Clearinghouse Integration



Tight Two-Way Integration

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Clearinghouse Integration

Many medical billing and scheduling software programs only allow a billing specialist to enter claims, but not submit the claims from their program. Consequently, these billing specialists then take the extra step of uploading these claims into a clearinghouse portal for processing. Using a separate clearinghouse and billing software can put a practice at risk of losing substantial sums of revenue due to a lack of visibility into the claims process form from within the billing software, as there's typically no integration between the billing software and the clearinghouse.

iSALUS has created a tight two-way integration between our billing software, and the Capario clearinghouse. This creates 100% transparency into the medical billing process and patient lifecycle - from the appointment to the claim, and eventually to the payment. Since iSALUS allows billing experts to submit claims from our billing software without leaving the system and logging into a separate clearinghouse, we're able to reduce claims leakage. This means when a claim's status changes at Capario, it's visible in the iSALUS application. For example, if a claim gets rejected at Capario, it's prominently displayed on a practice dashboard for everyone to see so that the iSALUS billing staff can be held accountable. This provides peace of mind for busy providers by cutting down the risk that claims could fall between the cracks between two disparate systems. Conversely, if a practice was using a separate billing software and clearinghouse without a two-way integration, a claim could be rejected and it would still display as submitted in the billing software. This means the clinician and office manage may not find out until it was too late and the claim was denied for timely filing.

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