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. 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 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 many advantages that it brings. You will get the advantages in the section 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. The information that is required to be in the claim file is much and requires concentration so that one can fill all the required info. There are times when you will have little information to offer in the medical billing software for the claim to the insurance company. The function of the medical billing clearinghouses is to ensure that the information is the electronic files for the claims is correct and they will be able to correct the errors so that they will make the job easier for the insurance company to process the claims.
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 programs that have differences that are used by both 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 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 other advantage of the medical billing clearinghouses if the convenience that they bring to the people. There are a lot of people who will need their medical bills to be taken care of 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.