Claim.MD

JSON twin: https://www.healthaidb.com/software/claim-md.json

Company Name

Claim.MD

Product URL

https://www.claim.md

Company URL

https://www.claim.md

Categories

• administrative Operations
• revenue Cycle
• data Integration
• billing
• eligibility Verification
• Administrative
• Revenue Cycle Management
• Clearinghouse
• Electronic Data Interchange
• Eligibility
• Remittance

Summary

Claim.MD is a cloud-based electronic data interchange (EDI) clearinghouse that streamlines medical claims processing for healthcare providers, payers, and software vendors.

Description

Claim.MD offers a web-based platform for creating and managing electronic medical claims, including CMS-1500 and UB-04 forms, with support for various file formats such as 837P, 837I, 5010, 4010, CSV, XLS, XML, NSF, and Print Image. The platform provides real-time eligibility checks, electronic remittance advice (ERA) downloads in standard 835, spreadsheet, and XML formats, and integrated support tools for efficient claim management. It also offers batch file processing capabilities and API integrations for software vendors. The company has achieved multiple certifications, including HITRUST Risk-Based, 2-year (r2) Certification, TX-RAMP Level 2 Certification, and CAQH CORE Certification on Eligibility & Benefits, Claim Status, and Payment & Remittance Rules, demonstrating its commitment to security and compliance. Founded in the early 1980s, Claim.MD processes tens of millions of transactions monthly and serves a vast network of providers and payers across the United States.

Api Available

yes

Certifications

• HITRUST Risk-based 2-year (r2) Certification

Company Founding

1980s

Company Offices

• United States

Compliance

• HIPAA
• HITECH
• SOC 2
• ISO 27001
• HITRUST Risk-based 2-year (r2) Certification

Customers

• Jennifer J.
• Diana
• Jody T.
• Ben F.
• Loretta G.
• Kristi S.
• Dr. Rathidevi R.
• Loyce E.

Data Residency

US-only

Data Standards

• 837P
• 837I
• 5010
• 4010
• CSV
• XLS
• XML
• NSF
• Print Image
• 835

Deployment Model

• SaaS

Features

• Electronic Claims (1500/UB-04)
• Remittance (ERA)
• Real-time Eligibility Verification
• Integrated Support Tools
• Batch File Processing
• CMS-1500/UB04 Form Validation
• Customizable Reporting
• Secure Claims Processing
• Transparent Pricing

Id

SW1091

Integration Partners

• Elion Health

Integrations

• Medical Billing Systems
• Jane Software

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• Electronic Appeals
• Paper & Faxed Claims/Appeals
• Attachments

Os Platforms

• Web

Pricing Details

Basic: $30/month; Small Volume: $60/month; Unlimited: $120/month; contact vendor for enterprise solutions

Pricing Model

subscription

Privacy Features

• BAA available
• Consent Management
• Anonymization
• Data Minimization

Product Code

SW1091

Product Name

Claim.MD

Ratings

• 5.0 out of 5 on G2.com

Regions Available

• United States

Related Urls

• https://elion.health/products/claim-md

Release Year

2015

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit Logs
• 2FA
• DLP

Specialties

• General Practice
• Specialty Care
• Hospital Services
• Ambulatory Care
• Mental Health Services
• Rehabilitation Services
• Laboratory Services
• Radiology
• Cardiology
• Orthopedics
• Pediatrics
• Geriatrics
• Obstetrics And Gynecology
• Dermatology
• Neurology
• Psychiatry
• Anesthesiology
• Pathology
• Emergency Medicine
• Family Medicine

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• clinicians
• nurses
• admins
• payers
• software vendors

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• Awesome! Claim.MD continues to prove they are the best and I only wish I had known about you sooner!! Thank you!
• I love Claim MD!! It's simply AWESOME!!! Thank you so so much for your service.
• You guys rock! Your continued mission to provide comprehensive support at an affordable cost while still delivering BEST IN CLASS CUSTOMER SERVICE is huge.
• I just wanted to compliment Claim.MD, your software is great and your support team has always been very helpful and responsive.
• I feel that you will love their clearinghouse. It literally blew my socks off. It does so much more than our present clearinghouse and is priced a lot better.
• You guys are wonderful; the system is the best, it is life-changing!
• I would also like to use this opportunity to thank Claim MD staff for the excellent and timely services that were provided to me regarding my billing needs during the period of my contract with Claim MD. I would recommend Claim MD to my colleagues who are interested in Billing services without any reservations.
• Please let me say what an incredible partner you have been for our small practice. Your service and staff are outstanding!! I have truly enjoyed working with all of you and Claim MD. A true class act of a company and the people who make it!

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Claim.MD",
  "company_name": "Claim.MD",
  "product_url": "https://www.claim.md",
  "company_url": "https://www.claim.md",
  "related_urls": [
    "https://elion.health/products/claim-md"
  ],
  "product_code": "SW1091",
  "summary": "Claim.MD is a cloud-based electronic data interchange (EDI) clearinghouse that streamlines medical claims processing for healthcare providers, payers, and software vendors.",
  "description": "Claim.MD offers a web-based platform for creating and managing electronic medical claims, including CMS-1500 and UB-04 forms, with support for various file formats such as 837P, 837I, 5010, 4010, CSV, XLS, XML, NSF, and Print Image. The platform provides real-time eligibility checks, electronic remittance advice (ERA) downloads in standard 835, spreadsheet, and XML formats, and integrated support tools for efficient claim management. It also offers batch file processing capabilities and API integrations for software vendors. The company has achieved multiple certifications, including HITRUST Risk-Based, 2-year (r2) Certification, TX-RAMP Level 2 Certification, and CAQH CORE Certification on Eligibility & Benefits, Claim Status, and Payment & Remittance Rules, demonstrating its commitment to security and compliance. Founded in the early 1980s, Claim.MD processes tens of millions of transactions monthly and serves a vast network of providers and payers across the United States.",
  "categories": [
    "administrative Operations",
    "revenue Cycle",
    "data Integration",
    "billing",
    "eligibility Verification",
    "Administrative",
    "Revenue Cycle Management",
    "Clearinghouse",
    "Electronic Data Interchange",
    "Billing",
    "Eligibility",
    "Remittance"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "clinicians",
    "nurses",
    "admins",
    "payers",
    "software vendors"
  ],
  "specialties": [
    "General Practice",
    "Specialty Care",
    "Hospital Services",
    "Ambulatory Care",
    "Mental Health Services",
    "Rehabilitation Services",
    "Laboratory Services",
    "Radiology",
    "Cardiology",
    "Orthopedics",
    "Pediatrics",
    "Geriatrics",
    "Obstetrics And Gynecology",
    "Dermatology",
    "Neurology",
    "Psychiatry",
    "Anesthesiology",
    "Pathology",
    "Emergency Medicine",
    "Family Medicine"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Basic: $30/month; Small Volume: $60/month; Unlimited: $120/month; contact vendor for enterprise solutions",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "1980s",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Electronic Claims (1500/UB-04)",
    "Remittance (ERA)",
    "Real-time Eligibility Verification",
    "Integrated Support Tools",
    "Batch File Processing",
    "CMS-1500/UB04 Form Validation",
    "Customizable Reporting",
    "Secure Claims Processing",
    "Transparent Pricing"
  ],
  "optional_modules": [
    "Electronic Appeals",
    "Paper & Faxed Claims/Appeals",
    "Attachments"
  ],
  "integrations": [
    "Medical Billing Systems",
    "Jane Software"
  ],
  "data_standards": [
    "837P",
    "837I",
    "5010",
    "4010",
    "CSV",
    "XLS",
    "XML",
    "NSF",
    "Print Image",
    "835"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITECH",
    "SOC 2",
    "ISO 27001",
    "HITRUST Risk-based 2-year (r2) Certification"
  ],
  "certifications": [
    "HITRUST Risk-based 2-year (r2) Certification"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit Logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "Consent Management",
    "Anonymization",
    "Data Minimization"
  ],
  "data_residency": "US-only",
  "customers": [
    "Jennifer J.",
    "Diana",
    "Jody T.",
    "Ben F.",
    "Loretta G.",
    "Kristi S.",
    "Dr. Rathidevi R.",
    "Loyce E."
  ],
  "user_reviews": [
    "Awesome! Claim.MD continues to prove they are the best and I only wish I had known about you sooner!! Thank you!",
    "I love Claim MD!! It's simply AWESOME!!! Thank you so so much for your service.",
    "You guys rock! Your continued mission to provide comprehensive support at an affordable cost while still delivering BEST IN CLASS CUSTOMER SERVICE is huge.",
    "I just wanted to compliment Claim.MD, your software is great and your support team has always been very helpful and responsive.",
    "I feel that you will love their clearinghouse. It literally blew my socks off. It does so much more than our present clearinghouse and is priced a lot better.",
    "You guys are wonderful; the system is the best, it is life-changing!",
    "I would also like to use this opportunity to thank Claim MD staff for the excellent and timely services that were provided to me regarding my billing needs during the period of my contract with Claim MD. I would recommend Claim MD to my colleagues who are interested in Billing services without any reservations.",
    "Please let me say what an incredible partner you have been for our small practice. Your service and staff are outstanding!! I have truly enjoyed working with all of you and Claim MD. A true class act of a company and the people who make it!"
  ],
  "ratings": [
    "5.0 out of 5 on G2.com"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2015",
  "integration_partners": [
    "Elion Health"
  ],
  "id": "SW1091",
  "slug": "claim-md",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/claim-md.json"
  }
}