Claims processing: Like to get paid? So how does your clearinghouse rank?

June 13, 2008

Navicure leads the clearinghouse pack, followed closely by ZirMed and Gateway EDI in a survey of their customers by IT research firm KLAS Enterprises.

Navicure leads the clearinghouse pack, followed closely by ZirMed and GatewayEDI in a survey of their customers by IT research firm KLAS Enterprises.

The KLAS report, titled Ambulatory EDI Claims Clearinghouse,” notes that such firms not only relay your insurance claims to payers like electronic mailmen, but also can boost revenue with tools for tracking claims in real time and handling rejections and denials (the industry buzzword for this is “revenue cycle management). So it literally pays to pick the right firm. A substantial minority of doctors doesn’t have a choice, since their practice-management system automatically comes with a clearinghouse service, but 70 percent of healthcare providers interviewed by KLAS said they could choose their service.

Navicure scored a 91.6 performance rating, while ZirMed and Gateway EDI came in at 91 and 89.1 respectively. Healthcare providers told KLAS that they liked Navicure’s high tech as well as its “high touch,” epitomized by live representatives on the phone as opposed to voice mail. While Navicure charged more than most of it rivals, it was the only company whose customers unanimously said they would not switch to another vendor if they had the chance.

Six other clearinghouse companies round out the survey in this order: RelayHealth, The Consult ECP, Misys Payerpath, Ingenix ENS, Emdeon Business Solutions, and Availity. Navicure had the least number of practices (a few thousand) while RelayHealth had the most (around 45,000), according to KLAS estimates based on self-reported numbers from the vendors.

To buy this KLAS report, click here. You can research individual vendor ratings at the company website free of charge by completing an online survey on software, medical equipment, or IT professional services that you use. For information on completing a KLAS survey, click here or call 1-800-920-4109.