Losing Thousands to Billing Delays? TherapyPM’s Clearing House Integration Can Stop the Leak

As a therapist, have you ever been denied claims? It can frustrate you as it affects your practice’s cash flow. But have you ever wondered if it is just happening for you?

No. You are not alone. According to a recent industry report, one-third of MA beneficiaries experienced a denial for 1 or more services in 2022. This totals to approximately $150 million. 

This number is huge. It can cause problems in cash flow and can significantly affect your practice’s financial stability. 

So how do you handle this?

Taking care of all the claims submitted, cross-checking the medical codes, and preparing them for billing can take away a lot of time. Dedicating a separate team is also not a good idea, as you need experts to handle these tasks, which might shoot up your budget.

This is where the clearing house comes to the rescue. It helps to automate critical tasks such as claim scrubbing and validation, checks for errors in claims submitted, and reduces rejection. 

In this blog, let us understand why clearing house integration is essential for your practice and how it can help you spend more time with your clients. 

Key Takeaways

• Integrating with a clearing house helps to streamline billing and reduce errors.
• Improve reimbursement rates with the help of automated scrubbing validation.
• Ensures a smooth revenue cycle for therapy practices by reducing errors.

Claim rejection: Why does it occur?

Claim rejection: One of the common reasons that disrupts the financial wellbeing of a lot of practices occurs due to the following reasons:

• Coding errors: using incorrect codes for the treatment provided to the clients.
• Missing information: missing key details while submitting claims, such as patient information, service provided, or insurance details.
• Non-compliance with insurance requirements: submitting claims without adhering to the requirements of specific insurance providers.
• Billing for eligible patients: Billing the services provided for patients who do not have active insurance coverage.

These are the top 4 reasons for claim denials. Now let us understand what a clearing house is and how it can help to mitigate these issues. 

Clearing House Integration—What is it?

Consider clearing houses as a bridge between therapy practices and insurance players. It clearly communicates the billing formalities between the two parties and helps to ensure faster and smoother reimbursements.

Clearing house electronically transmits billing information by understanding the payer requirements correctly. It checks some of the crucial components for reimbursements, such as incorrect coding for the treatment provided or missing details regarding treatments, before submitting claims to insurance companies. This is done to significantly reduce the chances of claim denials. 

Some benefits of clearing house integration include:

• Faster processing of claims,
• Reduces administrative burden by eliminating manual submission,
• Provides therapists the real-time status of claims and 
• Saves a lot of time for therapists and helps them focus on client care.

Clearing House Role in Reducing Denials

Clearing house acts as a shield and helps to prevent claim denials. Let us understand how it does this in this section.

• Scrubbing Validation 

Cleaning houses uses scrubbing validation, a process that helps identify errors before submitting applications. This process checks if all the required fields are filled and prevents errors due to incomplete or missing items.

It also confirms if the services provided are coded with the right CPT codes. This helps to reduce errors due to incorrect coding. Finally, it also validates if the applications are submitted without formatting issues and notifies therapists if any.

• Adhering to Regulatory Compliance

Insurance providers and Medicaid update the regulatory requirements frequently to prevent insurance frauds. It is difficult for therapists to keep track of this every time. Adhering to these requirements is crucial to get reimbursed. 

Clearing house tracks these requirements and updates its database regularly. On submitting the application, clearing house checks if it is in line with the recent updates. If not, it will be intimate therapy practices to make changes, preventing claim rejections.

• Rectify Errors Before Submission 

If you submit the application with errors directly to insurance providers, you will never be given a chance to rectify them. They will be straightaway rejected. 

On the other hand, the clearing house notifies these errors. It flags invalid items and will offer suggestions to rectify them. This saves a lot of time and manual effort for your practice. You can submit clean claims on the first try without the worry of getting rejected.

• Real-Time Monitoring

Post-submission, tracking the claims becomes easy with the clearing house. It displays claim status in real time with issues, if any. This helps therapists to correct the issues and resubmit the application. This speeds up the reimbursement process, avoiding any last-minute rejections or delays. 

Role of Practice Management Software in Billing 

Integrating with Therapy Practice Management Software can simplify the billing process even further. It helps to automate claim submissions, track claim status, and ensure that the billing happens with no hassle. It helps therapists to integrate clearing house functionalities and thus save a lot of time. 

Looking for one such software that can make your billing process easy? Meet TherapyPM, our intuitive, easy-to-use practice management software.

TherapyPM has an advanced scrubbing validation feature that gives actionable feedback to rectify errors. This helps practices know what is wrong and provides a change to rectify errors before submission. 

With TherapyPM, you can submit the applications directly to the clearing house digitally, without the need for manual billing.

Eliminate paperwork, go digital, and get yourself a lot of time with TherapyPM. 

Start now and enjoy a 30-day free trial. 

Final Words

In summary, clearing house integration is not just a tool. It is a strategic approach to reduce claim denials. By using practice management software that integrates clearing house features, you can significantly reduce claim denials and ensure a smooth cash flow for your practice. 

Embrace clearing hhouse integration and improve your revenue cycle management.