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Some Things that You Must Know About the Medical Claims Clearinghouse

There are several types of claims clearinghouses because there are also many medical claims that you can find like the DME claims, pharmacy claims, dental claims and several others. You may also find such 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 just imagine the million licensed healthcare professionals that utilize different claims software and they are sending medical claims to more than 4000 insurance carriers a day? In the 50 states, every state has their respective insurance regulations and each carrier make use of their own 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. For the transmitting process, there is no need to deal with the US Postal Service. 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.

You should keep in mind that there are various benefits which you can get from the medical claims clearinghouses. But, it is quite important that you search for one that provides premium services for you to focus on the things which demand your time. For this reason, take the time to compare the options that you find before making a decision.

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