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Clearinghouse vs. Direct to Carrier Medical Billing Submissions

Clearinghouse vs. Direct to Carrier Medical Billing Submissions

Clearinghouse vs. Direct to Carrier Medical Billing Submissions

When considering which to submit to, there is some pause for thought.

Most practices submit paper claims direct to the Carrier as they always have. This is not a very cost effective way to handle claims unless you only submit one claim to one carrier,which isn’t likely. You have a thriving practice with a lot of patients and therefore have a lot of claims with many different carriers.

With a clearinghouse, you need only contact one location and submit all your claims for routing and processing. Most medical billing firms use the clearing house method.
Furthermore, more carriers don’t allow editing of claims once submitted, most clearinghouses allow editing of claims for completeness and validity which will greatly reduce rejections and partial payments on medical billing claims.

As far as ease of use, many carriers have designated times when they will accept electronic claims. The clearinghouse will accept the medical billing claims when they are ready to be sent. Many carriers require that whoever is sending the medical billing claims into their system pay for the telephone expense to do so. Most clearing houses have a toll free number to use.

Software updates can be painful, and even more so when you’re dealing with individual carriers that require updating in a timely fashion to send in your claims. Outsourcing your medical billing to a company that can not only submit to a clearing house but also to carriers will alleviate the headaches about software updates, submissions and claims tracking.

Just one more reason to outsource your claims!

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