Bill Insurance in Office Ally Without Using the Calendar
Short answer: Go to the Patient Visit tab and choose Add a Visit, then select your patient. Choose an appointment type from the drop down menu, enter the chief complaint, then fill in the billing info: the diagnosis code, the dates of service, the place of service, the CPT code, the diagnosis pointer as either A or the number 1, and the charge. Click Update and the visit is ready. Find the visit, tick the check box, choose Create Claim, then go to the Claims and Billing tab and click Submit Claim, or print it and mail it yourself.
Whether you can bill without the calendar at all
Someone asked whether they could use Office Ally to bill insurance without using the calendar. That is not exactly how the system was designed. It also works, and if it fits how your practice runs, this is the path.
Two things need to be true before you start. Your CPT codes have to be loaded in your system already, and the insurance company information has to be filled in, because submitting depends on it.
The steps
Go to the Patient Visit tab.
Choose Add a Visit.
Select your patient. The visit opens blank.
Choose an appointment type from the drop down menu. The default may read as treatment, and you may have set up your own appointment types.
Enter the chief complaint. This area is similar to an electronic health record but it is not the true Office Ally electronic health record.
Move to the billing info and enter the diagnosis code.
Set the dates of service. This defaults to the current day, so change it if the service was on another date.
Set the place of service. For an office that is 11.
Enter the CPT code.
Enter the diagnosis pointer. Use either A or the number 1. This does not fill in automatically.
Enter the charge.
Click Update. The visit is now ready.
Find the visit you just created.
Tick the check box next to it.
Choose Create Claim.
Go to the Claims and Billing tab.
Click Submit Claim, provided the insurance company information is filled in. It goes to Office Ally, who send it on to the insurance company.
Or print it, and mail it yourself. If you want Office Ally to mail it for you, that is a different setup.
Why the payer check belongs at the start
This workflow puts a dependency at the finish line rather than at the beginning. You can build the entire visit, enter every code, create the claim, and reach Claims and Billing before finding out that submitting requires the insurance company information to already be in the system. At that point the work is done and the only available action is Print. Check that the payer exists in your system before you build the visit.
The mistake this prevents
The step that stops most people is expecting the diagnosis pointer to fill in by itself. Every other field on this screen behaves the way you expect. You enter the diagnosis, you enter the CPT code, and it is reasonable to assume the system connects them, because you have just told it both halves. It does not. The pointer, either A or 1, has to be entered by hand, and until it is, the claim will not build. What happens instead is that you click through to create the claim and get stopped by an error about a field you did not know existed, which sends people looking at their codes, their coverage, and their patient record instead of at the one blank box. Enter the pointer while you are filling in the billing info, not as something you go back and fix.
More Office Ally training
Watch the walkthrough: Office Ally User Tips playlist
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Office Ally consulting and training: mariematteson.com/officeally
Medical Receptionist and Biller Course: mariematteson.com/medcourse
Marie Matteson, MS, is a healthcare consultant, educator, and Office Ally specialist with more than 30 years in healthcare, emergency medicine, and practice management. Helping you understand what's really going on.
All patient information referenced here has been redacted. This content is educational and is not billing, legal, or coding advice. Always follow your payer contracts, your practice policies, and current coding guidelines. Not affiliated with or endorsed by Office Ally.
© Marie Matteson. All rights reserved.
