Clearinghouse Services

The central hub to a simplified revenue cycle.

More than just a commodity.

Though often overlooked, the relationship between a hospital or health system and its clearinghouse is central to optimizing both resources and reimbursements. With a strong clearinghouse partnership, healthcare providers gain an ally that can help minimize manual labor—and human error that often accompanies it. And that’s just the tip of the iceberg in terms of benefits.

So how can the right clearinghouse make a difference?

Using a clearinghouse to submit claims electronically…

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Simplifies and accelerates the claim cycle

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Allows for more rapid claims processing and reimbursement

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Enables users to catch and fix claim errors in minutes instead of days

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Results in fewer denied claims

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Provides a single location to manage claims

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Strengthens providers’ relationships with health plans

A clearinghouse built on experience and expertise.

Over 30 years ago, we got our start as a “claims scrubber” and even as we’ve expanded our offerings over time, our clearinghouse services still rank among the best in the business. And while some health systems and physician offices assume a run-of-the-mill clearinghouse vendor will suffice, we’ve proven to clients time and time again that the right clearinghouse can have a significant impact on payer collection efforts, along with your revenue cycle team’s efficiency and productivity.

The SSI difference.

Our industry-leading first-pass clean claim rate, robust edit suite, and high-touch customer service model provide healthcare organizations with the foundation necessary for financial success. By prioritizing integration with users’ existing health information systems, we help minimize claims processing challenges and enhance communication across the enterprise. It’s no wonder over one-third of the U.S. hospital market has chosen our clearinghouse to handle their claim submission and processing.

Through use of the SSI EDI clearinghouse, organizations can seamlessly submit HIPAA transactions in real-time or batch to commercial and government payers, including Medicare and Medicaid; check eligibility and benefits (270/271); file medical claims (837P and I); receive electronic remittance (835); review claim status (276/277); send attachments (275), and submit authorizations and referrals (278).

Clients also benefit from SSI’s:

  • Involvement with key standards groups, such as CAQH CORE Rules, and CAQH CORE Payer Certification and Training
  • Advanced enrollment technology, which expedites enrollment with payers
  • Large payer network—with direct connections to 4,355 payers, users experience minimal delays in processing

About that coveted edit suite…

Our [not so] secret to success lies in the strength, depth, and breadth of our edits. We offer over 1 million edit combinations, with edits provided for more than 4,500 payers. Not to mention, our dedicated team of healthcare professionals proactively monitor payer website for revisions to payer edits. As one of the largest clearinghouses, we also monitor payer rejections to capture undocumented payer-level edits. And while our internal team of edit experts average over 15 years’ tenure, clients themselves have the ability to make changes and requests within the system. Hospital, physician office, long term care facility, and more—we cater to a variety of healthcare organizations across the continuum of care, enabling them to ensure claim compliance upon initial submission.

Learn more about the components that comprise Claims Director, our comprehensive claims management solution.