Glossary term
Clearinghouse
Short answer
A healthcare clearinghouse is a company that sits between providers and payers to exchange electronic transactions. It checks claims for formatting errors, sends them to the right payer, and returns acknowledgments, 277 claim status responses, and 835 ERAs. Most practice management systems connect to a clearinghouse rather than to every payer directly.
What does a clearinghouse do with a claim?
It validates the claim against X12 and payer-specific rules, converts formats when needed, and forwards it. Rejections at this stage come back before the payer adjudicates the claim.
Does a clearinghouse handle claim status checks?
Many clearinghouses support 276/277 claim status transactions, but coverage and response detail depend on each payer. Some payers provide more detail through their own portals or APIs.
Which terms relate to Clearinghouse?
Which guides cover this term?
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Claimhound, a Veriflow Health company, checks claim status with each payer and posts EOB and 835 payment details into your billing system.