By definition, a clearinghouse is a company that functions as an intermediary between the provider's PM system and the insurance payer. Clearinghouses review claims for common errors and provide a pathway for the payer to return electronic files that contain processing information.
Clearinghouses allow for things such as:
- EDI Connection - allowing claims to be submitted electronically to the insurance payer
- ERA Connection - allowing claim processing information, including payment notifications and denials to flow into DrChrono and post electronically, eliminating quite a bit of work for billing staff members. ERAs are also referred to as electronic EOBs.
Currently, DrChrono utilizes eProvider Solutions (ePS), Change Healthcare (fka Emdeon), TriZetto, and Carisk Partners (fka iHCFA). Please notify your Implementation Specialist if you have an existing relationship with one of the above-mentioned clearinghouses.
To establish the EDI and/or ERA connections with payers, paperwork is usually required. Some can be completed online, while others will require a wet signature from the office. You will work with your implementation specialist to identify which payers you bill so that the enrollment requests can be submitted to the clearinghouse. A representative from the clearinghouse will reach out to you directly and assist with the paperwork needed to establish the connections between your DrChrono PM and the payers you will be submitting to.
** Please note, that not all payers allow for electronic claim submission (EDI) or electronic remittance advice (ERA). Your Implementation Specialist and/or clearinghouse representative will work with you to identify and establish a workflow for those payers.