JSON twin: https://www.healthaidb.com/software/claim-md.json
Claim.MD
Claim.MD is a US-based electronic data interchange (EDI) medical claims clearinghouse that enables providers, billers, EHR/EMR vendors and payers to submit, track, correct and receive electronic remittance and eligibility in real time.
Claim.MD is a web-based claims clearinghouse and EDI service offering online claim creation (CMS-1500/UB-04), batch file uploads (837, CSV, XML and others), real-time eligibility/benefit checks, electronic remittance advice (835/ERA), claim validation and rejection handling, integrated support, and APIs/partner integrations for software vendors.
yes
1980s
P0341
2025-09-07
proprietary commercial
Public tiers: BASIC $30/month (pay-per-use, small submitters), SMALL VOLUME $60/month (100 claims/ERA/eligibility per month), UNLIMITED $120/month (unlimited claims & ERA, 1,000 eligibility checks/month). Free demo available; enterprise solutions and per-claim rates available—contact vendor for custom/enterprise pricing.
subscription
product
1.0
{
"company_name": "Claim.MD",
"company_url": "https://www.claim.md/",
"company_offices": [
"United States"
],
"company_founding": "1980s",
"product_url": "https://www.claim.md/services",
"categories": [
"administrative",
"revenue cycle",
"claims clearinghouse",
"electronic data interchange (EDI)",
"billing",
"eligibility",
"remittance"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://www.claim.md/",
"https://www.claim.md/services",
"https://www.claim.md/pricing",
"https://api.claim.md/",
"https://www.claim.md/payer-list",
"https://www.claim.md/integrated-vendors",
"https://www.claim.md/about",
"https://edireport.com/claim-md/",
"https://www.mgma.com/vendors/claim-md"
],
"summary": "Claim.MD is a US-based electronic data interchange (EDI) medical claims clearinghouse that enables providers, billers, EHR/EMR vendors and payers to submit, track, correct and receive electronic remittance and eligibility in real time.",
"description": "Claim.MD is a web-based claims clearinghouse and EDI service offering online claim creation (CMS-1500/UB-04), batch file uploads (837, CSV, XML and others), real-time eligibility/benefit checks, electronic remittance advice (835/ERA), claim validation and rejection handling, integrated support, and APIs/partner integrations for software vendors.",
"target_users": [
"medical providers",
"medical billers",
"practice administrators",
"EHR/EMR software vendors",
"payers"
],
"specialties": [
"primary care",
"behavioral health",
"physical therapy",
"dental",
"radiology",
"cardiology",
"pediatrics",
"dermatology",
"chiropractic",
"ophthalmology",
"urgent care"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "subscription",
"pricing_details": "Public tiers: BASIC $30/month (pay-per-use, small submitters), SMALL VOLUME $60/month (100 claims/ERA/eligibility per month), UNLIMITED $120/month (unlimited claims & ERA, 1,000 eligibility checks/month). Free demo available; enterprise solutions and per-claim rates available—contact vendor for custom/enterprise pricing.",
"license": "proprietary commercial",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Electronic claims submission (837P/837I) via portal or batch upload",
"Real-time eligibility checks (270/271)",
"Electronic remittance advice (ERA) download (835) and PDF/ XML/JSON formats",
"Claim upload in multiple formats (X12, XML, JSON, CSV, XLS/XLSX)",
"Claims validation and real-time claim-level rejection/return for correction",
"Batch file processing (1–2000 claims per API call)",
"Provider enrollment workflows (payer-specific enrollment)",
"Claim appeals (online/forms/fax/mail options)",
"Reporting and downloadable reports",
"Integrated support/ticketing from the portal",
"Manage claims UI with modification and notes history",
"Payer list & payer-specific service capabilities",
"Webhooks for enrollment/appeal events",
"Archive/delete claims"
],
"optional_modules": [
"Unlimited/Subscription pricing tiers (volume-based features)",
"Alternate file format support (advanced file format handling)",
"Enterprise solutions (higher-volume/enterprise plans)"
],
"integrations": [
"Integrated vendors (example partners): Jane, Healthie, BestNotes, ICANotes, PIMSY, Practice Better, EZClaim, NowMD, Empower EMR, Canvas Medical, MediSys, Sycle, Jane",
"Payer network / thousands of payer connections (payer list / payer IDs)",
"Billing systems / practice management software (SFTP/API file uploads)",
"Electronic remittance (bank/EFT/ACH interfaces via ERA formats)",
"Webhook integration to customer HTTPS endpoints"
],
"data_standards": [
"X12 (837P/837I claims)",
"X12 (835 ERA)",
"X12 (270/271 eligibility)",
"XML",
"JSON",
"CSV",
"XLS/XLSX"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA"
],
"certifications": [],
"security_features": [
"API key (AccountKey) authentication",
"HTTPS/webhook delivery to HTTPS endpoints",
"Request rate limiting (100 requests/minute documented)",
"Audit/modification history for claims",
"User-facing support/ticketing (U.S.-based support)"
],
"privacy_features": [
""
],
"data_residency": "",
"customers": [
"Jane (Jane App users via integration)",
"Practice Better (users via integration)",
"Healthie (users via integration)",
"Elation (uses Claim.MD for eligibility checks)",
"EMSOW (integration mentions ClaimMD)",
"ABA Matrix (partners/promotions mentioned)"
],
"user_reviews": [
"Claim md is user friendly when signed directly into the clearinghouse.",
"We have very OLD software and instead of trying to sell me new software Claim.MD was able to adjust their program and accept our software and file our claims.",
"The lack of [integration/billing workflow] was mostly resolved now with ClaimMD being launched."
],
"ratings": [
"Clearinghouses.org / EDI Report: review indicates Claim.MD scores above 4 stars on support and overall in their clearinghouse review"
],
"support_channels": [
"ticketing",
"24x7"
],
"training_options": [
"documentation",
"webinars",
"live_online"
],
"release_year": "",
"integration_partners": [
"Jane (Jane App)",
"Practice Better",
"Healthie",
"Elation",
"EMSOW",
"BIPTrack / ABA Matrix",
"Various PMS/EHR software vendors"
],
"id": "P0341",
"slug": "claim-md",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/claim-md.json"
}
}