Clearinghouse and EDI management that keeps claims moving
Every claim has to reach the payer, pass its edits, and come back with a remittance. We handle clearinghouse and EDI management, the electronic side of billing, so rejections get fixed quickly and nothing sits unacknowledged.
- Claim edits
- Rejections fixed fast
- ERA enrollment
The problems we hear about most
Before practices come to us for clearinghouse and EDI management, these are the issues that keep coming up.
Silent rejections
Clearinghouse and payer rejections sit in a portal nobody checks, and the claim never really gets filed.
Manual remittances
Without ERA enrollment, payment details arrive on paper and have to be keyed in by hand.
Enrollment gaps
Each payer needs its own EDI and ERA setup. Missing one means claims or remittances don't flow.
Everything included in our Clearinghouse & EDI service
Certified billing and coding professionals handle every part of it, with HIPAA-compliant processes throughout.
Claim edits
Claims checked against clearinghouse and payer edits before submission.
837 claim submission
Claim batches submitted electronically and monitored.
Rejection handling
Rejections worked quickly, corrected, and resubmitted.
835 ERA setup
Electronic remittance enrollment so payments post faster and more accurately.
Claim status tracking
Acknowledgments and status responses tracked until adjudication.
EDI payer enrollment
Setup with each payer so claims and remittances flow electronically.
How clearinghouse and EDI management works with Optima
First, we set up a clear process from day one. That way, your claims keep moving while we get started.
Review your setup
We check your clearinghouse connection, payer list, and enrollments.
Fill the gaps
Next, we complete any missing EDI and ERA enrollments.
Monitor daily
After that, we watch batches, acknowledgments, and rejections every business day.
Fix and resend
When a claim is rejected, we correct and resubmit it quickly.
Is clearinghouse and EDI management right for your practice?
Tap anything that sounds like your practice today.
Let's see if we're a fit
Select the statements that describe your practice to see whether Clearinghouse & EDI would help.
What clearinghouse and EDI management changes for your practice
Claims that reach payers
Every claim is acknowledged, or its rejection is fixed.
Faster payment posting
ERAs replace manual keying of paper remittances.
Less portal checking
Our team watches the EDI side so yours doesn't have to.
Clearinghouse and EDI management for 30+ specialties
Our team works by specialty, so they know the codes, modifiers, and payer rules that apply to yours.
Services that work well together
A clearinghouse is the intermediary that checks claims for errors, converts them to the standard format payers accept, and routes them to each payer. It also returns acknowledgments, rejections, and remittances.
Not usually. We can work with your existing clearinghouse, or help you compare options if your current setup isn't working.
A rejection means the claim didn't pass edits and wasn't accepted for processing. A denial means the payer processed the claim and decided not to pay. Rejections can often be fixed and resent quickly.
ERA enrollment sets up electronic remittance advice (835 files) with each payer, so payment details arrive electronically and can be posted automatically instead of by hand.
See what clearinghouse and EDI management could change. Start with a free audit.
First, we'll review a sample of your claims, denials, and A/R. Then we'll show you where your revenue cycle needs attention.