Friday, August 8, 2008

Clearinghouse that receive Online Claim Status 276/277 reports

A medical billing service with over 150 providers / 80 data bases asked me one day on my thoughts of creating a medical software that would search medical insurance carriers websites for medical claim status. I explained to him that last year I had the same thoughts when I was frustrated checking online claim status for so many patients. I thought if I had a software system that could go out, log in to these medical insurance carriers websites and check for me it would save me 100's of hours.

Well, that got me to thinking that their has to be a better way and I also figured someone else must surely have already created it. So I searched high and low until I found this website: Practice Management Software Reviews and I was searching through the navigational bar and found a link for Medical Clearinghouse Reviews. I began clicking on the links to read more about the clearinghouses when I read that these clearinghouses could check claim status for those claims you submitted electronically through them. I was in awe!

So, I asked the VP of the billing service what clearinghouse he uses and he said RelayHealth. I told him he was in luck! His clearinghouse does receive the 276/277 reports . He mentioned that his practice management software is interfaced with RelayHealth so I told him to follow up with his PM and ask them to create a interface to receive the claim status reports from RelayHealth. He was excited knowing this was an option that he can present to his software vendor!

How Does this help for big or small medical practices -
Picture this - the client bills out over 16,000 claims a month. Of those 16,000 claims lets assume that all are being submitted electronically. He has claim scrubber and other tools that assists him in sending 95% of his claims clean resulting in a average of 5% denials or 800 denials a month. What if he had a tool that could search for those 800 claims within minutes and notify his billing office the status of the claim i.e.


  • claim pending
  • claim denied for XYZ
  • claim paid with check #, $ amount and mailed to
  • claim not on file
  • claim processed on XX/XX/20xx and check is coming
Within minutes his billers know what is expected and can promptly work those denials without having to first call for the status of ALL claims. Just think how this can change your business dynamics!

Clearinghouses that I was able to find
that accepted the 276/277 reports.

Expect more /get more!

ANS Affiliated Network Services
Instantly Track and report on claims status

Availity ThinEDI software
Manage accounts receivable by checking claim status for processed claims

Electronicclaim.net
Get check numbers and check dates on paid electronic claims
Detailed status of each outstanding electronic claim
Uses
837Direct to generate electronic Status Requests
Easy to use Wizard to generate 276 electronic claim Status Requests
837 electronic claim Batch Transmissions can be confirmed
Inquire on the Status of any outstanding electronic claims
Inquire on the status of multiple electronic claim batches

Emdeon
With Emdeon Vision, payers have the ability to perform claim searches, verify claim status and generate a variety of claim trending and summary reports

ENS Electronic Networking Systems
ECT allows you to quickly search any claims you have sent and ensure they were properly received by the insurance payer within seconds.
Greatly reduce follow-up time and phone work tracking unpaid claims
Track all claims online using quick or advanced search options
Easily print or view the results on your screen
Real-time response, accessed via the Internet

Gateway EDI Clearinghouse
Unlimited Individual Claims Status Inquiry

InstaMed clearinghouse
Get answers to your claim submissions in seconds, including claim acceptance, pre-adjudication results on eligibility, clinical coding verifications, and WEDI levels 1-7 claim edits.

Medavant
To find your claim's status at the payer, run a Claim Status Inquiry (CSI) for real-time information at every stage of the adjudication process.

Medx12
The MedX12 Claim Status Inquiry feature allows physicians and other healthcare providers to easily access up-to-date information on previously filed claims. By providing you with the most current status received from payers, we help you manage your accounts receivable and reduce the costs incurred in contacting the payer for an updated status.

Navinet
easily and efficiently submit, track, check the status of claims, and reconcile reports, electronically.

PayerPath
efficiently submit online, real-time inquiries to payers about the status of a transmitted health insurance claim. Even better, you'll reduce the amount of time spent manually checking a health insurance claim status while at the same time improve record keeping.

RelayHealth
RelayHealth’s website does not specify all of the reports they support however; they do offer them

ZirMed
Our Claims Tracking feature allows you to follow the progress of the claim every step of the way


For more information on how to Read EDI Reports:
How to read EDI clearinghouse reports
Clearinghouse EDI Reports
Clearinghouse Online Claim Status EDI Reports


Tags: Clearinghouse, Clearinghouse Reports, Who offers 276/277 Clearinghouse Reports, Claim Status clearinghouse reports, medical billing, medical insurance, claims filing, online claim status, electronic claim status review, understanding the status of your medical claims in a timely filing fashion, Medical claims processing, collections, billing, insurance, carriers, insurance carriers claims status, checking insurance carriers and the status of outstanding claims, filing of insurance carriers, knowing the accounts receivable, aging, medical collections, medical insurance claim filing, secure claims status check, private, free, tips, tricks, suggestions for saving time in the medical office, hospitals, employers, physicians, doctors, medical offices, hospitals, understanding EDI reports, clearinghouse review, what clearinghouses can offer, understanding insurance claims and reports

4 comments:

  1. Hello,
    I am in process of developing a tool, which should get the claim status(276/277) from the clearing house and update the status to the provider. this post perfectly matches with my requirements. is there any free/demo tool available? please give your suggestion on completing my task.

    please update your research status regarding this post.

    Thanks,
    Idris Gani R

    ReplyDelete
  2. Hi Idris,

    I would suggest sending your contact information to me using the comments option (I just won't release the comment to the general public).

    My initial question is:
    1. Are you developing software that can handle interfacing with the Insurance Carriers Website
    2. Are you looking at developing software to interface with the Clearinghouses?
    3. Do you want the information to be interfaced with the Practice Management Software or are you just looking at sending reports / data to the doctor’s office?
    4. Does the Clearinghouse, Insurance Carriers support API (Application Program Interface) which is like having a back door to the system with Calls which support you in the development piece of the software?

    I do not currently have a video of the steps required to complete a process this in depth but I would try and assist you with this project if you want to contact me.

    Regards,
    Jennifer

    ReplyDelete
  3. Can I ask a question without it being posted?

    ReplyDelete
  4. Hi Randy,

    Sorry, it took me a while to get back to you I was having logging in issues with Blogger.

    Yes, just make a comment and include your contact information. I will not publish comments with personal information.

    Look forward to talking to you soon,

    Jennifer

    ReplyDelete