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Doctor billing format for Security

when you schedule a doctor's appointment there are three things they typically ask you can you guess what they are if you guessed your name date of birth an insurance provider you guessed right they ask you this information because it goes into what is called a patient management system once the information is added to the system the revenue cycle begins ever wonder how medical facilities manage patient data insurance claims and billing all at the same time it's possible because of a medical billing clearing house but what exactly is a medical billing Clearing House let's break it down let's start with just the definition of a Clearing House a clearing house is an agency or organization that collects and distributes something especially information they have the resources to distribute payments enforce security measures and monitor transactions or statements it ensures all elements of a deal or transaction follow the rules and that there is no funny business going on now what is a medical billing Clearing House a medical billing Clearing House more often referred to as a medical claims Clearing House assists medical billers and Healthcare organizations in processing and managing thousands of patients insurance claims and billing a medical billing Clearing House is essentially the middleman between healthc care providers and insurance companies this type of Clearing House make sure that there are no mistakes in the insurance claims or in the medical bills because medical billing Clearing Houses are working with Phi or protected health information they must follow certain regulations like the health insurance Bo ability and accountability act also known as Hippa medical billing Clearing Houses are important for the provider's profits the provider is the doctor or medical professional that administers care a common issue in the revenue cycle of medical practices is denied insurance claims in 2021 177% of in network claims were denied a denying claim means a delay in the provider's profit you wouldn't want to work for free right didn't think so this is why a clearing house is so important if a claim gets denied it needs to be corrected submitted and go through the approval process again but this process can take anywhere from 15 to 45 days meaning if a claim is denied even once the provider will experience a significant delay in receiving Revenue denied claims result in huge Revenue loss even if they are approved upon resubmission besides handling denied claims consumes more time and energy compared to getting them approved the first time so you might as well do it right the first time and utilize a Clearing House a medical billing clearing House's goal is not only to help with the submission of claims but also minimize denied insurance claims to maximize the provider's profits Clearing Houses shrink the number of denied claims through claim scrubbing claim scrubbing is the validation checks the Clearing House performs before it is sent to the insurance provider almost like a spell check this improves the claims odds of getting approved and the provider gets paid on time have you ever waited months to see your primary care doctor or your dentist I know I have now imagine if your doctor had to do hours and hours of paperwork after each patient if this was a part of their job description you would never get that appointment regardless if you are a payer provider or just a patient you're a part of this never-ending revenue cycle if you would like to learn more about medical billing Clearing Houses reach out to e tactics and you already made it this far in the video so might as well like share and comment below