There are many important facets to the medical billing process. One of the most important steps includes the use of a medical billing clearing house. Though not everyone is fully clear about what a medical billing clearing house is, why it’s important and how to choose the best medical billing clearing house to meet your practice’s needs?
What Does A Medical Billing Clearing House Do?
A Medical billing clearing house essentially acts as a middle man helping to connect practitioners like physicians, doctors, dentists, therapists, and chiropractors with the payer, such as a medical insurance provider or public health institution.
The best medical billing clearing houses tend to use state of the art software to complete the medical billing process efficiently. This includes the use of electronic files like the ANSI-X12 837 file, which is seamlessly uploaded to your practice’s medical billing account.
The medical billing clearing house then carefully inspects the claim for errors. This ensures that the claim itself can be properly submitted to the insurance provider, payer, or public health institution. If the entered claim passes this vigorous inspection it is then passed on to the payer via an electronic transmission system that meets all the necessary HIPAA privacy standards.
At this point, the claim is processed by the payer institution and will then either be denied or approved based on the patient’s current coverage. This is a crucial step in the revenue stream. If the claim is denied a reason will be given such as a request for further information or noting a lapse in the patient’s coverage. This information will be passed along in hopes of meeting the stated requirements.
What Are The Benefits Of Using A Medical Billing Clearing House?
Right off the bat, a medical billing clearing house streamlines the claim processing system. This level of efficiency is far greater than the old fashioned paper systems used a generation ago. Medical billing clearing houses also help to catch errors, and incorrect information entered into a claim. This helps satisfy some of the payer’s concerns, which helps medical insurance providers and public health institutions to process more claims at any given time.
Incorrect claims that are caught by the medical billing clearing house also help prevent excessive delays in the medical billing process. This translates into a more consistent revenue stream for physicians and small practices who tend to have a relatively small administrative staff.
Analytics To Reduce Coding & Data Entry Issues
Medical billing clearing houses also help to catch data entry, filing, and coding errors. This includes recurring errors, which can cause frequent delays in the medical billing process. When caught via spot-checking or more sophisticated analytics these recurring coding errors can be corrected to improve the revenue stream going forward.
Software Compatibility Between Payers & The Medical Billing Clearing House
Software compatibility is also another major benefit of using a medical billing clearing house. Most small practices and solo practitioners have limited administrative staff. Though most don’t have the extensive experience and training in medical billing, the use of up to date CPT codes, and data entry to catch some of the more common errors. At the same time, medical billing clearing houses also use something called EDI, or “Electronic Data Integration” which is a sophisticated software system used to communicate with insurance providers, and public health institutions in a way that they are familiar with.
How To Choose The Best Medical Billing Clearing House For Your Small Practice
There are a few key aspects to keep in mind when choosing a medical billing clearing house. Factoring each of them into your decision-making process will help you find the one that is best for you.
The Interface
An interface that is user friendly will go a long way toward helping you or your administrative staff submit claims and prior authorizations to the medical billing clearing house efficiently. If there is some sort of delay or a question that needs to be addressed, an intuitive interface will also make it easier for you to address the issue, with minimal delays in your small practice’s revenue stream.
Existing Practice Management Software Integration
Ideally, you want a look for a medical billing clearing house that already uses, or has easy access to a similar software platform to what you already have in-house. This lets you and your administrative staff stay inside your comfort zone, without having to retrain on a new management software platform.
A Reputation For Superior Customer Service & Support
These days online reviews are everywhere, and this includes reviews on the customer service and support policies of medical billing clearing houses. Ideally, you want to choose one that has great reviews and a reputation for great customer support and service. This includes things like a fast response rate when questions arise.
A Clean Reputation For HIPPA Compliance
HIPPA compliance is more important than ever in today’s medical world. This goes beyond simple things like chain of custody in the handling of physical documents and the utmost discretion in policy compliance. You want to always prioritize a medical billing clearing house that is compliant with all Federally mandates HIPPA privacy practices. This includes things like the use of EDI software that is configured to maintain the highest privacy standards.
The Benefits Of Outsourcing Your Medical Billing Process
These days a lot of solo practitioners and small medical practices are outsourcing their medical billing needs to a third-party firm like Operant Billing Solutions. There are several benefits to taking this route.
Right off the bat, you will notice an increase in available hours for physicians as well as administrative staff. This opens up more opportunities to see more patients and grow the scale of your medical practices. At the same time, small practices that use third-party medical billing firms also see increasing consistency in their revenue stream thanks to reduced errors in submitted claims, and prior authorization requests. This includes coordinating with some of the industry’s best medical billing clearing houses to take the burden off of your shoulders.
