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Simplify Claims with an Integrated Insurance Clearinghouse

The Importance of Integrating Insurance Clearinghouse Software

Choosing to integrate an insurance clearinghouse software to your practice management can streamline claim processing and expedite insurance payment reimbursements. Features such as automated claim filters to check for errors and omissions, same-day automatic submission, real-time claim tracking and EFT reporting all in one place help to simplify administrative processes, leading to efficient processes for your billing team. 

What is an Insurance Clearinghouse?

An insurance clearinghouse facilitates the communication between the dental practice and the insurance payers; translating important information such as eligibility and benefit reports, claim submission, real-time claim statuses and even payment reporting. If your practice management software is directly integrated with an insurance clearinghouse, you can easily submit claims electronically, which means quicker reimbursement for services rendered. 

Key Features of an Integrated Insurance Clearinghouse 

Every clearinghouse provider is slightly different so are a list of a few key functions to look out for that can substantially improve your claiming workflows.

  1. Eligibility and Benefit Reporting: To ensure accurate claiming, eligibility checks help your team send the claim to the correct destination the first time.
  2. Automated Claim Submission: Patient and claim data is automatically passed to the clearinghouse to facilitate expedient claim submission without the manual work.
  3. Claim Check: Automatically identifies errors and omissions in your dental claims beforehand. No more back-and-forth with insurance companies due to claim denials. Submit the most accurate and effective copy of the patient claim, right from the start.
  4. Integrated Electronic Attachments: Helps to detect claims that need attachments and assist you in seamlessly attaching x-ray images, and other necessary documents to your claims in no time at all.
  5. Real-time Claim Status: Dentists can easily track the status of their claims in real-time, ensuring transparency and faster resolution.
  6. Referral Management: The software facilitates seamless referral processes, making it easier for dentists to manage and track patient referrals.
  7. Electronic Remittance Advice (ERA): Your team members receive EFT reports promptly and conveniently, all in one place instead of having to keep track of separate insurance portal logins.
  8. Optional Claim Mailing Service: The clearinghouse can facilitate printing and mailing of claims in the event that a payer does not support electronic submission. 
  9. Paperless Documentation: The software enables digital documentation of claims and referrals, reducing paper waste and improving efficiency.

If you are looking for an Insurance Clearinghouse solution that provides all of the functions above, we highly recommend EDSEDI. All DentalEMR users get automatic access to EDSEDI for insurance workflows and claim facilitation. 

Maximizing Revenue Through Streamlined Processes

For most practices, taking in-network write-offs and employing team members to manage and facilitate insurance claims comes at a huge cost. Having streamlined processes in place is crucial to ensure you are making the most of your insurance reimbursements. Not to mention, this efficiency affords you to focus more on patient care and less on paperwork.

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