Author Topic: Direct claims submission  (Read 1034 times)

williamportor

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Direct claims submission
« on: May 01, 2014, 09:34:50 PM »
Hello- I'm considering submitting claims directly to insurance companies instead of using a clearinghouse. Can anyone give me some advise on how to do this? I use Total MD software, which is pretty inexpensive, but these clearinghouse fees are eating into my profits. 

Merry

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Re: Direct claims submission
« Reply #1 on: May 01, 2014, 10:52:23 PM »
There are reasons to use a clearinghouse.  You get the edits and error reports and in most cases not the medical office.  You may need different software for different insurance companies and you would still have to enter the info in your practice management software.  I would look at what your time is worth and analyze your business practices before making such a change.  For example Medicare will give you low cost or free software but what about your time reentering all tbe claim info and demographics in your
PMS. 

djk

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Re: Direct claims submission
« Reply #2 on: May 02, 2014, 07:28:49 AM »
I do medical billing from home part time and there are clearinghouses that submit free for Medicare claims and for commerical claims the most inexpensive one i found is Ability they submit claims for Medicare then partner with Office Alley to do the commerical claims.. I think there is a set up fee, I was with Ivans and they got bought out by Ability so i was grandfathered in. Also you shouldnt be paying this yourself, i bill the providers i do the billing for they pay for the clearinhouse monthly fee. Hope this helps

Michele

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Re: Direct claims submission
« Reply #3 on: May 02, 2014, 08:37:32 AM »
We also use a free clearinghouse.  We have been using Office Ally for years with terrific experience. (No set up fees.)

Also, we used to submit direct to insurance carriers, but in order to do that we had to purchase a software add on which was a bit costly.  It worked ok for us though for many years.  It was much more user intensive though than Office Ally.  So if we can submit free to a clearinghouse, then why pay for the software and go through the extra work.

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