The function of the medical billing clearinghouse is to act as the middleman between the medical service provider and the insurance company. The professionals have a medical billing program that will be used to generate a claim file that they then forward to the clearing houses. The function of the medical billing clearinghouses will then be of importance at this point because they will check for errors in this file that have been committed during the filing process and then forward to the insurance companies. There are some inspection tests that the files must conform to. The insurance company then approves or rejects the claim. The approved claim will ensure that the doctor or the dentist is paid while the rejected can be sent back for more info to be added. There are a lot of benefits that are associated with the medical billing clearinghouses. You will get the advantages in the section below.
The first benefit of the medical billing clearinghouses is that they provide efficiency to both the provider and the payer. When filling there is a lot of information that is required to be filled so that the providers will receive the payment form the insurance company. There are times when you will have little information to offer in the medical billing software for the claim to the insurance company. This is where the medical billing clearinghouses come in to ensure that they scrutinize all these claim files and make the job simpler for the staff who work in the insurance companies.
The next importance of the medical billing clearinghouse is that they act the integration between the payers’ software and the medical service provider’s software. The medical service providers and the insurance companies all use programs that are varied. These are not compatible with each other and the files that they give as the claims may not be accepted by the other programs. The importance of the medical billing clearinghouse comes in this where they will provide the integration between the different software used and they will then will be able to communicate through the Electronic Data Integration (EDI) like the accepted Apex EDI.
The other advantage of the medical billing clearinghouses if the convenience that they bring to the people. Different people require their medical bills to be settled by the insurance companies. The health problems that the patients have may be expensive to cater for as individuals. Medical billing corruption has been reduced by the presence the medical billing clearinghouse which has also reduced the presence of the surprise medical bills to the patients.