Medical Billing Clearinghouse Services: Clean Claims, Fewer Rejections
Alpha RCM Solutions handles electronic claim submission for you: claims are checked, sent to the right payer, tracked, and any rejections are fixed and resubmitted, as part of our medical billing service.
- Claims checked for errors before they are sent
- Rejections worked and resubmitted promptly
- Claim status and ERAs tracked through to payment
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What a Medical Billing Clearinghouse Does
A clearinghouse sits between your practice and the insurance payers. It checks claims for errors, converts them into the standard electronic format and routes them to the right payer, then returns reports on what was accepted, rejected or paid.
Check. Claims are scrubbed for missing or invalid data against payer and format rules before they go out.
Route. Claims are sent electronically to the correct payer in the standard HIPAA format (837).
Report. Acceptance and rejection reports, claim status and electronic remittances (ERAs) come back to us for follow-up.
What We Handle For You
The claim submission work that sits between charge entry and payment posting.
Electronic Claim Submission
Professional and institutional claims submitted electronically to Medicare, Medicaid and commercial payers.
Claim Scrubbing
Claims checked for missing data, invalid codes and payer-specific rules before submission.
Rejection Management
Rejected claims investigated, corrected and resubmitted, with common causes reported.
Claim Status Tracking
Submitted claims followed through acceptance, adjudication and payment.
Eligibility Verification
Patient coverage checked electronically before the visit to avoid eligibility denials.
ERA & Payment Posting
Electronic remittances received and posted accurately, then reconciled with what was billed.
Secondary Claims
Secondary and crossover claims prepared and submitted once the primary payer has paid.
Paper Claims
Paper claims handled for the payers and situations that still require them.
Patient Statements
Clear statements sent to patients for the balance they owe after insurance.
How a Claim Moves Through Our Process
From charge entry to a posted payment, with every rejection and status change tracked.
1Payer setup
We confirm your payers, payer IDs and any electronic enrollment needed for claims, ERAs and EFT.
2Charges in
Charges and demographics come in from your superbills or system and are entered into the claim.
3Scrub & submit
Claims are checked for errors and submitted electronically to the payer.
4Fix rejections
We review acceptance and rejection reports, correct the cause and resubmit before the filing deadline.
5Track status
We follow each accepted claim until it is paid, denied or needs follow-up with the payer.
6Post & report
Remittances are posted, and we report rejection and denial trends so repeat errors get fixed.
Payer processing times and filing deadlines vary. We confirm them for your payers during setup.
What We’ll Need From You
- The practice management system and clearinghouse you use today, if any
- Your list of payers and plans
- Provider and group details: NPIs, tax IDs and taxonomy
- Any existing payer enrollment for claims, ERA and EFT
- Recent rejection and denial reports, if you have them
- Superbills or charge data for the claims to submit
Rejections We Fix
A rejected claim never reaches adjudication, so it earns nothing until it is fixed. The usual causes:
- Missing or invalid patient demographics
- Wrong payer ID or subscriber ID
- Missing or invalid provider NPI or taxonomy
- Invalid diagnosis or procedure codes
- Missing modifiers or place of service
- Duplicate claim submissions
Why Clean Claim Submission Matters
Every error caught before submission is a rejection, a delay or a denial you do not have to work later. Because the same team handles coding, billing and denials, the causes get fixed and not just the individual claims.
- Errors caught before the payer sees the claim
- Faster feedback on accepted and rejected claims
- Fewer resubmissions and delays
- Remittances posted promptly and accurately
- Rejection trends reported so you can fix the source
- One accountable team from charge to payment
Claims and Payers We Work With
We confirm your payer list and claim types with you at the start.
Payers that need provider enrollment first? See our credentialing and enrollment service.
Clearinghouse FAQs
Straight answers to the questions practices ask us most.
A clearinghouse is an intermediary between healthcare providers and insurance payers. It checks claims for errors, converts them into the standard electronic format and routes them to the right payer, then returns reports on whether they were accepted, rejected or paid.
Electronic claim submission is part of our medical billing service, and we handle it for you. If you already use a clearinghouse, tell us which one and we will confirm how we would work with it during your consultation.
A rejection happens before the payer accepts the claim, usually because of a data or format error, and the claim can be fixed and resubmitted. A denial happens after the payer has processed the claim and decided not to pay it. See our denial management service.
Medicare, Medicaid and most commercial payers accept electronic claims, though some require enrollment first. Send us your payer list and we will confirm what is needed for each.
Yes. A few payers and situations still require paper claims, and we handle those too.
Yes. Many payers require enrollment before they will send electronic remittances (ERAs) and electronic payments (EFT). We can help set these up as part of onboarding or provider enrollment.
Claim submission is part of our medical billing service. See our pricing or use the form above and we will send a quote for your practice.
We follow HIPAA privacy and security requirements when handling protected health information. Ask us about the specific safeguards that apply to your account and we will walk you through them.
Explore Related Services
Medical Billing
Claims, payment posting and follow-up handled by one team.
Credentialing
Provider enrollment so you can bill payers in network.
Denial Management
Fix denials, appeal what is owed and prevent repeats.
Revenue Cycle Management
End-to-end revenue cycle support for your practice.