Office Ally - Enroll now

Office Information

Practice Name (Covered Entity):

The name entered here will need to match the name you enter later in the Owner of Account / Practice Name field in the Authorization Sheet and the Covered Entity Name field in the Business Associate Agreement.

* Required

Mailing Address

* Required

Person Signing on behalf of the Practice (Covered Entity):

Enter the name of the person signing on behalf of the Practice (Covered Entity). Only someone authorized to sign on behalf of the Practice (Covered Entity) should be listed here. This information will auto-populate into the agreement forms and require an electronic signature by the authorized signer at the end of this process. If the person authorized to sign is not available, an email will be sent to the email address below where the agreements can be signed later.

* Required	* Required	* Required
* Required	* Required

Main Contact Information

Send invoices to this contact
* Required	* Required	* Required
* Required	* Required

Type of business	Billing Service	Solo Practice	Group Practice
* Required

Authorized Contacts

Authorized Contacts can make changes to the account. If the Owner of the Practice/Company is not the Main Contact, we suggest that you add them as an Authorized Contact. The Main Contact above will automatically be added as an Authorized Contact.


		Send invoices to this contact

Add Another

Name	Phone	Email	Send invoices

Select Products

Select the products you are interested in signing up for.

Claims Clearinghouse

$0.00*
per provider / month

Claims Clearinghouse Added

Features Include:
Submit to over 5,000 payers
Online Claim Entry (HCFA, UB04, ADA)
Claim Uploads
Electronic Remittance Advice (ERAs)
Unlimited Support

Learn More

Practice Management

$0.00
per provider / month

Add Practice Mate™

Features Include:
Claims Clearinghouse
Configurable Appointment Scheduler
Medical Billing
Accounting Module
Online Patient Intake
Patient Statements
Create HCFA and UB04 Claims
Unlimited Support

Learn More

Electronic Health Records

$39.95
per provider / month

Add EHR 24/7™

Features Include:
Practice Mate™
Configurable SOAP Notes
ONC-HIT Certified
Custom Document Templates
Radiology and Lab Integration
Immunization Registry Connections
Create HCFA and UB04 Claims
Unlimited Support

Learn More

* A $35.00 Non-Par processing fee applies per unique Tax ID + Rendering NPI combination whose claim volume is 50% or more to Non-Par Payers.

Select the types of claims you will be submitting: CMS 1500 UB-04 ADA

* Required

Will you be using another billing software to create claim files, then upload them to Office Ally? Yes No

Software Requiring Special Setup

If you utilize any of the following software to submit your claims, please indicate which one so we can proceed with performing the special setup steps required for them.

How did you hear about us? Check ALL that apply: (you must choose at least one)

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Completion - 25%

Provider/Group Information

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Group Providers

Add Another

Group Name	Tax ID	Group NPI	Specialty

Individual Providers

Add Another

Provider Name	Tax ID	Group NPI	Specialty

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Completion - 50%

OneHealth Port Users

Currently enrolled OneHealth Port users check the box below, and fill in your OneHealth Port User Name.

Are you a OneHealth Port user?

Yes

No

Please confirm you are not a robot

{ { message } }
Validated Successfully

Back Continue

Completion - 50%

Sign Enrollment Documents

Please review and sign the documents below to complete your enrollment. An electronic signature by the person signing on behalf of the Practice (Covered Entity) is required.If the authorized signer is not currently available to sign the documents, click here and a link will be sent to the person signing on behalf of the practice.

Having Trouble Signing Up? Contact Support at (360) 975-7000, Option 1

Back Submit

Completion - 75%

Enrollment Submitted

Your enrollment has been submitted and will be reviewed within 24-48 hours. We sent an email to with the Authorization, Business Associate Agreement, and any other applicable forms. If the email hasn't arrived within 5 minutes, please check the spam/junk folder.

Your account will be created within 24-48 hours

Accounts are usually created within 24-48 hours after receiving the enrollment forms. Once your account is created, getting your account up and running is easy! An email will be sent to with your username. Open the email and follow the provided link to create your Password and Security Question and Answer. Once your password has been set, use your credentials to log in. If you do not see the email, please check your spam folder.

Learning to use Office Ally

Click here to view our Training Video Library and learn how to use our products and services!

Haven't heard from us?

If you don't receive your account set up email or we haven't contacted you within 24-48 hours, please give us a call at 360-975-7000 Option 1.

Completion - 100%

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Office Ally Sign Up Form

Office Information

Practice Name (Covered Entity):

Mailing Address

Person Signing on behalf of the Practice (Covered Entity):

Main Contact Information

Type of business

Authorized Contacts

Select Products

Claims Clearinghouse

Practice Management

Electronic Health Records

Software Requiring Special Setup

Provider/Group Information

Group Providers

Individual Providers

OneHealth Port Users

Are you a OneHealth Port user?

Please confirm you are not a robot

Sign Enrollment Documents

Having Trouble Signing Up? Contact Support at (360) 975-7000, Option 1

Enrollment Submitted

Your account will be created within 24-48 hours

Learning to use Office Ally

Haven't heard from us?