Clearinghouses and How They Impact Your Bottom Line...
Billing Services typically submit claims electronically to a clearinghouse. The
clearinghouse then edits,
formats and submits this
 claims information to the
various insurance companies for payment. The reason
clearinghouses are important is that
they have the ability to meet the specific data requirements of each insurance company and their specific computer formats.
They can therefore submit claims to any insurance company that accepts electronic claims. This task is essential for electronic claims as it is
too complex to perform them independently on your own. You would need to
communicate electronically with perhaps dozens of insurance companies. Instead, you only have to communicate with a single clearinghouse.
ClaimTek's software provides you with flexibility in working with multiple
clearinghouses nationwide. You are not limited to just one like in the case of
some competitors. When you have your own
business, you need the freedom of choice. If you become dissatisfied with one
source, you can choose another without interrupting your business or being
forced to change your software. You should be concerned if any software you're
shopping allows only one choice for a clearinghouse.
Pay Less in Clearing House Fees With ClaimTek Systems
Keeping Your Costs Down is a Major Contributor to Small Business Success.
Compared to our competitors, ClaimTek Clearinghouse fees will
actually save you thousands of dollars each month adding tens of thousands to
your bottom line each year. Some of our competitors that use web-based
applications offer only one clearinghouse
choice with higher fees (about $1 per claim) for kickback commissions that put tens of
thousands in their back pockets while directly lowering your profit margin.
These kinds of secret business tactics are dishonest and uncalled for. Compare
for yourself with this helpful Clearinghouse fee chart below:
Number of Doctors
(based on the national average of 440 per month) |
Number of claims per month based on
the national average |
ClaimTek (flat fee average of $50 per
doctor/month). |
Browser-Based Competitors charging $1 per claim! |
| 1 |
440 claims/month |
$50 |
$440 |
| 2 |
880 claims/month |
$100 |
$880 |
| 3 |
1,320 claims/month |
$150 |
$1320 |
| 4 |
1,760 claims/month |
$200 |
$1,760 |
| 5 |
2,200 claims/month |
$250 |
$2,200 |
| 10 |
4,400 claims/month |
$500 |
$4,400 |
| 20 |
8,800 claims per month |
Only $1,000 |
$8,800 cost
per month
Money out of your pocket and into the company's! |
While our software is accepted by the majority of clearinghouse across the
nation we found that some have better service and pricing than others. We
recommend that you use one of the following for their outstanding service.
 Gateway
EDI: $86/mo Flat-Fee
 ENS-Health
| $60/mo Flat-Fee
 ET&T
- 35 Cents Per Claim
FreeClaims.com
$30/mo Flat-Free
Automated Clearing House |
For
Electronic Fund Transfer Service (EFT)
The ACH clearinghouse is where the Electronic Fund Transfer EFT transactions are sent. The Automated Clearing House (ACH) is the electronic network to which 95% of the nation's banks belong,
including the Federal Reserve.
For ACH, there is a one-time fee of $50. The cost per transaction starts at $0.45 but can be reduced to $0.23 depending on volume (this is explained in our Medical Billing Manual). Once you start processing transactions, a $25 monthly fee applies. There is no additional setup fees for new account or any annual fees.
Fees to all clearinghouses are not due until you start processing claims or EFT transactions.
|
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