Medical Billing Business Clearinghouse List


Medical Billing Clearinghouses, What Are They?

In layman’s terms medical billing clearinghouses are middlemen that take the information found on medical insurance claims and then submits that information electronically to the insurance companies (also known as Carriers or Payor’s) that a doctor is contracted with.

Picture This:


Your client sends you a medical claim, you input that information into your medical billing software, you print out that information onto a CMS1500 form, you mail that form out to the appropriate insurance carrier, the insurance company checks the claim for any errors, if everything is correct (called a clean claim) they submit payment to your client for the services rendered and then you bill/invoice the physician for the services that you provided them.


Now, how long do you think that process will take and what would be your expense?


Well if you were to do this for each and every claim, for each and every client that you have then I can assure you that it would only take about a month and some weeks before you’d be out of business.


Medical billing clearinghouses were born out of the necessity to cut down on the amount of time it took for medical claims to be accepted and processed by insurance companies.


The added benefit is they are also saving the environment because less paper is being used to complete the reimbursement process.


8 Reasons Why Medical Billing Clearinghouses Is A Must Have Option For Your Business?


1) Their claim scrubbing software catches errors that you may have made during the data entry process.


2) Once errors are found they let you know in real time where the mistakes were made for each and every claim so you can correct them thus reducing the chances of receiving rejected claims.


3) Because they submit your claims electronically to the insurance carries it will dramatically reduce your reimbursement times to under ten days. I guarantee your clients will love you to death and pay on time each and every month.


4) Electronic medical billing clearinghouses eliminates the need of you manually re-keying data over and over for each payer which saves you hundreds of man hours in data entry. Not to mention that because they have the insurance carries information in their system the less you have to worry about human errors being made when transmitting the claim information.


5) They allow you to submit all your claims at the same time, rather than submitting them separately for each individual carrier. Again, the faster and more cleanly your claims are submitted to the carries the faster the payments will be received by your client.


6) They provide you with a secondary location from which to manage all your submitted electronic claims. Your primary location is the back ups that you create of your work on a daily basis like on your computer, on CD/DVD, Flash Drives and off site location services like


7) Medical billing clearinghouses save you from spending valuable hours of your time being on-hold following up on claim errors or rejections with several different insurance carriers.


8) They drastically reduce and almost eliminate the need for you to print paper forms (known in the industry as dropping your claims to paper), envelopes and spend on stamps. In the event I haven’t been clear up to this point they “Get Your Clients Paid Faster” so “You Can Continue To Service Their Needs” which “Will Make Them Refer More Business To You Without You Having To Ask Them” and in turn “Your Profits Will Skyrocket”.


Electronic Medical Billing Clearinghouses Must:medical billing clearinghouses webpage checklist image


Provide You With A Huge Payer List To Choose From


They Should Be Nationwide NOT Regional


Provide Sync Support For The Type Of Medical Billing Software You Are Using To Create, Batch and Submit Claims


Have An Easy To Get Out Of Contract


Provide Excellent Customer Service and Support


Give You Online Access To Update, Track and Manage The Claims You Have Submitted


Not Charge Excessive Monthly Fees That Are Beyond The Industry Norm


Medical billing clearinghouses must Provide You With The Ability To Process the following (Note: Some of these services can be offered to your clients at an additional charge thus increasing your profits per client):

a) Eligibility Verification

b) Sent File Status

c) Claim Status Reports

d) Rejection Analysis

e) Drop and Mail Paper Claims If Needed

f) Secondary Claims Processing

g) Electronic Remittance Advice (ERA)

h) Patient Statement Services

i) Payment Processing Reporting

j) Transaction Summaries and Reports Of All Your Clearinghouse Activity


2016 – 2017 Medical Billing Clearinghouses Listing For Medical Billing Businesses


There are hundreds of clearinghouses however, this list consists of the ones that are and have been know to support home based medical billing business owners (the one’s I really like are denoted by a *):


*Zirmed Clearinghouse = (877) 494-7633


*Office Ally = (360) 975-7000


*Kareo = (888) 775-2736


Claimsnet = (800) 356-1511


Hew EDI = (877) 565-5457


*Capario = (800) 586-6870


McKesson = us/ (415) 983-8300


Relay Health = (800) 778-6711


Transmedic = (800) 795-6108


Emdeon Corporation = (877) 932-6301


Affiliated Network Services = (866) 865-0057 (ext.234)


Ingenix Cleringhouse = (800) 341-6141


Free Claims = (281) 325-0208


Gateway EDI = (800) 556.2231


Healthcare Data Exchange = (866) 439-3341


InstaMed = (215) 789-3680


iPlexus = (866) 337-4014


Jet Claims = (727) 943-2942


MEDTranDirect = (855) 855-6637


Navicure Clearinghouse = (770) 342-0200


Payerpath = (800) 877-5678


RealMed = (877) REALMED


Signature Claims = (877) 744-2561


SolAce EMC = (602) 439-2525


Medical Billing Clearinghouses – My Final Thoughts


Home based medical billing is a business that provides physicians with several levels of services and a clearinghouse does the same for the medical billing business owner. Be absolutely certain that you shop around for one that best fits your needs and budget but DO NOT choose one strictly because of your budget.


Your clearinghouse must do at the very least the functions I have listed above because if you have to wait due to customer service issues you will lose money, your personal and business credibility, and finally your valuable clients.


Lastly, pay special attention to the start-up and enrollment fees that you may have to pay for each practitioner or practice you will be submitting claims for because those charges take away from any profits that you as a medical billing business owner will make.


There are medical billing clearinghouses in the marketplace that charge flat fees regardless of how many physicians you bill for now or in the future so proper research is the best way to keep your business expenses to a bare minimum.


Now that we have completely covered the topic of clearinghouses, let’s move on to:


Medical billing forms & how to fill them out correctly


I really enjoyed sharing with you today and I hope you learned what a medical billing clearinghouse is and why you will need to utilize one to run your medical billing business.


Here’s To Your Success!


External Medical Billing Business Clearinghouses Resources


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