Corporate Compliance

Q: What is a healthcare clearinghouse?

Compliance Monitor, March 18, 2005

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.

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