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 may also find such 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 imagine the million licensed healthcare professionals that make use of a different claim software, and send medical claims to more than 4000 insurance carriers on a daily basis? Across the 50 different states, with each state having their respective insurance regulations and every carrier using their own internal software infrastructure.
For several years, medical claims processing has been done on paper. However, the manpower needed for thousands of insurance carriers to deal with all of the paper work as well as phone calls that every claim error produces would represent a big cost to healthcare that the beneficiaries are going to pay through the insurance premiums.
You should know that such healthcare claims are being processed or transmitted electronically now. However, you don’t need to deal with the US Postal Service for such 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.
Clearinghouses are considered to be the aggregators or senders as well as receivers of a lot of electronic claims information and many of them are done with the use of the software. As every claim would trigger various actions, the large clearinghouses these days are processing trillions of transactions annually. The medical claims clearinghouses are actually electronic stations or they are hubs which allow the healthcare practices to transmit such electronic claims to the insurance carriers in a secure manner which would protect the patient health information or such protected health information. The clearinghouses provide the medical billers or those billing managers a way to consolidate the different electronic claims and have them managed from just one place which is from a dashboard control panel which is just like online checking.
You should keep in mind that there are various benefits which you can get from the medical claims clearinghouses. But, it is quite important that you search for one that provides premium services for you to focus on the things which demand your time. Due to this, you need to take the time to compare the various options which you can find before you make your decision.