Choosing a Clearinghouse

Choosing a clearinghouse for your electronic billing process is quite a maze to navigate. Here are a fewtips to help you select one.

Payer Participation List:

A clearinghouse that does not participate with the insurance panels you are billing will not do you muchgood. The clearinghouse website should have a list of payors posted to view before you enroll in theirservice. If they don't, move on.

Practice Management Software:

Most clearinghouses are compatible with the majority of the software packages out there. If you areusing a custom solution, a simple mapping of your electronic claim form should make your system compatible. Jennifer-Mills can help you determine if you are compatible and, if not, help you throughthe mapping process.

Feedback:

The clearinghouse will furnish you with status reports on your claim submissions. If they don't, moveon. You will want to see the report dashboard to make sure that you won't need NASA training toobtain your reports. Also, make sure that the reports are detailed and easy to read. Manyclearinghouse reports are very reader-friendly, and it saves valuable time.

Long Term Contracts:

Clearinghouses should be able to offer you a month to month plan for their services. If not, they maybe desperate to lock clients in. If you are sold on their services, be cautious and read the fine print. Ifnot, keep shopping.

Support:

The better services out there will include unlimited technical support at no additional charge. If youthink about it, only those that are confident in their products will offer free support, and probablydon't get many calls. Also, call the technical support department prior to enrollment and make surethey are accessible. You may use the "electronic claim mapping" issue as the reason for your call.Then, email a similar question and track the quality and promptness of the feedback. Kinks in thesystem will be made apparent before you invest your time in that company.

Costs:

Good clearinghouses cost around $75 - $100 per month per rendering provider. Some of the best willcharge $100-$135. Anything over $150 is on the high end, and a better deal can be gotten elsewhere.

Additional Options:

The better clearinghouses will offer services in addition to claims submission. It is beneficial to look atthose that will give you access to other cost effective services, such as benefit verification, paper claimprocessing, and patient balance billing services.