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When You Want to Know More 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. Also, you will be able to find such medical professional claims. However, the easiest way that you can explain what the insurance claims clearinghouse is and what services they provide is to paint a picture of the problem which they solve and such is 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.

The medical claims processing has been carried out on paper for several years. However, the manpower needed for thousands of insurance carriers to deal with all of the paper work as well as phone calls that every claim error produces would represent a big cost to healthcare that the beneficiaries are going to pay through the insurance premiums.

Well, the healthcare claims now are being processed or transmitted electronically. But, you don’t have the US Postal Service to deal with the transmitting process. The electronic claims clearinghouses were being made by the Medicare and the large payers of insurance to step in electronically where the postal service wasn’t able to and also pre-screen for the claim errors and function as the air traffic controllers.

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. The clearinghouses provide the medical billers or those billing managers a way to consolidate the different electronic claims and have them managed from just one place which is from a dashboard control panel which is just like online checking.

You should keep in mind that there are various benefits which you can get from the medical claims clearinghouses. However, it is very important that you look for one that offers premium services so that you can just focus on the things that 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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