Clearinghouse Replacement – A Guideline

What is a Clearinghouse in Medical Billing?

Healthcare clearinghouses act as intermediaries between healthcare providers and insurance companies. They do some simple scrubbing of claims submitted by physicians, hospitals, and other medical organizations and ensure that payers receive clean claims for processing and (hopefully!) payment. Once a claim has been vetted by the clearinghouse, it is sent electronically to all appropriate recipients.

clearinghouse replacement guideline

How to Choose a Clearinghouse – A Guideline

Switching clearinghouses can be a difficult choice. There is so much to take into consideration — rates, customer service, integration into your existing software, and more.

If your current clearinghouse is raising its rates, dropping features, or adding new ones that you don’t want, maybe it’s time for a change. Save some time and read on for some tips on choosing the best clearinghouse for your business.

When You’re Looking for a Clearinghouse, you Want One with:

  1. Unlimited transactions

Stop worrying about how many transactions your sending and what your overage charges will be. Send and receive unlimited claims, electronic remittance reports and eligibility checks. Stop getting penalized for data entry errors requiring multiple submissions.

  1. A financial dashboard

See statistics about how you are doing. What percentage of your claims are denied? Rejected? Paid on time? Work the claims directly from the dashboard.

  1. Integration with your medical billing software

Downloading 837 files and uploading them to a clearinghouse website is double the effort. Send claims directly from your medical billing software to the clearinghouse without hassle, and eliminate room for error.

  1. Knowledgeable and immediate customer support

When you’re stuck you need experts to be available for quick resolutions, and an understanding of the issue so you don’t have the deal with it again in the future.

  1. Quick claim status checks

You need confidence that your claim has successfully arrived at the clearinghouse and is being processed. Information about the status of your claims is critical to the financial health of your practice.

Ready to switch? Sign up for Microwize Direct Today

How can Microwize help make your transition seamless?

Your on-boarding team will ensure that you have a Submitter ID in place, your software is configured, and your enrollments have all been processed with the payers you participate with before you go-live on the new clearinghouse.

We understand how important it is to avoid downtime when submitting claims. You will not experience any delays with claim submission and receiving payments promptly. The clearinghouse is a provider that works for you in the background, with a successful transition you may not even notice there was a change because you will continue to send claims while we make the change for you behind the scenes. Call or contact us today.

clearinghouse replacement guideline

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