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.
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.
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.
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Select the products you are interested in signing up for.
$0.00* per provider / month
Features Include: Submit to over 5,000 payers Online Claim Entry (HCFA, UB04, ADA) Claim Uploads Electronic Remittance Advice (ERAs) Unlimited Support
$0.00 per provider / month
Features Include: Claims Clearinghouse Configurable Appointment Scheduler Medical Billing Accounting Module Online Patient Intake Patient Statements Create HCFA and UB04 Claims Unlimited Support
$29.95 per provider / month
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
Will you be using another billing software to create claim files, then upload them to Office Ally? Yes No
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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Yes, I am interested in this service.
Complete the information below and an AxiaMed representative will contact you in 1-2 business days.
Currently enrolled OneHealth Port users check the box below, and fill in your OneHealth Port User Name.
*This will become your OfficeAlly User Name if available.
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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 sentto the person signing on behalf of the practice.
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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.
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.
Click here to view our Training Video Libraryand learn how to use our products and services!
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.
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The Health Insurance Portability and Accountability Act (HIPAA)
CAQH CORE® Certification
ONC-ACB 2014 Certified
Electronic Healthcare Network Accreditation Commission (EHNAC)
Maryland Health Care Commission