Our Executive Chairman and Co-founder, Jim Dougherty, was recently featured in the Q4 issue of HBMA’s RCM Advisor journal discussing the history of preferred clearinghouses and the opportunity now for more organizations to build direct payer connections.
“At the dawn of clearinghouses, they were revolutionary—organizations dedicated to managing and organizing millions of data points and processing billions of transactions, all with the intention of making both providers’ and payers’ jobs easier. Given that each year, 15 billion transactions occur between more than 900 payers and nearly 880,000 healthcare providers, this major undertaking was a win-win for everyone involved. But somewhere along the way, the function of clearinghouses—to simplify administrative tasks—ended up adding complications, as preferred organizations became bottlenecks and gatekeepers. Now, as the healthcare industry pushes for simplicity and clarity, direct payer connections are possible. These direct connections should be aggressively pursued among players in the RCM and clearinghouse space to open doors for better processes and eased administrative burden.”
