Q: How soon can I start submitting claims?
A: You can start submitting commercial claims immediately on selecting electronic claims through admin login. If you are e-Filing claims, Medicare, Medicaid and BCBS may require enrollment which will take more time - typically 2-4weeks depending on the payer.

Q: What is the enrollment process for e-Filing?
A: Certain payers need you to submit the necessary forms to approve our clearinghouses to submit claims on your behalf. Use 'Enrollments' tab under Administration module to sign up for enrollment requests and we will create the forms on your behalf.

Q: Do I need to prepare the enrollment forms?
A: No, if you are efiling claims through alloFactor we prepare the enrollment forms for you .

Q: Which payers require enrollment?
A:Medicare, Medicaid and some BCBS needs enrollment before you can start submitting claims electronicaly.

Q: Why do you charge for claim submission?
A: We charge the same fee that you would pay a clearinghouse. Using an tightly integrated solution makes filing claims as simple as clicking a button.

Q: Do I pay additional to the clearinghouse?
A: No you pay nothing directly to the clearinghouse if you eFile. However if you choose to export claims, then you will still owe whatever you owe to your clearinghouse.

Q: Which clearinghouses do you use?
A: We use Zirmed, Officeally and Availity to route our claims.

Q: Are the price breaks calculated per provider or per clinic?
A: Per clinic

Q: Is there a price break for submitting volume?
A: Yes, there is a price break. See pricing page for details on price breaks.

Q: Do I pay if get a rejected claim?
A: It depends on who rejected the claim. If the claim error was caught in alloFactor first level edits, then no fee is charged. If claim was rejected by one of the clearinghouses, then the claim will be charged a fee.

Q: Do I pay for resubmissions?
A: It depends on whether the reason for initial submission. If the first submission was caught due to first level edits at alloFactor end, then no fee is charged. If claim was rejected by one of the clearinghouses, then the first submission was charged a fee.

Q: How do I resubmit a claim?
A: Select the claim, fix the error using Claim tab, and click 'File electronically' button

Q: How many can you submit claims to electronically?
A: alloFactor is electronically linked to over 2000 payers for claim submission

Q: Can I verify eligibility?
A: Yes, see the electronic eligibility section for more details

Q: Can I receive remittance electronically?
A: Yes, see the electronic remittance section for more details

Q: What is EFT?
A: EFT stands for electronic funds transfer and is setup for the payer to deposit a check electronically direct into your bank account. It is separate from ERA which is an electronic version of paper EOB (Explanation of Benefits).

Q: How do I sign up for EFT?
A: Even though it is usually done through the same enrollment paperwork, alloFactor is not involved in the EFT process. It is between you and the payer. When you receive the enrollment paperwork, read through it carefully and fill out the appropriate information if you want to make use of EFT. For commercial payers, they usually have the forms on their website.

Q: What is legacy id? Why is it mandatory?
A: Legacy ids were issued by individual payers before NPI numbers were issued in 2007. You should not submit legacy ids on claims unless your payer mandates it. But payers that require enrollment still require that information to complete the enrollment process.

Q: I dont have my legacy id. What do I do?
A: You need to contact the payer directly to get the legacy information. We cannot help you with that.

Q: I am a provider. Can I be associated with multiple clinics?
A: Yes, you can be associated with multiple clinics. Contact your payer to ensure that your provider profile is linked to all the clinics that will be submitting claims on your behalf.