Which entity handles the electronic transmission of hospital claims from Resolute to payers?

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Multiple Choice

Which entity handles the electronic transmission of hospital claims from Resolute to payers?

Electronic claim transmission from Resolute to payers is handled by a clearinghouse. The clearinghouse serves as the intermediary that receives the claim data from the hospital billing system, converts it into the standard HIPAA format, runs edits and validations, and then securely forwards the claim to the payer’s system. This central role ensures claims are properly formatted and reach the payer for adjudication. A payer portal is a web interface for viewing or querying claims, not the transmission path itself. Hospital records are the clinical documentation stored in the hospital, not used to transmit claims. An insurance broker handles policy placements and related services, not electronic claim transmission.

Electronic claim transmission from Resolute to payers is handled by a clearinghouse. The clearinghouse serves as the intermediary that receives the claim data from the hospital billing system, converts it into the standard HIPAA format, runs edits and validations, and then securely forwards the claim to the payer’s system. This central role ensures claims are properly formatted and reach the payer for adjudication.

A payer portal is a web interface for viewing or querying claims, not the transmission path itself. Hospital records are the clinical documentation stored in the hospital, not used to transmit claims. An insurance broker handles policy placements and related services, not electronic claim transmission.

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