Managing Electronic Data Interchange (EDI) processes can be complex for large healthcare providers: Maintaining reliable connections, ensuring seamless claim submissions, accurately tracking remittances, verifying eligibility, and handling EDI transactions across multiple payers. These are burdensome without the right clearinghouse partner. That’s where our comprehensive clearinghouse solution and support team steps in.

Why Large Providers Need a Reliable Clearinghouse

Large healthcare providers deal with high volumes of claims and remittances, making efficient EDI management essential. Medical administrative transaction volume increased by 11% to 55 Billion transactions in 2022 (per CAQH). Handling mountains of transactions makes the need for automation that much more apparent. 

A robust claim management solution consolidates all payer connections into a single, reliable network, reduces administrative costs and labor, improves cash flow, delivers real-time eligibility, and supports EDI enrollment. 

1. Access to an Extensive Payer Network

We pride ourselves on having one of the most comprehensive payer networks available. Without reliable payer coverage, even a minor disruption can lead to significant revenue cycle issues. That’s why verifying your connections upfront is vital. 

Setting up payer connections and managing your claim volume across the network can be overwhelming and complicated. Using a clearinghouse, like UHIN, lifts the burden by handling the vast, dynamic relationships with payers and trading partners for you. Our clearinghouse connects with thousands of payers nationwide, ensuring that you have the necessary reach to keep your operations running smoothly. You can further simplify your connections with payers by integrating the UHIN Clearinghouse into your current Electronic Health Record (EHR) or Practice Management system (PM), making communications and claim management that much easier in your preferred workflow.

We encourage you to check out our payer list to verify if we have the connections you require. With our national EDI network, you can be confident that your claims will reach their destination without a hitch, reducing delays and improving your cash flow.

2. Real Cost Savings

Switching to our clearinghouse solution could lead to substantial savings for your organization. We offer usage-based pricing that ensures you only pay for what you use, with no long-term contracts or hidden fees that are common with others. We earn your business every day. 

Because we’re a non-profit, we provide competitive rates and exemplary support. We’re a mission-driven company focused on the improvement of care and costs. Private and public companies that operate clearinghouses tend to focus on their own costs and revenue first, then their customers. We invite you to explore our pricing options and see how much you could save by making the switch today. Don’t miss out on the opportunity to enhance your EDI management, maximize payments, and reduce costs at the same time.

$1 Billion in Cost Savings Opportunity Annually for the Medical & Dental Industries Combined
by transitioning to fully electronic administrative transactions

– CAQH (2023 CAQH Index Report)

3. Improved Cash Flow

Working with a clearinghouse that focuses on connectivity and modern EDI practices improves cash flow by streamlining critical processes, such as eligibility checks and claim submissions. Maintaining connections with payers enables consistent reimbursement and offloads risk if other networks are compromised. 

In addition, automating claim management systems reduces errors, accelerates claim approvals, and minimizes claim denials. This supports consistent payments and allows caregivers to focus on delivering quality patient care, contributing to sustained financial health.

4. Dedicated EDI Enrollment Support

In order to submit claims electronically to payers, providers must first complete EDI enrollment. Getting started with a new clearinghouse can be daunting, but our team of EDI enrollment specialists (all based in the U.S.) are here to help. They are ready and waiting to assist providers with enrollment, ensuring a smooth transition. 

EDI enrollment is vital to your success as claim management moves further into the fully electronic era. Enrollment enhances efficient communication with payers, enabling providers to submit claims and get paid faster. Our specialists provide personalized support to establish your connections quickly, so you can start experiencing the benefits of our services right away. With our team by your side, you’ll have the support you need to easily make the change.

5. Verifying Patient Eligibility

Electronic patient eligibility verification improves patient payment by allowing providers to check insurance eligibility easily before treatment. This results in reduced manual work for staff, less mistakes, and fewer denied claims. Providers can collect more co-pays or coinsurance upfront using electronic patient eligibility verification. Leveraging a software solution also ensures that the data being transmitted is accurate, and can be processed quickly and in real-time in many cases.

Real-time patient eligibility verification ensures that all patient information is correct right from the start and has long-term effects. Accurately verifying patient eligibility before treatment ensures that submitted medical claims align with insurance policies and patient coverages. Effective verification processes directly lead to fewer claims rejections and more approvals. Streamlining this process leads to reduced administrative burden, and expedites payments by not having to reprocess rejected claims.

Key Benefits for Large Providers

Our clearinghouse service offers several critical benefits tailored to the needs of large healthcare providers. By partnering with us, you can expect:

1. Extensive payer network that ensures you have the necessary reach to keep your operations running smoothly.
2. Cost savings with automation and a non-profit clearinghouse model focused on your success.
3. Improved cash flow through faster automated claim processing and fewer rejections.
4. Simplified EDI enrollment supported by a team of EDI enrollment specialists ready to help you.
5. Real-time patient eligibility verification that reduces delays and improves patient satisfaction.

Ready to Get Started?

If you’re ready to take the next step, visit our National EDI Network solutions page for more details on the benefits of working with UHIN. Next, check out our payer list and review our pricing options. Then, see how easy it is to start with our dedicated EDI Enrollment team.

Contact us today to learn more about how we can help streamline your EDI processes and support your organization’s growth.