Top 18 Clearinghouses In Medical Billing

Do you experience struggles regarding your company’s profitability such as increasing operational costs and decreasing payer reimbursement rates? Luckily, the top clearinghouses in medical billing have managed to tackle these issues in order to guarantee payer reimbursement and reduce financial risk associated with patient exposure to accounts receivable. The scope of services is now greatly expanded and  includes the entire revenue cycle, from insurance verification and submission to processing and remittance, as well as appeals and settlement. In this article we will discuss the benefits of modern progressive technologies and go through the list of some of the best providers.

Clearinghouse in Medical Billing

What Is a Clearinghouse in Medical Billing

Medical billing clearinghouse is a third-party organization that serves as a go-between for insurance companies and practices during financial submissions. It receives claims from vendors, processes and verifies them, makes sure they are accurate and comprehensive, and sends them to financial companies to complete payment.

Switching to entirely electronic transactions, the wellness sector may save $20 billion, or 48% of current yearly expenditure, out of the $42 billion. Even though the sector has already saved $166 billion a year by automating administrative activities, there are still many opportunities to cut expenses and overall spending even more.

In addition to processing payments and managing electronic transactions you can facilitate the process of healthcare reimbursement and payment. It converts data received from systems into a format that is compatible with various payer platforms prior to submission, allowing to speed up the process and pay providers more quickly.

Clearinghouse Medical Billing

What Does a Medical Billing Clearinghouse Do?

A clearinghouse facilitates communication between providers and payers by serving as an intermediary. It improves the process by lowering mistakes, confirming eligibility, supporting patient operations, providing analytical tools, and handling refusals. Below let’s see how this all-inclusive function guarantees you less rejections, faster payments, and an overall more seamless procedure.

  • Eligibility Verification You can verify a patient's insurance coverage prior to treatment. This phase helps you set clear expectations and lower denials by verifying that the payment is active, identifying cover limitations, and highlighting potential out-of-pocket costs.
  • Claim Receipt Either directly or via management systems, you can submit claims to the clearinghouse. This centralized filing helps to ensure that the request starts its trip in a controlled environment and helps with rapid, consistent processing.
  • Scrubbing It conducts thorough examinations and looks for inconsistencies, code mistakes, and missing data. By identifying and fixing mistakes that might result in rejections, this procedure seeks to increase the likelihood that the applications will be approved.
  • Conversion into Standard Format Submissions get transformed into a commonly accepted format that meets all HIPAA requirements. Regardless of the format of the original system, this uniformity guarantees that insurance companies can easily read and process all the information.
  • Transmission The request is electronically sent to the designated payer once it has been standardized and verified to be error-free. This smooth transition lowers the possibility of loss or delay and is faster than manual submissions.
  • Verification of Receipt The provider receives an acknowledgement from the medical billing clearinghouse. You can feel secure in the filing procedure knowing that the submission was successfully accepted and delivered thanks to this acknowledgment.
  • Reaction from Insurance Payer After reviewing the application, the vendor determines whether to approve it, deny it, or ask for further details. Their choice is redirected through the platform, establishing an orderly communication route.
  • Communication of Errors or Rejections The providers notify you if the insurance company finds problems with the submission or if it rejects it outright. By identifying certain mistakes, suppliers may identify and fix the underlying issues, expediting subsequent submissions.
  • Patient Billing It assists you in producing accurate patient invoices when the answer is understood. They provide a clear explanation of any unpaid expenses that are not reimbursed by insurance, guaranteeing open communication about any unpaid debts.
  • Reporting and Analysis Сlearinghouses for medical billing provide analytical capabilities in addition to processing submissions. Providers may examine comprehensive statistics that display submission patterns, success rates, and common causes for rejections. These reports offer valuable insights that help you optimize your workflows.
  • Refusal Navigation It provides assistance to parties who have their applications denied by outlining the reasons and recommending remedial measures. By taking a proactive stance, practices may better manage reoccurring problems, streamline their submission procedure, and increase their chances of payment.
Clearinghouses for Medical Billing

Our Top Medical Billing Clearinghouse List

The success of your revenue cycle revolves around medical billing software development. One of the most crucial aspects of controlling your cash flow is selecting the ideal solution for your business. However, it can be overwhelming trying to choose from numerous choices in the market. Here let’s go through our list of top ventures to best fit your practice.

CleverDev Software

CleverDev Software's custom medical practice management software streamlines transactions with efficiency and accuracy. It integrates seamlessly with various systems, ensuring compliance with HIPAA regulations and providing robust security measures. By automating processing and offering real-time status checks, we optimize revenue cycles and reduce administrative burdens. Our advanced analytics empower data-driven decision-making, while comprehensive support and training resources maximize value for organizations. CleverDev Software enables better patient care through streamlined operations and enhanced financial performance.


MediConnect distinguishes itself by prioritizing the simplification of intricate procedures. In order to minimize denials and guarantee prompt reimbursements, MediConnect uses state-of-the-art artificial intelligence and machine learning algorithms to find any mistakes prior to submission. They have a great reputation among professionals because of their proactive attitude.


Kareo makes a great focus on automation to support independent practices by enabling them to use various types of healthcare software for all management aspects. This is a great way to streamline fee procedures for physicians who wish to reduce paperwork and personnel. However for certain professionals the lack of personal interaction and one-on-one assistance with clients can be disadvantageous. Still, Kareo remains among the best systems on the market today due to their advanced technologies.


Trizetto allows you to handle workers' compensation, institutional, dental, and professional submissions. Their simplified filing procedure includes all formats, with payment-specific modifications to prevent errors from becoming rejections. In addition, rejection analysis monitors frequent mistakes, while solutions locate denials and streamline the appeals process.


The company provides big hospitals and clinics with different types of EHR software and practice management systems. Despite its complexity for smaller ventures, it is a top option for large enterprises due to its strong security and compliance. Their technologies are perfect for big businesses due to their competent and knowledgeable medical billing clearinghouse services.  


HealthBridge is widely recognized among major corporations and small practitioners for their commitment to upholding industry norms and laws. The business shows an extraordinary commitment to compliance and professionalism. Their integrated solutions accelerate the whole process, from generating requests to reconciling payments.


CureMD provides comprehensive reporting, which enables them to monitor important indicators and spot problems before they escalate. CureMD is a great option for self-sufficient clinics since it provides good support and advanced medical billing software. It is a great option for businesses that focus on technology and strong analytics, however for service-oriented enterprises it requires more attention to detail.

ClearClaim Connect

ClearClaim Connect sets itself apart from other medical billing clearinghouse companies with its emphasis on insights and data analytics. They help providers make well-informed decisions regarding their strategies by utilizing data. The company's adaptable reporting capabilities of ClearClaim Connect give insightful information that enables you to maximize their revenue cycle management.

PrecisionBilling Pro

PrecisionBilling Pro is well-known for its dedication to accuracy and precision in financial operations. With their team of seasoned specialists on staff, they make sure that submissions are carefully examined, reducing the possibility of rejections. The company gained their reputation as a trustworthy partner through their dedication to staying up to date with ever changing trends.


Among medical billing clearinghouses, OmniHealth stands out by providing a one-stop shop for all needs. Their end-to-end services address the various issues from eligibility verification to claim filing and follow-up. They have a devoted following of customers because of their user-friendly platform and attentive customer service.


ClaimBridge is renowned for emphasizing cooperation and openness. You can monitor the real-time progress of their claims through their online portal, which promotes control and responsibility. Additionally, ClaimBridge's focus on communication between payers and providers is able to decrease friction and speed up the processing of claims.


ApexEDI is widely renowned for its commitment to affordability and accessibility. They provide a cloud-based platform that makes submitting claims safe and easy for both small practices and big facilities. Their focus on prioritizing user assistance and training has made them an optimal choice among professionals.


One distinctive feature of RevenueSync is its creative approach to revenue cycle management. This electronic medical billing clearinghouse improves productivity and reduces human mistakes in procedures by utilizing AI-driven processes and automation. The ability of RevenueSync to integrate with different practice management systems guarantees a smooth experience for professionals.

eClaim Gateway

The most outstanding characteristic of eClaim Gateway is that they place a strong emphasis on customization and adaptability. Recognizing that every business is distinct and has various demands, eClaim Gateway provides customized solutions that adjust to varied procedures. They have established themselves as reliable clearinghouse for medical billing due to their commitment to client satisfaction and flexibility.


Following a recent merger, ZirMed and Navicure are currently operating under separate identities. The revenue cycle management firm provides a cloud-based software system that simplifies all aspects of payment, including the examination of patient eligibility, remittance, rejection, and appeal management, as well as the original filing of claims. Four "Best in KLAS" awards have been given to the firm, one of which was given this year.


Emdeon is one of the top suppliers of clinical services that integrate medical billing clearinghouse software and automate critical commercial and administrative tasks for payers  and providers. They help customers increase cash flow, decrease expenses, and manage the intricate revenue and payment cycle and clinical information exchange processes more effectively. Emdeon's full suite is specifically made to seamlessly integrate with current technological infrastructures.


BellMedEx works closely with each customer as an internal partner. Since each specialization has an individual account manager to guarantee that specific demands are satisfied, BellMedEx's ability to manage its revenue cycle leads to significant gains in collections. BellMedEx also gives demos and free consultations and BellMedEx helps you get into profitable payer networks and challenges clearinghouse rejections in medical billing to guarantee proper payment.


CareCloud's strong team improves financial health by optimizing payments and minimizing claim denials. They improve workflows by real-time reporting and interaction with scheduling and practice management platforms. Due to cost and flexibility concerns, it might not be appropriate for major hospitals or systems, even though it works well for outpatient and ambulatory services.

To Sum Up

Overall, navigating the complexities of transactions and reimbursement can be challenging, especially with increasing operational costs and decreasing payer reimbursement rates. However, best clearinghouses for medical billing can address these challenges to ensure you full and timely payer reimbursement while minimizing the financial risks associated with accounts receivable. The evolution of services from basic transaction facilitation to comprehensive revenue cycle management can greatly benefit you with improved efficiency, accuracy, and financial performance. Utilizing the modern progressive technologies and the expertise of leading organizations you can streamline processes, optimize revenue cycles, and ultimately deliver better patient care.

If you are interested in a comprehensive solution to tackle your unique challenges, CleverDev Software experts are committed to deliver a personalized approach tailored specifically to your needs. Reach out to us today for bespoke services provided by our seasoned team.

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About the Author

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Anastasiya Kastsiukovich

Anastasiya Kastsiukovich

Tech & Innovation Expert

Anastasiya is committed to making the complex simple. Her passion for writing, proficient research, and strong interviewing skills allow her to share in-depth insights into the ever-evolving IT landscape.

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