A medical billing clearinghouse acts as the middleman between the medical service provider such as the doctor, dentist or the chiropractor and the insurance company who are the payers. This has been made possible by the presence of the medical billing software that will be used by the professionals to generate a claim file which is then sent to the clearinghouses. Once the claim file which is in an electronic form is forwarded to the medical billing clearinghouses, they will then check for the errors that are in the files and if there are no errors, they will then forward them to the insurance companies. The clearinghouses ensure that the electronic claims pass the inspection tests. It is then the job of the insurance company to accept the claim or reject it. The approved claim will ensure that the doctor or the dentist is paid while the rejected can be sent back for more info to be added. The medical billing clearinghouses have a lot of advantages that they bring. Some of these benefits are discussed in the text below.
One of the benefits that you will realize from the medical billing clearinghouse is that they will provide convenience to both the provider and the payer. When filling there is a lot of information that is required to be filled so that the providers will receive the payment form the insurance company. At times, the information that is in the files that are generated by the medical billing software may not be enough or may be irrelevant. This is where the medical billing clearinghouses come in to ensure that they scrutinize all these claim files and make the job simpler for the staff who work in the insurance companies.
The other benefits of the medical billing clearinghouses is that they act as the integration between the software that is used by the doctors and the dentists and the programs that the insurance companies use. There are programs that have differences that are used by both the doctors and the insurance companies. With the different software the files that are the claims will be different and cannot be handled by a different program. The importance of the medical billing clearinghouse comes in this where they will provide the integration between the different software used and they will then will be able to communicate through the Electronic Data Integration (EDI) like the accepted Apex EDI.
The other advantage of the medical billing clearinghouses if the convenience that they bring to the people. Different people require their medical bills to be settled by the insurance companies. The health problems that the patients have may be expensive to cater for as individuals. The medical billing clearinghouses have brought the advantage of preventing medical billing corruption by the insurance companies and this has prevented the presence of surprise medical bills.