Why Medical Claims Clearinghouse

Medical Claims Clearinghouse software actually does the work of 2-3 people in your medical office all for about $100.00 a month, + eStatements, eCollection Letters, and ERA fees (depending on the Clearinghouse you select).

Importance of a Medical Claims Clearinghouse...

Based on a medical office basic front office and billing cycle let me show you the importance of medical claim clearinghouses:

Patient calls to schedule their appointment. The front office gets the health insurance information and checks Eligibility through the Clearinghouse (takes seconds). They identify the patients benefits, deductible balances, co-payments and what procedure codes are approved. Saved a 15 minute phone call with the health insurance carrier.

Some Medical Claim Clearinghouses can also verify patients mailing address, patients credit verification and credit history (can they afford this visit and can they pay this visit) within seconds of inquiring.

Patient is treated and the charges are entered. Medical Claims Clearinghouses will scrub the medical claim based on the providers Taxonomy code (specialty) and the health insurance carriers coding rules. They will kick out the claim if they identify issues. You are notified within minutes instead of 3-5 weeks by EOB from your health insurance carrier.

The medical office receives notification from the clearinghouse within 24 hours that the claim was accepted by the insurance carrier or rejected.

The medical office receives notification from the health insurance carrier within 3 days if the claim was accepted or not. Including usually a check number and date the EOB will be sent. If denied it will have denial reasons for you to work (no more waiting 2-5 weeks for a EOB to say denied).

The medical claim is not processed and paid by the Health Insurance Carrier usually within 10 days of receipt. They send an Electronic Remittance Advice or electronic file of your Explanation of Benefits. You can use this to post health insurance payments, attach for proof of timely filing and use in appeals etc. Also, no more paper - everything is stored in a convenient location; so save time from not having to pull paper.

ERA posts the payments automatically saving your medical biller time from having to manually post each payment. And now that you are getting payments from insurance carriers faster, patients will get statements faster. Some Medical Claim Clearinghouses will actually process your statements and collection letters for you. This can save over 8+ hours of manual labor in your medical office from printing, stuffing, stamping and mailing patient statements each month. You also save money by not having to purchase professional statements

This is just the iceberg of what Medical Claim Clearinghouses can do for your medical practice or billing service. The beauty is it saves time, money and paper by doing as much for you electronically as possible.

Other Clearinghouse Articles

What is a Medical Claim Clearinghouse

Why you need a Claim Clearinghouse

How to read Clearinghouse EDI Reports

Review Medical Claims Clearinghouses