Real-time electronic claims processing, for FREE!
Earn residual income from clearinghouse commissions!
Keeping clearinghouse costs low is a key element for the success of your medical
When you have your own business, controlling expenses is often a key element for
reaching a good level of profitability. You also need flexibility and the freedom
of choice. After all, that's one of the main benefits of having your own independent
business. You should be concerned if a company you're interested in doing business
with allows only one choice for a clearinghouse. We advise you to analyze and learn
about all fees before making a decision. We say this because it's not uncommon for
competitors that offer basic web-based software to charge a flat monthly fee of
$250 or more per doctor per month or charge nearly $1.00 per created
claim, which is far above industry standards of 35 cents. What's more, they charge
you another 95 cents if you discover an error, correct and re-save the claim!
If you're looking to start a new billing service business without prior experience,
we advise you to be alert to this kinds of secret business tactics. High fees and
limited choices are not the norm in this industry and will hurt your business.
Compare costs for yourself!
If you are a ClaimTek client and have 10 doctors for example, your clearinghouse
fees will be free or around $500. With some competitors that use browser-based systems,
you're looking at a cost of around $250 per provider per month ($2,500 for 10 doctors!)
or $4,400 per month if you pay per claim. If you have 20 clients, your fees will
double to $5,000 or $8,800 per month. With ClaimTek your cost would be around $1,000
or much less and you have many choices of clearinghouses:
Number of Doctors You have:
Number of claims per month based on the national average
Browser-Based Competitors charging $250 per Provider per Month or $1 per claim!
ClaimTek (FREE or average of $50 per doctor/month).
Per Month: $250 flat fee or $440 (if based on per claim)
Per Month: $500 or $880
Per Month: $750 or $1320
Per Month: $1,000 or $1,760
Per Month: $1,250 or $2,200
Per Month: $2,500 or $4,400
8,800 claims processed per month
$5,000 or $8,800 cost per month. This is money out of your pocket UNNECESSARILY!
$1,000 or much less
ClaimTek claims processing is fast and inexpensive. you can send claims direct &
FREE to many insurance companies. ClaimTek will save you thousands of dollars each
month adding tens of thousands to your bottom line each year.
Clearinghouses and how they work...
Billing Services typically submit claims electronically for real-time processing
at a national clearinghouse (there are dozens of them nationwide). The clearinghouse
scrubs, formats and submits claims in real-time to hundreds of insurance companies
for payment. The reason clearinghouses are important is they have the ability to
meet the specific data transmission requirements of every insurance company that
accept electronic claims. This task can be time-consuming to perform independently
on your own. You would need to communicate electronically and individually with
hundreds of insurance companies, which can be a tedious process. Instead, you only
have to communicate with a single clearinghouse. For this, you pay a small fee to
some clearinghouses but with some other clearinghouses, this service is FREE!
You may wonder, why FREE? In order to understand this, it's important to
know how clearinghouses make the bulk of their income. Clearinghouses receive rebates
paid by the insurance companies for every claim that's submitted electronically
to them. Insurance companies do this to encourage electronic billing and cut the
cost of manual processing. Most clearinghouses make additional income by charging
consumers (doctors and billing services) a small fee as well. So some clearinghouses
make money from both side of the equation: (1) From insurance company rebates,
and (2) From consumers (end-users of various software, like doctors' offices & billing
companies). In recent years, several reputable clearinghouses decided to offer this
service FREE to the consumer side in order to attract higher volume of claims submissions
and capitalize only on the handsome rebates paid by insurance companies.
Now, the majority of the clearinghouses that charge consumers, the fees they charge
are typically small and reasonable. For example, some charge 35 cents per claim
and some charge a flat monthly fee that's around $50 per month per account, on the
With ClaimTek's software, you're in control to decide which clearinghouses fit your
need the best. You are free to make many important decisions for your business.
Our software allows you to:
- Submit claims electronically, directly, and FREE to several clearinghouses
- Submit claims electronically and directly to several clearinghouses that charge
- Submit claims electronically and directly straight to insurance companies
(You may elect to do this if you have a doctor that deals mostly with one or two
insurance companies. i.e. Medicare and Blue Cross). You can go direct and bypass
the clearinghouse altogether!
Your decisions to choose one clearinghouse over another depend on several factors.
You may sign up a client in a different state and some insurance companies may not
be on the list of payors with your current clearinghouse. In this case you may want
to choose another clearinghouse for this new doctor account. Another reason can
be customer service. If you become dissatisfied with one clearinghouse, you need
to be in a position to choose another without interrupting your business or being
forced to change your software. Also, a clearinghouse may increase their fees. If
they're your only choice, you cannot go elsewhere.
Does ClaimTek benefit from clearinghouses fees? Can I benefit as well?
Yes, ClaimTek receives commission of a few cents per claim from most clearinghouses.
We've built close relationships with reputable clearinghouses to provide you with
several choices and ensure that you receive top notch service. However, you're not
limited to the clearinghouses that we recommend. Our software submits claims in
a compliant EDI format that's accepted by all clearinghouses.
ClaimTek also benefits from Merchant Transaction Processing when our clients use
the credit card module of our software.
As a reseller of our software, we can set you to earn monthly residual income from
our approved clearinghouses and merchant services when your doctor clients use our
software to submit electronic claims and credit card transactions! This can amount
to thousands of dollars monthly when you have a healthy client base. Such income
is paid as long as you have your business, even for a lifetime!
As you can see, while ClaimTek has vested interest in your success, your relationship
with ClaimTek is built on mutual benefit, mutual respect, and mutual balance. You're
charged reasonable fees for services, and allowed to participate in generating residual
income as you grow your business.
Below is a list of some clearinghouses on our recommended list:
HeW: 35 Cents Per Claim or $40/mo Flat-Fee
Gateway EDI: $86/mo Flat-Fee
Ingenix: $60/mo Flat-Fee
Automated Clearing House | For Electronic Fund Transfer Service (EFT)
The ACH clearinghouse is where the Electronic Fund Transfer EFT transactions are
sent. The Automated Clearing House (ACH) is the electronic network to which 95%
of the nation's banks belong, including the Federal Reserve.
For ACH, there is a one-time fee of $50. The cost per transaction starts at $0.45
but can be reduced to $0.23 depending on volume (this is explained in our Medical
Billing Manual). Once you start processing transactions, a $25 monthly fee applies.
There is no additional setup fees for new account or any annual fees.
Fees to all clearinghouses are not due until you start processing claims or EFT