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Important Things to Know Regarding the Medical Claims Clearinghouse

There are various kinds of claims clearinghouses since there are also different medical claims which you are able to find such as the dental claims, the pharmacy claims, the DME claims and a lot others. 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 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 different states, every state comes with their own insurance regulations and each carrier uses their respective 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.

But, the healthcare claims are now being processed electronically. 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. Because every claim would trigger several actions, the huge clearinghouses nowadays are processing trillions of transactions every year. 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. 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 keep in mind that there are various benefits which 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.

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