Clearinghouses

Clearinghouses & Medical Billing Software

Why use a clearinghouse with medical billing software?

This is a question that we have heard countless times. Yes you can submit claims directly to many insurance companies as long as your medical billing software will let you create an electronic claim using the ANSI 837 format. BUT, there are drawbacks. InstaCode Institute recommends using clearinghouses for several reasons.

Benefits to Using a Clearinghouse

Cleaner Claims - No one is perfect. Human errors eventually show up on claim forms and a clearinghouse can pick up errors before submission to the insurance company. It is easier to fix a problem BEFORE it gets to an insurance company than AFTER.
Billing Support - Most reputable clearinghouses can help you figure out how to fix errors in your claims.
Extra Services - Most clearinghouses offer other billing services to help you streamline your billing process. Services like patient statements, benefits verification and more.

InstaClaim & Clearinghouses

InstaClaim has been tested with several different clearinghouses. Below are two recommended vendors that are known to work with InstaClaim's "Electronic Claims" module. Contracts need to be made directly through them. Just let them know that you use InstaClaim software.

How to Compare

Be sure when you compare companies and services that you do an "apples-to-apples" comparison. Some companies say they are free, but only non-government claims are free - you pay for all Medicare/Medicaid/etc. claims and can end up paying more than you would have if you had gone through another vendor.

Be sure you truly understand the real costs. We recommend knowing you claim volume and break that down by claims submitted to government programs versus traditional insurance.

Here are some important questions to ask:

What is the customer support like? Do you call and get a real live human being or do you have to wait endlessly and be told to go to a website to find the answer? This alone can MORE than make up for being slightly higher in price.
What kind of training to they offer? Do they patiently walk you through the process?
What is the enrollment fee? Even if a company has no enrollment fee, their monthly costs may make up for it.
What is the monthly fee?
How many claims may I submit for that monthly fee?
Do they process claims for all the insurance companies that come through my office? You can print a list of insurance carriers in InstaClaim to make sure that they can ALL be submitted to the vendor.