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3 Questions To Ask When Picking A Clearinghouse



As the digital world advances, the healthcare industry is constantly adapting to these changes. Today, there are a set of standards that most fields need to comply with.

Possessing a medical billing clearinghouse is one of these standards. However, the process of picking a clearinghouse may not be all that simple. How do you know what to look for before selecting a service? Why do you even need a medical clearinghouse?

In this article, we will answer the 3 Questions To Ask When Picking A Clearinghouse and more to help you choose the most suitable medical clearinghouse service for your needs.

What’s The Purpose Of A Medical Clearinghouse?

For those unfamiliar with the topic, a medical clearinghouse serves as an intermediary between healthcare professionals and insurance companies. The job of clearinghouse companies is to process claims scrubbing. This means they scrutinize the claims to look for any errors that may interrupt the payment procedure.

One aspect of this process revolves around checking the CPT codes, varies codes, and modifiers. By doing that, the chances of costly mistake processes and rejection of claims drop dramatically.

As a medical clearinghouse company, they need to update their information on a regular basis to optimize the revenue cycle of healthcare providers. Additionally, a medical billing clearinghouse needs to meet your needs as a healthcare provider, especially when it comes to claims scrubbing, processing claims, and receiving payments.

All of these moving parts make choosing a clearinghouse service daunting. Moreover, you constantly need to evaluate the offered services even after making a deal with a company.

The next few sections will cover the 3 essential questions that you need to ask when picking a clearinghouse.

3 Questions To Ask When Picking A Clearinghouse

1 – Does This Service Have Good Customer Support?

The answer to this question can be challenging to obtain when you are not affiliated with the clearinghouse service yet. How can you tell if they have good customer support without trying them first?

For starters, do an online investigation, looking for reviews, reports, and feedback from other healthcare professionals. If you read that this clearinghouse service takes a long time to respond or has poor communication, it’s a very bad sign! You are trying to get the service to solve problems, not create new ones.

In today’s age, quality customer support is absolutely indispensable. What happens otherwise? Well, you risk hindering insurance claims, especially those with timely filing limits. Your revenue cycle also slows down, which can negatively affect the quality of your services.

The primary objectives of a medical billing clearinghouse should be to deal with denial management and accelerate reimbursements. If you’ve already chosen a clearinghouse service and feel like you work for them instead of the other way around, it is time to look for an alternative.

2 – Can This Clearinghouse Service Boost The Productivity Of Your Office?

A medical clearinghouse should increase the productivity of your office shortly after using its services. At the same time, these services should not be rigid. As the industry changes rapidly, clearinghouse companies should be able to adapt as well.

For instance, a practice can grow and becomes quite complex. These changes require new features that a clearinghouse service needs to provide. Is the clearinghouse service you are about to choose apt to deliver these features? If you already have a clearinghouse service, you should ask yourself the same question.

A practical example would be the web interface of the clearinghouse. Is it constantly changing? Does it have to be rebuilt whenever a new feature gets added or connected to other support software?

If the answer to these questions is possible yes, then you need to think twice before signing the contract!

At the same time, don’t set your expectations too high. You need to be realistic. Optimally, you would set goals for the practice every 1, 3, and 5 years. If you are expecting your medical practice to grow, make sure to ask the clearinghouse company about its ability to adapt to these changes.

3 – What Technical Features Does The Clearing House Service Offer?

The final question you need to ask before picking a clearinghouse mainly depends on your vision for the medical practice.

Here are some questions to help you:

  • Do you want streamlined user features?
  • What is the level of integration your practice needs?
  • Does your practice require additional features?
  • Are you okay with a service that offers many features but has a steeper learning curve?
  • Do you need insurance verification or patient statements?
  • What about claim management analysis?
  • Do you already have other online services that you want to integrate with the clearinghouse?

Depending on how you answer these questions, the type of clearinghouse service that fits your needs will vary.

For instance, some healthcare practitioners prefer to have a clearinghouse service integrated with EMR and practice management. This helps them improve their workflow. An integrated service such as this one is not standardized by all clearinghouse companies. At the same time, a defect in one portion of the system can break down the whole thing. To avoid these crashes, you can divide the clearinghouse, billing database, and EMR to separate interfaces.

Speak with the candidate clearinghouse service and express your concerns and thoughts. Write down the things you want to be included in the service and the things you want to omit. Having a clear idea about the future of your practice and the potential features you may need becomes essential at this point.

Takeaway Message

Selecting a high-quality medical billing clearinghouse is crucial to boost your revenue cycle and focus on other important aspects of your practice. You do not want to choose a service that creates problems for you instead of solving them.

We hope that this article will serve as a mini-guideline to assist you in getting the best possible deal with a clearinghouse service.

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