Q: What is a healthcare clearinghouse?
Compliance Monitor, March 18, 2005
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
A: A healthcare clearinghouse is a public or private entity, including a billing service, repricing company, community health management information system or community health information system, as well as "value-added" networks and switches, that performs either of the following functions:
- Processes or facilitates the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction
- Receives a standard transaction from another entity and processes or facilitates the processing of health information into nonstandard format or nonstandard data content for the receiving entity
Go to Section 160.103 Definitions: Healthcare Clearinghouse for more information.
Editor's note: Attorneys from Bricker and Eckler, LLP answered this question. This is not legal advice. Consult your attorney for legal matters.
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- Do not code 57288 with 52000
- Searched
