Switching · Clearinghouse included
The clearinghouse is part of the platform.
You do not bring one and you do not keep the one you have. Claims go out, remittances come back, and eligibility runs through Claim.MD — connectivity that is already built in, priced in, and enrolled on your behalf.
Powered by Claim.MD. No separate clearinghouse invoice, and payer enrollment is handled during implementation.
What's included
Six things you no longer buy separately.
Included
Claim submission837P for professional claims and 837I for facility claims, submitted directly from the encounter.
Included
Remittance return835 files import automatically, match line by line, and post without anyone downloading a file.
Included
Eligibility270/271 real-time benefit checks, run from the chart and from the intake lead.
Included
Claim status276/277 status updates arrive on the claim rather than waiting in a portal for someone to check.
Included
Rejection handlingFront-end rejections come back with the failing field identified, in the claim you are already looking at.
Included
Payer enrollmentEDI enrollment with your payers is submitted through Claim.MD as part of implementation, per billing entity.
The transition
How the switch actually happens.
We submit EDI enrollment through Claim.MD for each payer and billing entity on day one.
Step 1Your existing clearinghouse stays live. New claims start flowing through ours as each payer approves.
Step 2We verify 835s are arriving and posting correctly before anything is switched off.
Step 3Once every payer is live and the last claims are worked, you give notice on the old contract.
Step 4Before you commit
Five things to check first.
We would rather you find these now than three weeks into a cutover. Every one of them has delayed somebody's go-live.
Print this, or bring it to the walkthrough and we will go through it with you.
Most clearinghouse agreements have a notice period, and some auto-renew annually. Find your date before you plan a cutover.
Claims already submitted through your current clearinghouse should be worked to completion there. Do not cancel mid-cycle.
EDI enrollment is a payer-side process. Some approve in days, some take several weeks — Medicaid plans are usually the slowest.
We run parallel until the new enrollments are live and remittances are arriving correctly.
If your current clearinghouse also provides eligibility, patient statements or reporting, confirm what else you are switching off.
Revenue cycle
Claim scrubbing
Validation runs before the claim leaves, highlights the exact field that will get it kicked back, and says why in plain language — not a rejection code you have to look up.
Read more →Revenue cycle
Remittance & bulk posting
Read the ERA, match the lines to the claims, post the payments and adjustments, and route what didn't match to the denials queue.
Read more →Revenue cycle
Eligibility & benefits
Real-time eligibility on the chart, with behavioral health benefits broken out — deductible, copay, coinsurance, and whether the level of care you're admitting to is covered at all.
Read more →Why it is not optional
Claim scrubbing that knows your authorization status, remittances that post against the original claim, and denials that route themselves only work when the connectivity is part of the same system. Building against one clearinghouse is what makes those seams disappear.
Bring your current contracts and renewal dates to a walkthrough and we will map the timeline against them.
Get started
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