Setting up insurance

This page is the foundation for everything insurance-related in Ona. Eligibility checks, claim submission, and payer enrollments all depend on it, and the clearinghouse page will refuse to create enrollments until it's complete.

Turn insurance on

Go to Settings → Insurance — "enable insurance features and set the billing provider details used on your claims".

The toggle at the top "activates real-time eligibility checks (270/271) and claim submission (837P)". Those are the X12 transaction types: 270 asks a payer about coverage, 271 is their answer, and 837P is a professional claim. Nothing insurance-related works until this is on.

Require insurance at intake

Directly below the master toggle sits Patient intake, which "applies to patient self-registration and one-time profile links".

Require insurance decides whether a patient can get through intake without handing you a plan. It's off by default, and only appears once insurance itself is on.

• Off — the insurance step still shows, with a Skip for now button beneath it. The patient can move past it and you chase the card later.
• On — that button is gone. The step reads "Insurance required", and the patient cannot finish until they've added at least one plan.

It covers both routes a patient takes into your records: signing themselves up through the patient portal, and the no-login setup link you send from a patient's Details & Settings page.

Turn this on deliberately. There is no "I don't have insurance" option — a genuine self-pay patient hits a wall and has to phone you. If you see a mix of insured and self-pay patients, leave it off and collect insurance at the front desk instead.

Two things worth knowing. It isn't retroactive: a patient who already completed setup keeps their access when you switch it on. And it isn't only a hidden button — Ona refuses to mark intake finished without a plan on file, so the rule holds however the patient gets to the end.

Organization billing provider

These are the "Type 2 NPI and EIN used on the billing header of all claims".

• Billing NPI (Type 2) — your organization's NPI. Search by name looks it up if you don't have it to hand.
• Tax ID — choose EIN or SSN, then enter the number.
• Legal name — your registered entity name, e.g. "Acme Mental Health PLLC". This must match what the payer has on file, not your trading name.
• Phone
• Enrollment contact email (optional) — "used for payer enrollment and claim correspondence".
• Billing address — street, city, state, ZIP. The hint notes that ZIP+4 (9 digits, no dash) improves EDI matching, so use the full form if you know it.

Ona explains the distinction on the page: Type 2 NPI identifies your organization (clinic, PLLC, group) and appears on the billing header, Box 33 of the CMS-1500 form. EIN is required for payment processing.

Team rendering NPIs

Below the organization details, each team member gets a Rendering NPI — "Type 1 NPI per member for claim service lines".

Type 1 is the individual clinician's NPI, as distinct from the organization's Type 2. It identifies who actually delivered the care on each service line of a claim.

Ona validates these against the national registry. An NPI it can't find is flagged Not found in the NPPES registry beneath the field. Treat that as a real warning: a rendering NPI the payer can't match is a common cause of rejection, and it's far cheaper to fix here than to chase a rejected claim later.

Taxonomy codes

A clinician's taxonomy codes live on their profile under Settings → Team, on the Provider tab. Taxonomy is the NUCC code for a provider's specialty — you pick it from a searchable list rather than typing it, so a mistyped code can't reach a payer.

A clinician can hold more than one. The list is ordered, and the first code is the one sent on claims — it carries a Primary badge. If a clinician bills under a different specialty, drag that code to the top (or use the arrow button) and it becomes the primary; there's no separate per-claim setting.

This is the rendering provider's taxonomy and is deliberately separate from two others: the organization's billing taxonomy (Box 33b, under the billing provider details above) and each location's service facility taxonomy (Box 32b). They describe different parties on the same claim, so setting one does not fill in the others.

What comes next

With insurance configured, two more pieces are needed before you can submit:

1. Clearinghouse — choose who transmits your claims. See Setting up your clearinghouse.
2. Billing Rules — decide what Ona checks before a claim goes out. See Billing rules and claim scrubbing.

Locations also carry claim data: each site has its own Facility NPI (Box 32a) and Taxonomy code (Box 32b) under Settings → Locations. Those identify where care was delivered, and are separate from the billing and rendering NPIs set here.