Healthcare Clearinghouse Solutions

A healthcare clearinghouse acts as a middleman between healthcare providers and health insurance companies, specifically in handling medical claims. Here's a breakdown of their key functions:

Standardization:

They convert medical billing data into a standard format, ensuring it's understood by insurers with different requirements.

Error checking:

Clearinghouses meticulously check claims for errors or missing information that could lead to denials and payment delays.

Eligibility verification:

They verify a patient's eligibility for coverage with their insurance plan before submitting the claim.

Secure transmission:

Claims are securely transmitted electronically to the appropriate health plan using secure connections that comply with HIPAA regulations.

Claim status tracking:

Clearinghouses can track the status of claims submitted, allowing providers to follow up on payments and identify any issues.

Healthcare clearinghouses streamline the claims submission process, minimizing errors and expediting reimbursements for healthcare providers.

View Clearinghouse Solutions Business Partner List

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BUSINESS PARTNER COMPANY WEBSITE DESCRIPTION
1 EDI Source1edisource.comHQX is a new innovative platform comprising of multiple EDI products
AdvancedMDadvancedmd.comComplete medical office software solution
Assertusmobile.assertus.comASSERTUS offers a new generation of Clearinghouse service for the processing of health transactions between healthcare providers and insurance companies
athenahealth, Inc.athenahealth.comMedical practice automation and claims management software to medical groups and health systems.
Availity LLCavaility.comProvides Internet-based health information exchange services.
Avidityavidityhcs.comAvidity Health Care Solutions, Inc. is a progressive management service organization with an emphasis on health plan government program operations.
AVS Medicalavsmedical.comSimplify the billing processes and leverage revenue cycle management services to support staffing and claim denial management.
Benchmark RCMbenchmarksystems.comExpedite collections and maximize reimbursements with Benchmark RCM.
BillPronybillpro.comBillPro is an efficient Medicaid billing software for transportation companies in New York
Carisk Intelligent Clearinghousecariskpartners.comCarisk Partners is a specialty risk transfer, care coordination company serving insurers, government entities, self-insured plan sponsors and other managed care organizations.
Change Healthcarechangehealthcare.comExtensive network, innovative technology, and expertise inspire a stronger, better coordinated, increasingly collaborative, and more efficient healthcare system.
Cirius Groupciriusgroup.comStarted from a simple concept that by automating claim processes in billing and reimbursement there could be a way to positively impact employee’s day to day workload. This would allow staff to get more done with less stress and at the same time help healthcare organizations achieve stable cash collections and minimize cost.
ClaimShuttleclaimshuttle.comPerform claim entry, claim corrections, and claim and payment inquiries with ClaimShuttle's secure Internet access to the Medicare Enterprise Data Center's (EDC) FISS/DDE system.
Claimgenixclaimgenix.comClaimgenix is a fully automated medical billing software service that ensures claims are submitted accurately and on time.
ClaimRevclaimrev.comWe take pride in offering tailored solutions to reduce claim denial rates and optimize revenue for healthcare providers, especially those serving Tribal communities.
Claims Bridgewww2.claimsbridge.comOur solutions provide the infrastructure and expert support that help employers, administrators, payors, providers, and healthcare networks gain control over healthcare coverage and costs.
Conduentconduent.comConnecting payers and providers to streamline claims submissions, improve claims accuracy and enhance auto-adjudication rates.
Cortex EDIcortexedi.comCortex EDI's Ebill Cloud is a practice management software that can be accessed from any computer, at any location, and at any time.
Data Dimensionsdatadimensions.comData Dimensions is a technology services company that provides integrated solutions for the P&C industry with our EDI CLEARINGHOUSE, DIGITAL MAILROOM & PAYMENTS services.
DataLink Solutionsdatalinkms.comDataLink offers Payment Solutions that automate the payments process and patients are happier as well.
DataTrans Solutionsdatatrans-inc.comDataTrans specializes in supporting your company’s needs with our multichannel EDI and eCommerce software solutions empowering your business.
efficientCos-healthcare.comPowerful denial analytics, claim scrubber and clearinghouse technologies
Electronic Medbilling & Associateselectronicmedbilling.comOur main goal is to Minimize your Cost, Increase your bottom line by Maximizing your Reimbursement
Emedixemedixus.comeMEDIX helps organizations discover the best path to overcoming healthcare payment struggles.
eTACTICSetactics.comClearinghouse, Invoice Services, Pharmacy Statement Services, Revenue Cycle Management, Invoice Solutions, EDI, Eligibility, Appealing Denied Claims
Everesteverestar.comOur clearing-house services are designed to eliminate the need for manual data entry and paper submissions, which can lead to errors and delays in payment.
Experian Healthexperian.comWe partner with over 63 percent of US hospitals and 7,700+ other risk bearing entities to provide data-driven insight, connecting and simplifying healthcare for all.
FinThrivefinthrive.comRevenue management to advance the healthcare economy
Fusion EDIbellmedex.comFusionEDI® is a healthcare clearinghouse EDI software for an ‘instant’ transmission of claims with absolute accuracy.
Greenway Health, LLCgreenwayhealth.comElectronic health records (EHR), practice management, and revenue cycle management solutions
Health Catalysthealthcatalyst.comHealthcare organization with powerful data, analytics, and expertise that improve performance and quality of care
HealthEChealthec.comHealthEC® delivers fully integrated analytics and insights that enable value-based health systems and care organizations to identify high-risk patients, close care gaps and recognize barriers to optimal care.
Health Smarthealthsmart.comHealthSmart is one of the largest third party administrators in the country and the premier provider of customizable and scalable health plan solutions for self-funded employers.
Infinediinfinedi.netInfinedi Electronic Data Interchange creates software solutions for electronic claims processing, business analytics, electronic statements and third-party office management tools for medical facilities across all 50 states.
Inmediataportal.inmediata.comOur clearinghouse leverages our business rules and facilitates the claims process, validations, analysis and follow-up.
Inovaloninovalon.comInovalon is a leading provider of cloud-based solutions empowering data-driven healthcare.
Instamedinstamed.comBoost cash flow and optimize revenue cycle while increasing staff efficiency.
InterSystems Corporationintersystems.comBuild a Foundation for the Future with Clinical Data Archiving
Madaket, Inc.madakethealth.comData Management (PDM) platform gives you full control of your healthcare administrative ops.
MaxRTEmaxrte.comHelping healthcare organizations strengthen their finances for 20+ years
NantHealthnanthealth.comWe build technology that simplifies healthcare. · We manage the data and decisions that help the healthcare industry deliver better care.
Netsmartntst.comPartnering with providers to deliver value-based care through technology, services, and advocacy.
Net Healthnethealth.comBuilt for providers by clinicians, our intuitive Electronic Health Records (EHRs) and analytics tools deliver business efficiencies to reduce claim delays and better engage patients.
NextGen Healthcarenextgen.comTransforming ambulatory care with a powerful healthcare IT platform and state-of-the-art EHR and Practice Management tools. Discover how today!
NGSConnexngsmedicare.comNGSConnex is a free, secure, web-based application developed by National Government Services just for you! NGSConnex provides access to a wide array of self-service functions that save you time and money
nThriventhrive.comWe rethink revenue management to pave the way for a healthcare system that ensures every transaction and patient experience is addressed holistically.
Office Allycms.officeally.comWe are here to support healthcare providers and payers with high-value software solutions that are reliable, affordable, and easy-to-use.
PHI Curephicure.comAt PHIcure we create Clearinghouse and Banking Reconciliation solutions for optimum financial health.
PNT Datapntdata.comAt PNT Data, we’re committed to providing superior customer service to all of our partners and customers
Practice EHRpracticeehr.comPractice EHR supports efficient and accurate reimbursement, regardless of the EHR or practice management software you choose to use.
Practice Solutionspracticesol.comPractice Solutions, LLC provides mental and behavioral health billing solutions and services to your practice, freeing you up to focus on providing best-in-class care to your Patients and growing your practice.
Precision Hubprecisionhub.comPrecision Hub’s full-scale healthcare practice management services cater to every clinic’s needs.
Quadaxquadax.comOffers premier healthcare revenue cycle software solutions supported by a first-class customer service organization.
SMARTDATA SOLUTIONSsdata.usIndustry Leader in Healthcare Process Automation
SSIthessigroup.comLeading provider of revenue cycle management solutions and analytics
Switch RCMswitchrcm.comOur team of patient access and revenue cycle experts will collaborate with your organization to increase your staff’s efficiency and workflows, using our data-driven solutions.
Transact RXtransactrx.comThe Nation’s Only Cross Benefit Clearinghousev
TriZetto Provider Solutions, a Cognizant Companytrizettoprovider.comProvide complete revenue cycle management services to empower our clients to succeed.
TruBridgetrubridge.comHelps healthcare organizations of all sizes clear the way for care. We understand many things get in the way of providing great patient care.
Veradigmveradigm.comVeradigm is focused on research, analytics, and building scalable data-driven solutions of value for ALL healthcare stakeholders.
VisibilEDIvisibiledi.comVisibilEDI delivers real-time healthcare EDI transaction management and encounter data solutions that are simple, transparent, secure, and accurate
VisionWebcontent.visionweb.comStreamline Your Billing with Our Electronic Claims Clearinghouse
Waystarwaystar.comMarket-leading technology that simplifies and unifies healthcare payments
WellSkywellsky.comWellSky Revenue Cycle Services delivers timely, compliant, and accurate billing to maximize cash flow and help ensure revenue integrity.
ZOLL Data Systemszolldata.comOur cloud-based platform helps you manage the unique challenges of healthcare from EMS dispatch, to facility discharge, to billing and AR optimization.

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