Know your clearinghouse and the services they offer. Your clearinghouse is vital to your claim submission process. Know how to gather information received from your clearinghouse and learn the platform for efficient processes.
Important to note: Not all clearinghouses are created equal. Some may charge more than others and some charge a flat fee or per claim sent electronically.
Interface Ability – Your clearinghouse should interface with your practice management software to ensure that all features are fully functional.
Comprehensive Support – Support should be provided in real time. Nothing is more frustrating than not having a way to contact the clearinghouse. Do they give you a real person to speak with?
Eligibility Verification – The clearinghouse should provide real time eligibility verification that can be run prior to your patients appointment.
Claim Status Reports – Your clearinghouse should provide you with same day claims receipt verification. And for that “Claim not on file” rejection, the system should provide you with proof that the payer received the claim.
Rejection Reports – Claim rejection reports should be clear and easy to read.
Printed Claims –You should have the ability to easily convert electronic claims to a printable format.
Advanced Revenue Cycle Management Features: Over and above just processing dental claims, the best clearinghouse providers offer many highly desirable advanced features such as: Eligibility Verification, Sent File Status, Claim Status Reports, Rejection Analysis, Paper Claims (created for you and mailed when necessary), Secondary Claims Processing, Electronic Remittance Advice (ERA), Patient Statement Services (you no longer have to mail out all those patient statements each month), Payment Processing, and finally, Transaction Summaries of all your clearinghouse activity. These advanced features make a good clearinghouse worth its weight in gold.
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“Chris set up an efficient system that allows insurance companies to pay me via direct deposit. She did an amazing job, and I love getting paid quickly from insurance companies.”