How Par vs. Non-Par Payers Affect Your Office Ally Claim Fees

Your claim submission fees are influenced by the payer’s participation status on Office Ally’s Payer List—Participating (Par) or Non-Participating (Non-Par). Understanding this distinction helps you make informed billing decisions and monitor how claim activity may affect monthly charges. 

Par vs. Non-Par Payer Defined:

• Participating (Par) Payers - No cost for submitting claims to Par payers.
• Non-Participating (Non-Par) Payers - Submitting claims to Non-Par payers may result in a Non-Par processing fee. 

When do Non-Par Processing Fees Apply?

The Non-Par Claim Processing Fee is charged per month, for each unique combination of Tax ID and Rendering NPI if 50% or more of that combination’s claim volume for the month is submitted to Non-Par payers.

Example: If 60% of the claims for Tax ID 123456789 + NPI 1234567890 are sent to Non-Par payers in July, the fee will apply to that combination for July.

Special Notes:

For Institutional claims: 

• If a Rendering NPI is not present, the Attending NPI will be used. 
• If neither Rendering nor Attending NPI is present, the Billing NPI will be used instead. 

How to Monitor a Payer’s Status

Use the Payer List on Office Ally’s website to check if a payer is Par or Non-Par.

1. Visit www.officeally.com
2. Navigate to Resources > Payer List 
3. Search for the payer
4. Non-Par payers will show a checkmark in the Non-Par column, whereas for Par payers, that column will be blank.

Stay Informed: 

Payer statuses can change so it’s important to monitor the Payer List regularly. You can also monitor your monthly claim volume using the Par/Non-Par Report.