
*** *** *** *** *** *** *** *** ** *** *** *** ***

Refunds were issued to the payment credit card ($and $to the Visa card used). Email confirmations sent to email address on account: ***

Complaint: ***I am rejecting this response because the problem has not been resolved and it is clearly Office Ally's responsibility to do soI am not satisfied with the resolution nor have I ever said I was satisfied as stated in their responseI would also like to respond to the following that Office Ally wrote:1. "*** giving the provider information that was confusing to him." This is trueI'm a therapistI'm not trained in EDI billingThis is why I use Office Ally.2. "The user not sharing all of the information with the past reps." This is not trueI gave them all the information I had and my understanding of the problem to SIX different repsEach time having to re-explain the problemI asked them many times to contact *** directly to figure out the issueThey said they would but did not until I filed a complaint.3. "One rep that didn’t contact him back when she should have (she has now been spoken to)." - There were more than one rep who was unresponsive"His true frustration is due to the apparent lack of communication and the feeling of frustration that he could not seem to get his issue rectified by *** (knowing full well that *** was the cause, but wanted Office Ally’s assistance to get a resolution)." - While this issue stems from ***, I cannot manually fix it nor can ***It seems only Office Ally can do thatBelow is an email exchange they had with ***I don't believe this is something a user can manually resolve on his own without some sort of technical intervention from Office AllyIt's virtually incomprehensible to me."If loop/segment 2010AA and 2310D NMare the same (have the same NPI in both fields) will you accept the claim?What qualifier do you want in REFif REFhas the site id?"In any event, the problem is still not solved and Office Ally has stopped responding to my inquiriesI have been sending in paper claims to *** and I cannot switch clearing houses at this time because we are a busy practiceWe would have to change all of our clients filesI would really like for this problem to be resolved by Office Ally once and for all.Sincerely,*** *** ---

The Supervisor of Customer Service was assigned to this case and has been in contact with the complaintant today and is clearing up any confusion that was had in the past between the complainant and our staff.  The complainant is satisfied with the situation being looked into. Below is the...

Supervisor's notes on the situation: The issue stems back to:1.       [redacted] giving the provider information that was confusing to him.2.       The user not sharing all of the information with the past reps.3.       One rep that didn’t contact him back when she should have (she has now been spoken to).  I am helping him now. The full resolution is that he needed to add a site id that is assigned by [redacted] to differentiate between the different offices that a rendering provider practices at. Without this number the claim is processed under the default ID, causing a denial due to conflicting address vs. site id. Currently I am in contact with [redacted] via email, with the user cc’d, confirming the information that was given. They are stating that the provider needs to send the facility with the site id assigned by [redacted], the issue is that the facility is the same as the billing, and their ANSI guidelines clearly state to only send the facility when it is different than the billing. So I am confirming that they will allow this. Otherwise he will be putting this site id in 33b, which I will assist him with in Practice Mate. He is satisfied that the situation is being looked into fully. His true frustration is due to the apparent lack of communication and the feeling of frustration that he could not seem to get his issue rectified by [redacted] (knowing full well that [redacted] was the cause, but wanted Office Ally’s assistance to get a resolution).

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
I have confirmed the credits to my account.
Thank you.
Sincerely, [redacted]

It looks like this customer’s issue is already on its way to being resolved, but here is a recap.   The customer’s claims were rejecting at the Insurance Company (Network Health [[redacted] Health Plan] Payer ID: [redacted]) due to “Acknowledgement Rejected for Invalid Information - The...

claim encounter has invalid information as specified in the Status details and has been rejected. Rendering Provider not found.” The customer stated that he contacted the Insurance Company and was told that there is nothing wrong with the providers. In speaking with the Office Ally CS Supervisor, [redacted] was asked to provide a claim example that was successfully paid by Network Health with the providers listed as they are. He was unable to provide a paid claim example, however he stated he found documentation on [redacted] site that both providers were valid, and sent those screen shots to Office Ally at 12:01pm. Before we could contact [redacted], he sent another email at 12:05pm: From: "[redacted], Ph.D." Sent: Wednesday, August 16, 2017 12:05 PM Subject: Re: Per Our Conversation I think I figured out what the problem may have been. I'm going to correct and send it again. Please hold on to this information. I'll let you know if they get rejected again.   [redacted], Ph.D. [redacted]
[redacted]
[redacted]
[redacted] Once the correction was sent in today, we checked the claims and found that they were not corrected accurately. The Office Ally CS Supervisor then emailed the customer the following today: Hello Dr. [redacted],  Thank you for the update that you'll be resending the claims due to a problem that you found. I did see the new claims were updated with the Billing NPI in box [redacted], however, this is still incorrect as the name must match the NPI. We have rejected the file for Network Health that was updated today; before the payer receives them to allow you to fix the claims one more time. Please correct box ** for the billing provider name to: [redacted]. Additionally, I do see that the address listed in 33 has the state name spelled incorrectly. Please update Bosotn to Boston (The payer will check this as well).   Once the customer corrects his claims accurately so that the Insurance Company accepts them, his problem will be resolved.  NOTE: The corrections being made must be made by the customer and were not caused by Office Ally as originally reported in this complaint. The actions taken on this issue were already in process before this Revdex.com complaint was received and processed by Office Ally.

Complaint: [redacted]I am rejecting this response because:
As of today (9/13/16 1:49pm), I have not received the refund. I will accept your response as soon as I received it.
Sincerely,[redacted]