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Managing the Claim and Getting Paid
Ambulatory Clearinghouse Services
The economic downturn has caused healthcare provider organizations to count every penny and reexamine every vendor relationship, especially those that impact cash flow. One CEO explains, “I have proposed that we leave McKesson (RelayHealth clearinghouse). We are pretty much a McKesson flagship, and we use McKesson’s products across 80 percent of our business. Leaving McKesson would be a hard decision, but in light of the issues the whole industry is experiencing with cash flow …Before, nobody would have given it a thought.”
If this CEO goes to the market, what options for vendors will he have to consider? How does the nature of the relationship between the practice management (PM) and clearinghouse vendors impact the client experience? Does client satisfaction vary with the price of the clearinghouse service? Which vendors help clients achieve a high percentage of payments on first-time claims submissions? KLAS interviewed 520 ambulatory healthcare organizations to answer these and other questions relating to the EDI claims clearinghouse market.
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.