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. They do this by ensuring that the file has passed all necessary inspection. The file submitted to the insurance company will then be accepted or rejected. 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. The benefits are discussed below.
One benefit associated with the medical billing clearinghouse is that they will bring convenience to both the payer and the provider of the medical services. 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. At times, the information that is in the files that are generated by the medical billing software may not be enough or may be irrelevant. The medical billing clearinghouses will play an important role in ensuring that the files which are the claims to the insurance companies have the correct information and this will help the staff at the insurance companies process the claims and pay the money to the relevant medical service providers.
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. There are programs that have differences that are used by both the doctors and the insurance companies. The compatibility of the files that are generated by the different programs will not be possible. 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. Many people have medical bills that require being settled by their insurance companies. Most of this would not be possible for most of them because some complications can be so expensive to the patients. The medical billing clearinghouses have brought the advantage of preventing medical billing corruption by the insurance companies and this has prevented the presence of surprise medical bills.