Man working on laptop

4 benefits of a clearinghouse for home health and hospice

Home health and hospice agencies often mistake a clearinghouse as a tool just for uploading claims and downloading payments, but it can be much more. A clearinghouse is also a place where payments can be received, keeping everything in one location — which streamlines a process that typically requires multiple web portals. It can provide better visibility into the entire lifecycle of the billing process and make it easier on teams to follow up on everything.

In this blog, we explore four benefits of using a clearinghouse.

A clearinghouse can improve home health and hospice operations

Since all claims can be submitted to one location, the clearinghouse scrubs everything. This means that organizations are likely to have a cleaner claim rate because clearinghouses work with payors on an ongoing basis, they know what each payor requires, and they can easily identify problem areas within the software setup causing claim issues.

Without a clearinghouse, there’s no up-front scrubbing designed to identify problems before claims are sent to the payor. Rejected claims can take up to 30 days just for the payor to communicate denial reasons — which means delayed payment for your organization.

A clearinghouse allows you to see trends

When a clearinghouse has an analytics program, organizations get visibility into denial reasons. Is it a payor for a certain region, potentially caused by a software glitch? Is it new regulation your organization isn’t aware of? While there might be one-off denials, there will always be trends and room to improve. A clearinghouse can provide a bigger picture so you can dig a little deeper to fix it.

A clearinghouse can fix the problem at the source

The goal is never having to touch a claim after it leaves the software (you should strive for a 98% clean claim success rate). But when issues arise again and again, a clearinghouse not only identifies that trend, but also fixes it at the source — saving you time on administrative tasks so you can focus more on patient care.

A clearinghouse features a denial management tool

Just receiving payments back through the clearinghouse doesn’t provide a full picture of your business. Getting your remits back through the clearinghouse allows that data to be scrubbed and into the analytics program, where it looks for anything denied and why — saving time and resources if done manually. The denials can then be corrected and resubmitted with ease and efficiency.

Other benefits of using a clearinghouse include:

  • Detailed eligibility reports
  • Tracking claims based on pay date and amounts vs. payment
  • Historical data to understand how long a claim has been an issue
  • Notification of payments coming

Using a clearinghouse for home health and hospice claims has become pretty standard, but not all clearinghouses are created equal. Free options lack major benefits and the features of paid options vary. Be sure to determine the needs of your organization and consider whether your clearinghouse can deliver.

Connect with us to learn how we can help streamline your claims process and ultimately improve your operations.

Jeremy Crow

Jeremy has been employed as the Director of Revenue Cycle Services since January 2020. He possesses extensive expertise in the Healthcare Information Technology field, specifically in Home Health and Hospice, spanning over 25 years. Throughout his career, Jeremy has collaborated with Fortune 20 and private equity companies, specializing in project management, training, consulting, custom technical services, and overall professional services operations. He has successfully overseen multinational teams, introduced new services, and facilitated the integration of acquisitions. Jeremy holds an MBA from Washington University in St. Louis and has been PMP certified since 2004.

Two office professionals looking at a laptop

See MatrixCare in action

Start by having a call with one of our experts to see our platform in action.