Clearinghouse Upgrade FAQ

What’s happening?

Therabill, WebPT’s billing software, currently uses Office Ally as our main clearinghouse for processing Member claims. (A clearinghouse is a company that functions as an intermediary by forwarding claims information from your practice to insurance payers.) Due to changes with Office Ally and government payers, the cost of doing business has increased dramatically. To avoid passing these costs on to you, we sought out a new clearinghouse partner: Availity. We already work with Availity on a limited basis, but we’re now expanding our partnership to use Availity as our main clearinghouse for Therabill.  Your costs will not increase as a result of this change, and we will be working with Madaket, a preferred partner of Availity, to complete most of your EDI/ERA enrollments. This should help simplify and streamline the process of switching you over to the new clearinghouse.

Why are you switching clearinghouses?

Due to changes with Office Ally and government payers, the cost of doing business has increased dramatically. To avoid passing this cost on to our Members, we sought out a new clearinghouse partner: Availity. We are committed to making this transition as easy as possible for your clinic, and in making this change, we are able to keep your costs the same.

What do I need to do? Are there forms to fill out?

Right now, there is nothing you need to do. Eventually, you will receive additional messaging from us as well as an email from Madaket (support+av@madakethealth.com), a preferred partner of the new clearinghouse, Availity. Madaket that will assist with enrollment. The email you receive from Madaket will contain EDI and ERA enrollment forms for most of the insurance providers in your Therabill account (as well as instructions on how to complete enrollment for the insurance providers whose forms are not available). You will simply need to review and sign the attached enrollment forms. For the payers without attached enrollment forms (like Medicare), you’ll be required to log into the payer’s web portal to complete enrollment. Again, Madaket will provide you with step-by-step instructions on how to complete this action.

If you have any questions about the enrollment forms you have received, contact WebPT/Therabill Support directly. Do not contact Madaket or Availity.

Madaket will send you a weekly reminder to complete enrollment until all forms are signed and returned. Once you review and sign your forms, you can either email or fax the forms to Madaket using the email address or fax number listed below.

• Email: support@madakethealth.com
• Fax: 617-274-8745

Madaket will forward your signed enrollment forms on to your payers.

Will my practice experience a delay in receiving payment/reimbursement?

We’ve pored over every detail of this clearinghouse transition to mitigate any risk that could potentially cause reimbursement delays. While we don’t expect any delays, there is always a chance. But please know that we are doing everything in our power to ensure this transition is as smooth as possible for your practice.

Will my price increase?

Your costs will not increase as a result of this change, and you may even notice a more simplified EDI and ERA process for any new payers you add in the future.

Will I see any other benefits from the switch?

In our search for a new clearinghouse partner, we kept costs and functionality top of mind. While most functionality will remain untouched, you may notice a more simplified EDI and ERA process for any new payers you add in the future.

Can I use my old/existing Availity login/account?

No. WebPT will manage an account that all of your claims and ERAs will be routed through.

I see that Availity offers eligibility and benefits checks. Can I access that feature via Therabill or the WebPT EMR now?

This article describes current functionality with Availity for eligibility and benefits checks. We’ll continue to explore additional Availity functionality after we complete this transition to identify opportunities to provide additional Member benefits.