Outsourced dental billing company vs a clearinghouse: What’s the difference?

Dental professionals commonly mix up a dental clearinghouse with an outsourced dental billing company. Both help tremendously with the insurance claims process, and both try to make sure your insurance claims are accurate. So what’s the difference, and why do you need both? 

It’s a fair question, and as you look through your dental practice expenses, paying for both might feel redundant. But they’re very different entities. 

Dental ClaimSupport is a trusted dental billing partner that has spent over ten years working with dental teams to streamline their billing process to get easy claims income. Through our work as an outsourced dental billing company, we’ve worked with dental clearinghouses, and can tell you for ourselves: we are different! And both profitable resources for dental teams. 

In this article, we will break down the definition of both a dental clearinghouse and an outsourced dental billing company to help you understand the difference between the two resources. We will also explain the benefits of using both resources in order to get more income from your dental insurance claims. 

By understanding the difference between a clearing house and an outsourced dental billing company, you can feel confident that paying for these resources will give you an invaluable return on investment. 

Dental clearinghouse

So, what is a dental clearinghouse? 

A clearinghouse is a private or public company that connects healthcare providers and payers to serve as a middleman between the two. Clearinghouses ensure that claims sent by dental software are distributed electronically to the appropriate insurers.

Your dental team would purchase a clearinghouse software that you would run claims through, and the software makes sure you are submitting clean claims. For example, a clearinghouse will flag errors on your insurance claim before it’s submitted to insurance, and can also prompt claim attachments for necessary procedure codes.

Some clearinghouse programs will charge a flat rate for unlimited claims while others charge you per claim submitted.  There are tons of great clearinghouse software choices available, depending on your budget and needed features. They all complete the task of making sure you’re submitting accurate insurance claims to the insurance company. 

Of course, even with a clearinghouse, there are no guarantees that insurance companies will approve and pay your insurance claim. 

Outsourced dental billing company

Outsourced dental billing means contracting your dental billing services to an outside agency. This is not limited to just insurance billing, though that is typically the most profitable service that a dental billing company can perform. 

As soon as your practice signs on with a dental billing company, you will be assigned an expert (or experts based on the size) who will work daily on your dental billing. Your biller will get to know the team and your current billing process, looking to where improvements can be made. Your team has the opportunity to develop a warm working relationship with this vital new “team member.”

Working with an outsourced dental billing company is more like adding a staff member to your team without the added overhead cost. They will remote into your practice management software and submit insurance claims for you, and follow up with those claims if they are denied. An outsourced biller will also work through your insurance aging report to make sure older insurance claims are paid. 

They will then post payments to your software, completing the insurance claim process.

What’s the big difference between a clearinghouse and a dental billing company?

In a sense, a clearinghouse and dental billing company are similar in that they submit insurance claims for you, making sure they are accurate. 

But a clearinghouse is a software, and when you work with a dental billing company - your claim is being reviewed by a real person. The clearinghouse software automates the way they “audit” each claim. A clearinghouse also does not work on your insurance aging report. 

But these two are not mutually exclusive! Having both tools in your belt can increase your claim acceptance rate because your outsourced billing will review your claim before sending it to the clearinghouse, and then correct the claim if the clearinghouse flags any errors. 

The automation of the clearinghouse in addition to the expertise of a dental biller can reduce claim denials and the stress of your dental team. Utilizing both of these tools lets your in-house team focus on delivering an amazing patient experience while the clearinghouse and outsourced dental billing take care of your insurance claims. 

Ready to take your insurance claims income to the next level?

Both dental clearinghouses and dental billing companies can be amazing resources with financial benefits for your dental practice. They can work together to streamline your billing process and increase your claim acceptance rate. You don’t have to choose between one or the other, especially with the value they both deliver. Both serve your dental practice in different ways. 

Dental ClaimSupport is a billing friend to dental teams, working to help you deliver an excellent dental experience from start to finish. 

To learn more about how a dental billing service can give you cash flow you can count on, schedule a call with one of our billing specialists.