HOW A MEDICAL CLAIMS CLEARINGHOUSE WORKS

Here’s the nuts and bolts of how it works. The medical billing software on your desktop creates an electronic file (the claim) also known as the ANSI-X12,  837 file, which is then uploaded and sent to the medical billing clearinghouse chosen. The clearinghouse then scrubs the claim, which means it is checking it for errors : arguably the most important thing a clearinghouse does; is scrub: which means to check for errors of submitted claims information.  Then once the claim passes inspection, the clearinghouse securely transmits (also very important) the electronic claim to the specified payer with which it has already established a secure connection, that meets the strict standards laid down by regulations which called HIPAA Transactions’.