Insurance and billing

Clearinghouse

Also called claims clearinghouse

A service that receives electronic claims from offices, checks them and passes them to insurers.

A clearinghouse is a go-between company that offices use to send electronic claims to many insurers through a single connection. It checks the claims for basic errors, formats them as each insurer needs, and returns reports on accepted or rejected claims. Staff should check these reports regularly, since rejected claims never reach the insurer and are easy to miss. Ask your software vendor which clearinghouse your office uses.

Example at the front desk

The clearinghouse report shows two rejected claims, so I will fix the subscriber IDs and resend.

Sources

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