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electronic medical billing


Electronic Medical Billing

     What is Electronic Medical Billing and how does it work? Billing your medical insurance claims electronically means that you are actually creating a data file of all of your insurance claims and sending it electronically to the insurance company either via telephone line, internet, or some other form of communication.

     The major advantage of billing electronically is that the insurance companies save money because electronic claims are less costly to process over paper claims so they process them quicker thereby paying you faster.

      In order to send your claims electronically, you will need to be connected to a clearinghouse, or you will need special software that allows you to act as your own clearing house.  Here is more information on the differences.   The purpose of a clearinghouse is to take the electronic file that you created and edit it for errors, sort it out and forward the claims to the correct insurance company.

      Most clearinghouses charge you a per claim fee anywhere from $.25 to $.50. Some will charge a monthly fee.  Some will charge an initial set up fee.  Clearinghouses vary greatly and you need to research them thoroughly before picking one.     The software that allows you to act as your own clearinghouse is usually quite costly, sometimes costing close to the same as your billing software. But if you are billing for multiple doctors (such as a billing service would) or you have a very large practice, this may actually be more cost effective.

     Keep in mind that this method requires a little more behind the scenes work on your end.  You will need a reliable person who is knowledgeable about computers to keep up with this type of system.

     Whichever way you choose, it is important to have a good reliable method for electronic medical billing. Some insurance companies have already mandated it, and many more are headed that direction.

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