Online Education

Any medical billing service not satisfied with their clearinghouse should seriously consider switching to a free clearinghouse. Want to increase margins? Want to pump up your bottom line? Want to lower your fees and increase volume? Then a free clearinghouse just might be your ticket to reaching your financial goals.?

Our medical billing service recently made the switch from a fee-based clearinghouse to a free-based (no fee) clearinghouse and could not be happier with our decision. We no longer pay to file electronic claims or receive electronic remits and will save thousands of dollars annually. Best of all we pass those savings on to our clients in the form of lower rates. Did we fail to mention our new clearinghouse provides nearly identical services as our fee-based clearinghouse? Did we also mention we do not pay a penny? In fact our clients’ cash flow has not been healthier.?

As you know, clearinghouses electronically accept, process and aggregate claims from a multitude of billing offices throughout the country. These claims are then forwarded to the appropriate insurance companies (payers). The billing software tends to be just as diverse. In many cases the clearinghouse will even print and mail paper claims to the payers when necessary (in addition to providing some peripheral services).

Understand clearinghouses (fee and no fee) have a little secret they really do not want you to know. They actually have another paying customer: insurance companies. The payers do not have the capability of processing claims from a variety of medical billing software. However to their credit more and more insurance companies are offering online claim submission. We continue to use some online billing portals. ?

Wondering how a free no fee clearinghouse can afford not to charge for electronic data interchange (EDI) services? They have a business model that requires low overhead, lean but productive staffs, offer value added services like electronic health records and use no frills software. In the end these businesses are able to thrive via payer revenues.

Free clearinghouses may not be for everyone. Our fee-based clearinghouse had very good customer service and software representatives that could essentially train a novice on the fly. If you are a solo or group practice that has high staff turnover or an inexperienced staff then a fee-based clearinghouse may be for you.

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