The function of the medical billing clearinghouse is to act as the middleman between the medical service provider and the insurance company. This is done through the use of a software which then the professionals use to create a file which is then uploaded to your medical billing clearinghouse. 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. The clearinghouses ensure that the electronic claims pass the inspection tests. The insurance company then approves or rejects the claim. The claims that are accepted will have the medical service providers paid by the insurance company while the rejected files will be sent back for additional information. The medical billing clearinghouses have a lot of advantages that they bring. The benefits are discussed below.
One of the benefits that you will realize from the medical billing clearinghouse is that they will provide convenience 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. 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.
The other benefits of the medical billing clearinghouses is that they act as the integration between the software that is used by the doctors and the dentists and the programs that the insurance companies use. There are different programs are used for the medical billing by the doctors and the insurance companies. With the different software the files that are the claims will be different and cannot be handled by a different program. The medical billing clearinghouses will act as the integration between the two software and they are able to 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.