Switching · Clearinghouse included
The clearinghouse is part of the platform.
You do not bring one and you do not keep the one you have. Claims go out, remittances come back, and eligibility runs through Claim.MD — connectivity that is already built in, priced in, and enrolled on your behalf.
Powered by Claim.MD. No separate clearinghouse invoice, and payer enrollment is handled during implementation.
What's included
Six things you no longer buy separately.
Unisona Health includes the Claim.MD clearinghouse in the platform: claim submission, automatic 835 remittance import, real-time eligibility, claim status and rejection handling, with no separate clearinghouse invoice. EDI enrollment with your payers is submitted during implementation, and your existing clearinghouse stays live until every payer is switched over.
Included
Claim submission837P for professional claims and 837I for facility claims, submitted directly from the encounter.
Included
Remittance return835 files import automatically, match line by line, and post without anyone downloading a file.
Included
Eligibility270/271 real-time benefit checks, run from the chart and from the intake lead.
Included
Claim status276/277 status updates arrive on the claim rather than waiting in a portal for someone to check.
Included
Rejection handlingFront-end rejections come back with the failing field identified, in the claim you are already looking at.
Included
Payer enrollmentEDI enrollment with your payers is submitted through Claim.MD as part of implementation, per billing entity.
The transition
How the switch actually happens.
We submit EDI enrollment through Claim.MD for each payer and billing entity on day one.
Step 1Your existing clearinghouse stays live. New claims start flowing through ours as each payer approves.
Step 2We verify 835s are arriving and posting correctly before anything is switched off.
Step 3Once every payer is live and the last claims are worked, you give notice on the old contract.
Step 4Before you commit
Five things to check first.
We would rather you find these now than three weeks into a cutover. Every one of them has delayed somebody's go-live.
Print this, or bring it to the walkthrough and we will go through it with you.
Most clearinghouse agreements have a notice period, and some auto-renew annually. Find your date before you plan a cutover.
Claims already submitted through your current clearinghouse should be worked to completion there. Do not cancel mid-cycle.
EDI enrollment is a payer-side process. Some approve in days, some take several weeks — Medicaid plans are usually the slowest.
We run parallel until the new enrollments are live and remittances are arriving correctly.
If your current clearinghouse also provides eligibility, patient statements or reporting, confirm what else you are switching off.
Revenue 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
Eligibility & benefits
Real-time eligibility on the chart, with behavioral health benefits broken out — deductible, copay, coinsurance, and whether the level of care you're admitting to is covered at all.
Read more →Why it is not optional
Claim scrubbing that knows your authorization status, remittances that post against the original claim, and denials that route themselves only work when the connectivity is part of the same system. Building against one clearinghouse is what makes those seams disappear.
Bring your current contracts and renewal dates to a walkthrough and we will map the timeline against them.
Questions
Common questions.
Does Unisona Health include a clearinghouse?
Yes. Claim.MD connectivity is built into the platform and priced in, with no separate clearinghouse invoice. It covers 837P and 837I claim submission from the encounter, 835 remittances that import and post automatically, 270/271 real-time eligibility, 276/277 claim status on the claim itself, and front-end rejections returned with the failing field identified.
How long does payer EDI enrollment take when switching clearinghouses?
It varies by payer: some approve in days, others take several weeks, and Medicaid plans are usually the slowest. That is why enrollment is submitted through Claim.MD for each payer and billing entity on day one of implementation, and why your slowest payer sets your go-live date.
Can we keep our current clearinghouse while we switch?
Yes, during the transition. Your existing clearinghouse stays live while new claims move to Claim.MD as each payer approves enrollment. Claims already submitted through the old clearinghouse are worked to completion there, and you give notice on the old contract only once every payer is live and remittances are verified.
What should we check before cancelling our clearinghouse contract?
Your termination clause and notice date first, since many clearinghouse agreements have a notice period and some auto-renew annually. Then confirm outstanding claims will be worked to completion there, and check whether the clearinghouse also provides eligibility, patient statements or reporting you would be switching off at the same time.
Switching
The rest of what moving to Unisona Health involves.
Switching
How migration works
Migration is a data question, not a project-management one. Exactly which records move by default, which move on request, and which are better left alone.
Read the switching guide →Switching
Implementation
Implementation is not a project you staff. It is four weeks of configuration, data migration and parallel running, with your programs running normally.
Read the switching guide →Switching
Leaving Unisona Health
You can export everything, in a usable format, at any time — during your subscription or on the way out. No fee, no notice requirement, no retention team.
Read the switching guide →By role
Who this matters to most.
By role
Billing manager
A third of your denial queue traces back to something that happened before the claim existed: an authorization nobody watched, a credential that lapsed.
See the week from this role →By role
Practice manager
Every gap between the scheduling tool, the EHR, the billing service and payroll is filled by someone retyping. Invisible, unbillable, most of the week.
See the week from this role →Get started
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