A healthcare clearinghouse receives claims from providers, checks them for format and data errors, converts them to each payer's requirements and forwards them. It also returns payer responses such as acknowledgements, rejections and remittances.
Related terms
- 837 (electronic claim)
- The HIPAA-standard electronic format for submitting healthcare claims.
- Claim rejection
- A claim returned before processing because of errors; it never entered adjudication.
- ERA (835)
- The electronic remittance advice: the payer's electronic explanation of payment.