Many practices around the country use a clearinghouse or want to incorporate one into their workflow. While clearinghouses are commonplace today, I am still often asked what practices should look for in a good clearinghouse and how they know a clearinghouse will benefit their practice. So how should you evaluate your current or prospective clearinghouse?
Evaluating and selecting the right clearinghouse is the first step to proactively managing your revenue cycle and maximizing profits. As the demand for physician services rises, profitability levels don’t always increase proportionately, which often causes the revenue cycle to suffer. Knowing what to look for when partnering with a clearinghouse can help you ensure your practice receives full, timely reimbursements.
Over the past two decades clearinghouses have evolved into sophisticated solutions that facilitate accurate, timely claims filing in addition to eligibility verification, payment posting and reporting capabilities. The newest generation of clearinghouses are web-based and can facilitate superior financial performance and ROI through advanced analytics, robust ROI monitoring and real-time claims status.
This advanced technology helps streamline the revenue cycle process, which ultimately leads to higher profits. With the help of the right clearinghouse, your practice can evaluate current workflow processes to determine the areas that need improvement and how to best improve those areas.
For example, you should evaluate the different steps in the patient encounter process from pre-encounter administration to patient-provider encounter and back-office administration to make sure every part of the workflow process is efficient. This includes assessing everything from scheduling, eligibility management and benefit authorization to coding, fee schedules and reimbursement management. The right clearinghouse can help you flag any issues and identify solutions to any problems throughout the entire process, which will ultimately help you maximize profits.
To learn more about the specific features you should look for when selecting a clearinghouse, download this free white paper, Managing Your Revenue Cycle: What to Expect from Your Clearinghouse.