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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 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.

For several years, medical claims processing has been done on paper. 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.

Well, the healthcare claims now are being processed or transmitted 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.

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. Because every claim would trigger several actions, the huge clearinghouses nowadays are processing trillions of transactions every year. Medical claims clearinghouses are electronic stations or they are centers that allow the healthcare practices to transmit the electronic claims to the insurance carriers in a secured way that would protect the health information of the patient or protected health information. In addition, the clearinghouses are providing medical billers as well as billing managers a method to consolidate all the electronic claims as well as manage them from just one place, from the online dashboard control panel, which is the same to online checking.

Be aware that there are several benefits that you will be able to get from the medical claims clearinghouses. It is very important that you look for one that offers premium services so that you will be able to focus on those things that actually need 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.

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