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hcfa 1500


Medical Billing Clearing House

      When you choose a medical billing clearing house to submit your medical insurance claims electronically, it is crucial that you pick one that will meet your needs.  Clearing Houses can vary greatly, and the following factors should be considered when choosing:

  • price per claim
  • set up fees
  • insurance companies able to receive claims
  • support
  • types of reports available

     Try to calculate the amount of claims you will be sending per month.  If there is a price per claim fee, multiply it times the number of claims you will be submitting to give you an idea of your monthly cost.

     Do they charge a set up fee?  

     Does the medical billing clearing house you are looking at offer electronic submission to the companies you submit most of your claims to?  Make sure your larger insurance carriers in your area are covered by the clearing house.

     Support is extremely important because you want to keep your electronics working properly and know you have someone to call to fix it if you have a problem.  Does someone at support answer the phone or do you have to leave a message and they will call back?  If so, how soon will they call back?

     You'll also want to make sure you can access all the reports you require.  What capabilities does the clearing house have for reports?   

    Another factor to take into consideration is how long the clearing house has been operating.  A newer clearing house may be still working out some of the bugs, although just because a clearing house has been operating for some time doesn't mean they are good. 

     There are other options available if you don't feel that sending your claims thru a clearing house is the right method for you.  Many of the larger insurance companies can receive claims directly from you if you have the appropriate software.  For information on the
direct submission software we use.   Here is more information on submitting your claims directly to the insurance company. 

     For professional providers, the software has to be capable of taking the claims data from your medical billing software program and putting it into an ansi 837 HIPAA compliant format.  Once in that format you can submit the file directly to the insurance carrier instead of going thru a medical billing clearing house.  

     When choosing which method you will use to submit your claims electronically, just make sure you pick a method that is appropriate for your needs.

     For more information on Medical Billing Clearing House.

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