Preparing for Aloha's Insurance Billing Services

Preparing for Aloha's Insurance Billing Services

Before you meet your assigned RCM manager from the Aloha Billing team, please complete the following steps:


Required Steps to ensure accurate billing:

Clearinghouse Set-up

1.  Review the status of your payers on Office Ally or Availity and verify if they are non-participating members to determine the best clearinghouse to use: Understanding Payers in Office Ally and Availity
2.  Create your account with the appropriate Clearinghouse— we will need your SFTP username and password.
  1. Office Ally Integration
  2. Availity EDI Clearinghouse Integration
  3. Provide your CSM with both your SFTP and regular login to your clearinghouse
3.  EDI Enrollments Completed
  1. EDI Enrollment in Office Ally
  2. EDI Enrollment in Availity
4.  ERA Enrollments Completed 
  1. ERA Enrollment for Office Ally
  2. Route Availity ERAs through Office Ally
5.  277/999 Enrollment Completed (this is done automatically if you enroll in Office Ally)
  1. 277/999 Availity Enrollment

Client Profiles
1.  Client Authorizations added to client profile
2.  Client insurance cards uploaded to all Client Cabinets
3.  Secondary Payer has Coordination of Benefits selected & correct auto-transfer selected (if applicable)

Payer Profiles
1.  Payers Added with Services, Fees, Modifiers
2.  Payer Contracts uploaded to Cabinet (with fees)
3.  Billing rules updated as per Payer Contract
  1. Billing Rules per Payer

Staff Profiles
1.  All staff qualifications are updated if using modifiers (e.g., HP, HO, HM)
2.  NPIs added and checked off appropriate Provider type (e.g, Rendering provider, billing provider)
  1. Managing NPI Numbers
3.  Taxonomy codes added on NPI page (if applicable)

Settings
1.  System Settings > Billing Settings has "Auto-Post ERAs" and "Auto-transfer to secondary" turned on.

Schedule
1.  Appointments are scheduled and completed in the schedule.

Once this is completed, please review with your CSM. 
​
The manager assigned to your account will contact you via email. Weekly review of reports includes the following: Appointment Billing Report, Billing Ledger Report and Payer Ledger Report
 





    • Related Articles

    • FAQ: Billing

      These frequently asked questions will help provide guidance as you troubleshoot through the billing section of Aloha. I settled a claim, but then ended up getting paid for it. How can I unsettle? Start by going to Billing > AR manager and double ...

    • Secondary Billing in AlohaABA

      As of 7/3/24, our Secondary Billing feature will exclusively support Office Ally as the selected clearinghouse at this time. Secondary Billing cannot be completed with an Availity integration. As this feature is newly released, we recommend ...

    • Billing Rules per Payer

      Aloha gives you the flexibility to customize billing rules to fit your organization’s workflows and preferences. However, it’s important to remember that each payer has its own specific billing and documentation requirements. We recommend reviewing ...

    • Secondary Billing Instructions in Office Ally

      Aloha Secondary Billing: Secondary billing within Aloha is now available. The steps in this current article below are to show you how to bill to secondary within Office Ally's site. You can access the instructions to complete your Secondary Billing ...

    • Billing Overview

      Getting Ready to Bill It is vital to have the correct information in the system to submit for billing. Make sure you have the correct Payer ID (double check the clearinghouse) and have completed eligibility checks for your clients to ensure that you ...