As of February 2019, because of ACA regulations, our ClearingHouse provider OfficeAlly has instituted mandatory claims processing fees for each unique tax ID + rendering NPI combination of claims filed through their clearinghouse.
All providers will be subject to a $35 / month / unique tax ID + rendering NPI fee for each month that claims are submitted through TheraThink.
If the administrative fee for processing claims is less than 5% of your total invoice, we will not charge you this claims processing fee.
The following message is directly copied from OfficeAlly’s new claims filing agreement:
Per the Medical Loss Ratio (MLR) required by the Affordable Care Act, insurance companies are required to spend no more than 15-20% of premium dollars on administrative costs. We continue to see an increase in reimbursement cuts by Payers/Trading Partners. This reduction in rebates and the increased cost of keeping up with government rules and regulations has made it necessary for Office Ally to make adjustments to the Non-Par processing fee in order to continue to provide quality clearinghouse services to our valued customers.
Effective February 1, 2019 the Non-Par processing fee shall be calculated and charged PER UNIQUE TAX ID + RENDERING NPI COMBINATION on the claims (if no Rendering NPI is present, the Billing NPI will be used).