CLAIM.MD




Professional
Monthly Price
$100/mo
Institutional
Monthly Price
$100/mo
Setup Fee$0.00
Annual Fee$0.00
Per-Provider Fee$0.00
Electronic ClaimsUnlimited*
Electronic Remittance (ERA/835)Unlimited*
Patient Eligibility1,000 Included
$0.10/each additional
Online SupportIncluded
Telephone SupportIncluded
*limited number of payers have a per-claim fee. Check the Payer List for details.


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Contact Us

(855) 757-6060





CLAIM.MD is a web based EDI Clearinghouse. Which means no software to install, and the ability to access and work your claim data from any location.

Connect with payers for electronic eligibility, claims and remittances.

Realtime Eligibility for Medicare (HETS) and hundreds of other payers. Simple quick enrollment process.


Claim.MD manages and documents all provider's electronic transactions.


Upload claim files from any medical billing system that produces a claim file (ANSI 4010 & 5010, NSF or Print Image).


Providers in all states can submit unlimited commercial claims to any payer on the industry's largest payer network. Click here for a list of commercial payers on our network.


NOW AVAILABLE - WORKERS COMP! With your monthly account Claim.MD now offers unlimited Workers Comp electronic claims. Providers in Texas and other states have access to a large network of Workers Comp payers. Claim.MD's interactive claim form makes it simple to attach prescanned documents, or scan new documentation directly into electronic Workers Comp claims. For a list of Workers Comp carriers on our network, click here.


Easy ICD9 to ICD10 Migration (GEMS)

When using Claim.MD as your EDI Clearinghouse we can make your current billing software ICD-10 capable.


Automatic conversion from ICD9 to ICD10 codes, and easy prompting for codes that don't have an exact match. General Equivalence Mappings (GEMS) are built into every claim form.




Request a Demo to see how easy we make ICD-10, and how most providers can continue to use their current billing software without making any changes.

Instant 5010 Compliance for any billing system. (837/835/270)

Claim.MD automatically up-converts any claim format to 5010 837, from any medical billing system that produces a claim file (ANSI, NSF or Print Image, 4010 837).

Even more, Claim.MD can downgrade 5010 835 (Electronic Remittance) to 4010, so you can continue to use your existing Practice Management software with no changes or upgrades required.

Manage Claims with confidence using Claim.MD.

When you upload a claim file to Claim.MD, you know instantly which claims fail our initial payer specific edits. If a payer rejects a claim that is transmitted through Claim.MD, the claim instantly shows up in Manage Claims for further corrections. Never again will you miss a rejected claim because you overlooked it in a long cluttered report.


If we don't receive an expected payer response in a timely manner, we give you an alert so you can check status on those claims. When re-billing is required, one click does that for a single claim or an entire group of claims.


Follow-up is time consuming and costly, but spotting issues before they impact cash flow is key to effective electronic billing. Claim.MD's new visual interface shows potential problems at a glance, with one click access to relevant detail so you can make the most of your investment in follow-up time.


SFTP, REST & Command Line API's

For Billing Software and system developers Claim.MD offers Application Interfaces.


Contact us for information on how to directly integrate your system with Claim.MD for Electronic/Paper Claims, Eligibility and ERA.


10 Years of History

Claim.MD will maintain your data for up to 10 years.


Bill through Claim.MD and have the security of knowing your claim history will be available even between switching billing systems. For active account holders Claim.MD now maintains claim history and ERA's for up to 10 years.


Track claims from submission to remittance, with detailed claim history to prove timely filing.

Regain confidence in your claims with detailed claim history and tracking, which shows all vital claim level statistics with a single click (e.g. proof of timely filing and payer responses). You get the data you need, when you need it -- no more, no less.


All claim documents, from eligibility to remittance, are searchable in a concise and easy-to-read Claim History. Field level narratives record all changes made to the claim, and the History includes all electronic payer responses as well.


Remittances can be downloaded for posting into your practice management system. Remittances are searchable by payer, check date and dollar amount. Individual remittances are searchable at the claim level.


Claim.MD gives you control of your claims throughout the entire lifecycle of the transaction.


Fix rejected claims real-time to speed cash flow and eliminate delays.

Claim.MD's Visual Claim Editor™ is totally unique -- an interactive claim form that performs payer-specific edits as you make changes to your claims. The ability to edit claims online with real-time data validation makes for fast turn-around of claims that would otherwise need to be re-billed from scratch.


Know at a glance when payers are slow to respond to claims.

For claims to payers that send your remittances through Claim.MD, we provide automatic alerts when an expected remittance hasn't posted in a timely manner. You have one-click access to the claim history when you contact the payer to check status on the claim and track the missing response or remittance. Notes that you make during the follow-up process are stored in the Claim History for future reference.


See first hand where your billing stands.

A picture is worth a thousand words. Claim.MD has a revolutionary new visual approach to "traditional" reports -- instead of giving you lists with details and totals, Claim.MD uses interactive graphs with detail presented in an easy-to-read narrative. Reports include:

  • Age of Charges Billed
  • Daily Billing Summary (claims uploaded, transmitted, rejected)
  • Billed Charges by Payer, Provider, Procedure or Diagnosis
  • Patient Geographics by Payer, Procedure or Diagnosis

One click access to personalized expert support.

You may never need it, but when you do you'll be happy you have Claim.MD for support. Our support interface allows you to request help at the touch of a button.


Click GetHelp™ from any claim to open a support ticket. Everything about the claim in question is automatically transmitted to our support team, so we have instant access to the complete Claim History when we begin researching your issue. You receive email notices when we have replied to your question, and if you have further questions or more information, you can keep the dialog going until the payer accepts your claim.


Personalized support has never been so easy or efficient!