Basically, clearinghouses are simply electronic hubs that enable healthcare practitioners to make electronic claims to insurance payers. Usually, these electronic stations act as middlemen. They receive the medical claim information that is then electronically submitted to the insurer.
The medical billing clearinghouse will also check to ensure the diagnosis and procedural codes that are submitted are valid. They also ensure that every procedure code is the right one for the diagnosis code given. Basically, claims processing software will check for errors to ensure it matches the insurance payer software. If a claim passes inspection by the clearinghouse, it is securely transmitted electronically to the payer. The payer will then approve or decline the claim. A denied claim may require more information to be processed. Expound the information about Apex EDI
There are several benefits that come with clearinghouses such as the Apex EDI.
This is the main advantage of a clearinghouse. Clearinghouses check the medical claims to ensure the data is correctly entered. If there is no checking of errors in claims, then, payers would receive incorrect claims regularly. The consequences of incorrect claims include more work for the payer and the staff, inefficiency, as well as denied claims because of incorrect coding and filing. Enhance the important knowledge that you can get about Apex EDI
B. Integration between the provider and the payer software
Usually, the provider and the payer uses different software and the software do not have to be compatible. If the clearinghouse integrates each software individually, both the provider and the payer can be able to make each system to communicate through EDI or the electronic data integration.
C. Your work is simplified
Since the submissions are made electronically, the need to key in data over and again is eliminated. As a result, more time is saved. Again, human errors are eliminated when transmitting the medical claim information.
D. Submissions are made once
The clearinghouse makes it possible to submit all the claims at once. Therefore, you will not have to submit the claims to every insurer separately. Also, a medical billing clearinghouse will save you valuable time following up rejections from several insurance payers due to claim errors.
E. No paperwork
Electronic clearinghouses significantly minimize or eliminate printing paper forms. Also, the need for envelopes or postage money is drastically reduced.
However, when selecting a clearinghouse, it is important to consider some factors. Ensure that the clearinghouse has an interface that is user-friendly and allows privacy and compliance. Also, check the customer service and how it integrates with the practice management software already in place. Read more about Medical Claims Clearinghouse click the link https://en.wikipedia.org/wiki/Medical_billing