When You Want to Know More About the Medical Claims Clearinghouse
There are various kinds of claims clearinghouses which you can find as there are also different medical claims available such as the pharmacy claims, the DME claims, dental claims and many more. You will also find medical professional claims. But, the easiest way for you to explain what the insurance claims clearinghouse is and the services that they offer is to paint a picture of the problem that they solve and this is actually the piece of the puzzle.
Can you think of the million licensed healthcare professionals which use various claims software and would send medical claims to over 4000 insurance carriers every day? Across the different states, every state comes with their own insurance regulations and each carrier uses their respective internal software infrastructure.
The medical claims processing has been carried out on paper for several years. The manpower necessitated for the thousands of insurance carriers to manage all the paperwork and also the phone calls that each error is going to produce would represent a big cost to the healthcare that the beneficiaries would pay via insurance premiums.
But, the healthcare claims are now being processed electronically. But, you don’t have the US Postal Service to deal with the transmitting process. Such electronic claims clearinghouses were made by Medicare and the big payers to step in electronically that such postal service wasn’t able to and prescreen for those claim errors and serve as air traffic controllers and speak of electronic claim submission.
The clearinghouses are known to be the aggregators or the senders and receivers of so many electronic claims information and most of them are done through the software. As each claim would trigger many actions, the big clearinghouses today are processing trillions of transactions each year. Those medical claims clearinghouses are actually electronic stations or they are known as centers which permit the healthcare practices to transmit such electronic claims to insurance carriers in a secured manner that protects the health information or that protected health information. Aside from that, the clearinghouses are offering medical billers and billing managers a method to consolidate all electronic claims and also manage them from a single place, from a dashboard control panel that is similar to online checking.
You should know that there are certainly various benefits that you can get from the medical claims clearinghouses. However, it is very important that you look for one that offers premium services so that you can just focus on the things that need your time. For this reason, take the time to compare the options that you find before making a decision.