Corporate Compliance

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!

    Strategies for Health Care Compliance
  • Strategies for Health Care Compliance

    News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...

  • Compliance Monitor

    This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...

  • Medicare Weekly Update

    Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...

  • Medicare Update for Physician Services

    Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...

Most Popular

Related Articles