Factors to Consider When Picking Up the Health Claims Clearinghouse.
The payer receives the claims through the electronic way from the clearinghouse which receives the claims from the medical such that they make the necessary corrections. There is certain software which they use to check and corrects those mistakes. The claim can be acknowledged or overruled by the payer. If the payer has accepted to your plea, then you wait for the payment, and if rejected then you do the necessary changes to make it approved.
The clearinghouse customer support should be available and ready to use. Handling your claim and as well clear some errors should be their quality. It will help to reach the payer faster if they are fast enough. If the company will handle your claim very late due to its slowness in their work, then your payment has to be delayed. The clearinghouse should provide an all-time customer service, which means that whenever someone sends a request then they receive the response the soonest time possible. The clearinghouse is not right for you if it takes 24 hours for you to get a response to your query.
They should handle your claims within one hour. The clearinghouse should respond to the claims you sent, to make sure you are aware of which claims passed and which ones did not pass. The clearing houses which respond to you they help you to resubmit the file which you have made some changes and wait for the cash to flow.
The clearinghouse should be accountable for sending the 835s and payment forms consistently to the claimer. If you receive the files sooner, then you will do the reconciliation of your cash flow consistently. It will help you to clear the reconciliation process for each month timely, such that you don’t have to take your time and track down the month you did not do reconciliation since it is wastage of time. Most of the clearinghouses send 835s forms later after you get paid; hence you should take caution when selecting the firm.
The clearinghouse should provide the efficient claim information. It means that you don’t have to do duplication of the information since it should be accessible to all your staff members, and they have the authority of making the necessary changes. The changes are made faster since the data information is available to all staff.
You should select an easy clearinghouse since the complex ones need a deep training to understand how it works and you will be forced to provide that training. It will help you to save the funds and time when training your employees.