The medical billing clearinghouse is the link between the doctors and the dentist 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. Once the claim file which is in an electronic form is forwarded to the medical billing clearinghouses, they will then check for the errors that are in the files and if there are no errors, they will then forward them 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. The medical billing clearinghouses have a lot of advantages that they bring. Some of these benefits are discussed in the text below.
The first benefit of the medical billing clearinghouses is that they provide efficiency to both the provider and the payer. To be paid by the insurance companies, the medical service providers will need to give all relevant information in the files that are generated by the medical billing software. Such information will be of importance and at times it will be hard to acquire all the info that requires being ion the files. 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.
It is also the function of the medical billing clearinghouse to act as the integration between the different programs used by the doctors and the insurance companies. The medical service providers and the insurance companies all use programs that are varied. The compatibility of the files that are generated by the different programs will not be possible. The medical billing clearinghouse is of great importance when it comes to this as it will ensure that the different programs communicate through the Electronic Data Integration (EDI) such as the Apex EDI.
The medical billing clearinghouses bring convenience to the people. Different people require their medical bills to be settled by the insurance companies. The complications that they receive treatment for might require much money to pay for. Some illnesses may make us have surprise medical bills but with the medical billing clearinghouses, the cases of medical billing corruption have reduced significantly.