Replaces · Your clearinghouse portal
The clearinghouse is built in. Stop living in its portal.
Claim.MD is included in Unisona Health: claims go out from the encounter, remittances come back and post, and eligibility and claim status run inside the record. What goes away is the daily routine of logging into a portal to check status, decode a rejection code, and download an 835 to key in by hand.
Claim.MD included. No separate clearinghouse invoice; payer enrollment is handled during implementation.
The real invoice
What it costs, including the parts that never appear on one.
Unisona Health replaces the clearinghouse portal and the separate clearinghouse contract: Claim.MD is built into the platform, with no separate invoice. Claims go out from the encounter, scrubbing flags the failing field before submission, 835 remittances import and post automatically, and denials route to a queue with an owner.
The subscription is the visible line. Everything marked hidden below is paid in staff hours or in revenue that quietly never arrives.
Illustrative. Subscription ranges are typical rather than quoted, and the hour estimates come from the programs we built this with. Your numbers will differ — the point is which lines are on the invoice and which are not.
Where it breaks
Four seams, all of them at the same boundary.
The portal tells you a number. Fixing it happens in another system, by someone reconstructing what went wrong.
The file exists in one place and the claims exist in another, so a human moves the numbers between them.
Nothing tells you a claim moved. Someone checks, on a schedule, forever.
What did not pay gets copied into a spreadsheet, which is where appeal deadlines go to expire.
Payer connectivity, enrollment and transmission are exactly what a clearinghouse should do, which is why Claim.MD is built into Unisona Health rather than bolted on. The portal was a workaround for a billing system and a clearinghouse that were never connected — not a product anyone wanted to use.
Switching
What moving actually involves.
No implementation fee on Solo or Group Practice. Larger migrations with historical data are quoted separately.
EDI enrollment is submitted for each payer and billing entity during implementation.
Step 1Submit against sample data before anything reaches a payer.
Step 2835 files import and match automatically from the first batch.
Step 3Your current clearinghouse stays live until every payer has switched over.
Step 4Revenue 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
Denials work queue
Every denial and underpayment lands in a queue with the reason, the dollar amount, the deadline, and the person responsible.
Read more →A portal is a symptom
Nobody chose to work in a clearinghouse portal. It is where you go because two systems that should be connected are not.
Bring your current stack to a walkthrough and we will go through it line by line, including the ones we cannot replace.
Questions
Common questions.
How do we stop posting 835 remittances by hand?
Turn on remittance import. 835 files import and match line by line against the original claims from the first batch, payments and contractual adjustments post automatically, and only exceptions reach a person. That replaces downloading files from a portal and keying them into a billing system one claim at a time.
How is claim scrubbing different from a clearinghouse rejection?
Scrubbing runs before the claim leaves and highlights the exact field that will fail, in plain language. A clearinghouse rejection arrives days later as a code and a claim number, looked up in a portal and fixed in a different system. Behavioral health edits such as authorization windows, credentials, modifiers and level of care are checked on the claim in front of you.
Where do denials go instead of a spreadsheet?
Into the denials work queue. Denials and partial payments route there during remittance posting with the reason attached, and each one carries the dollar amount at risk, the appeal deadline and a named owner, so appeal windows stop closing unnoticed in a shared tab.
Do we still need our own clearinghouse?
No. Claim.MD is included in Unisona Health and priced in, with no separate clearinghouse invoice. EDI enrollment is submitted through Claim.MD for each payer and billing entity during implementation. Your current clearinghouse stays live until every payer has switched, and claims already submitted there are worked to completion.
Also replaces
The other tools that end up living on the same record.
Replaces
Your admissions CRM
It captures the enquiry well. Then someone types everything it captured into the EHR a second time, and the two records begin drifting apart from that moment.
See what it replaces →Replaces
Your outcomes tool
Assessments go out, scores come back, and they live in a system that knows nothing about the episode of care or what any of it was billed at.
See what it replaces →Replaces
Your LMS
Every new hire is created twice and every departure remembered twice. Completion reports are reconciled against a staff list that lives elsewhere.
See what it replaces →Replaces
Your census spreadsheet
A whiteboard at the nursing station, a spreadsheet someone updates, and an EHR that learns about admissions later. Three records of the same census.
See what it replaces →Get started
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