Providers

Medical offices, Dental, Radiological Centers, Health Centers and others


All Clearinghouse technology, integrated into the ProClaim® billing system.

Our billing system, ProClaim®, is integrated with our ASSERTUS Clearinghouse technology.  This allows for a direct communication between your billing system and the vehicle through which electronic transactions are sent and received between the healthcare provider and the health insurer.  Transactions are processed in real time, which allows for greater efficiency and accuracy in the data.  Through ProClaim® the following electronic transactions (HIPAA-EDI) are sent and received.

  • Eligibility Verification (270-271)
  • Claim Delivery (837)
  • Automatic reception and processing of Acknowledgment Receipts (277 and other). As a result of this process, the system gives off the following alerts:
    • Claims with Errors
    • Claims Without Acknowledgment of Acceptance from health insurer
    • Claims Not Processed
  • Automatic reception/gathering and processing of Payment Explanations (835)
  • Claim Status Verification (276)

CORE Phase II Certification

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