Clearinghouses and EHR: How to Make Them Work for You

 

claims clearinghouseMany of you already know what a clearinghouse is. For the uninitiated, a claims clearinghouse is the conduit through which claims are submitted to various insurance companies. However, most clearinghouses do much more: they enable providers to check eligibility, check the status of and scrub claims, and retrieve payment information in electronic format (also known as electronic remittance advice-ERA).

There are several clearinghouses, some of which connect to thousands of insurance companies, and others, less. They can be further segregated by the additional services they provide, and whether they are paid or free.

As medical practices and hospitals endure, they establish relationships with and become partial to certain clearinghouses that provide certain feature sets. Likewise most EHR systems that include practice management features integrate with one exclusive claims clearinghouse. Therefore it becomes extremely difficult for practices to transition to a different EHR vendor.  

It would be naive to think that this is not done deliberately. Every act by vested, monolithic EHR companies is designed to increase the stickiness of the customer, leaving the customer no choice but to stay with them.

This is what the blueEHR system is committed to disrupt. blueEHR allows for the integration of the medical billing clearinghouse of the customer’s choice. Moreover, blueEHR can be integrated with multiple clearinghouses for medical claims at the same time, enabling the customer to choose which medical billing clearinghouse they send a specific set of claims to. The blueEHR system is integrated with Emdeon, Zirmed, and Availity but is capable of connecting with many other clearing houses.

blueEHR does not just stop there: this philosophy of choice permeates every aspect of the product. A customer can choose their e-prescription provider, or payment gateway, or preferred laboratory, or reminder systems. You get the idea.

blueEHR offers APIs (application programming interfaces) that enable bi-directional interfaces to various platforms and services. Our eHealth platform can communicate with any practice management (billing) system, and is encrypted, so data is secure.

The healthcare tech industry has a responsibility to provide open EHR systems that are compatible with a variety of additional services. It is imperative that some providers in the electronic health industry be technology or software agnostic – in this age of technology there is no reason why clients should have systems that work for them.

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