• Home
  • Contribution of clearinghouse in making healthcare more efficient

Contribution of clearinghouse in making healthcare more efficient

Posted by Patrick

In the world, where everything is getting automated, healthcare isn’t lagging behind by any means. Medical billing can be quite complex at times and clearinghouse is one of the most complex of them all. Clearinghouse is kind of a middleman between doctors and the payers (insurance companies).

The base billing software createsan electronic file which is called a claim. This file is then transferred to claims clearinghouse, which analyzes the eligibility of the claim, errors and other important factors. Once the claim passes the criteria it is sent securely to the payer. After this, the payer has to either accept or to deny the claim, if approved the payer will pay for the services and if rejected the claim will have to be resent with more Information.

Benefits of Clearinghouse

The primary benefit of a clearinghouse is its efficiency. It ensures that claims are filed correctly by checking each claim properly, this ensures fast processing. Apart from this clearinghouse allows transfer of claims even if the payer is using different software than yours. It is a great advantage asthat software may not be compatible with yours. If the payer is using software that isn’t supported by yours, clearinghouse uses EDI or Electronic Data Integration to transfer data and facilitate communication with the payer’s software.

How to choose the right clearinghouse software?

Clearinghouse software is fast becoming an inseparable part of modern healthcare and insurance. This is why these tools should be chosen very carefully. The following are some important factors-

  • User-interface

The UI of a clearinghouse should be clean and easy to understand. Make sure that you check the user interface before going for specific software.

  • Integration

You should also try to find out if the tool allows for integration with your existing software. If not, consider using one that does support it.

  • Customer support

This tool deals with complex business transactions and you should make sure that the customer support is great and instantaneous as you may need it often.