An agent between a provider and a payer that takes claims and other electronic data from providers, verifies the data integrity of the information, and forwards the proper forms to the payers. More than a transfer station, a clearinghouse acts as a fact-checker and a data format translator. It accepts and forwards electronic transmissions to insurance companies. The clearinghouse formats the data into the HIPAA 837 format, then batches the claims by payer and transmits them to each payer. It is an entity providing electronic connectivity to any number of payers. Providers can transmit all claims directly to a clearinghouse. Examples of clearinghouses are RECS, Envoy, Professional Alliance and Dentec/Softech. Some Practice Management System vendors also provide clearinghouse services. Examples of PMS vendors with clearinghouse capabilities are Professional Alliance and Dentec/Softech.
An entity that accepts paper or electronic transactions from another organization, performs high level edits and value-added processing, then electronically routes the information to a receiving entity. Clearinghouses also perform data translations from one format to another.