Payer EDI clearinghouse services for claims, eligibility, and ERA

Services for Payers

Claim.MD offers industry-leading clearinghouse services tailored for payers, facilitating seamless electronic transaction management.

Standard Connection

$0

/month
This is a good option for established payers that expect to support connectivity with each of their provider's clearinghouses.
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Plans that do not have an established payer ID must choose the Premium Payer Plan.

Premium Connection

$500

/month
Perfect for new health plans, or those who don't want to contract and connect with all clearinghouses.

Compare Plan Features

Key Features

Accept Electronic Transactions

  • Establish an electronic Payer ID
  • Receive Claims in 837P, 837I, XML or JSON formats
  • Return Electronic Remittance Advice (ERA)
  • Accept Electronic Attachments

Claim Management Portal

  • Online Claim Manager for providers to create or correct claims
  • Attach PDF documents
  • ERA 835 Viewer
  • Eligibility Portal
  • Eliminate paper claims

Eligibility

  • Web portal realtime eligibility checks
  • API and Batch Eligibility
  • Over 400 payers supported

Easy appeal generator

Establish Payer ID

Let Claim.MD help you establish a payer ID. This ID can be used on your insurance ID cards and will be used by providers to route electronic claims through Claim.MD to your system.

Clearinghouse Network

Claim.MD works with many other clearinghouses, making access to your payer ID easier for your providers. Your providers can use one of any Claim.MD network clearinghouses or their partners to reach you.

Provider Claim Portal

An online portal for your providers to upload, view, edit and manage claim submissions, as well as view and download ERA online. Payers can participate in Claim.MD's online support portal, viewing and responding to online tickets and questions from providers.

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