Register your organization

Organization

Organization / practice namePractice phone (optional)

Organization Tax ID

SimpliClaim uses the Tax ID as the starting ISA06 sender value. Confirm or replace it with the clearinghouse-assigned sender ID during Networking setup before the first submission.

Administrator

Admin full nameAdmin email

Billing email

The administrator receives a secure activation email after payment clears.

Plan

Payment method

Card details and the billing address are collected securely by Stripe at checkout.

I authorize SimpliClaim to start the secure payment checkout, provision the organization after verified payment, queue the activation email, create the first portal admin account, and measure applicable claim usage under the selected plan and Stripe billing cycle.

By continuing, you agree to the Terms of Service and acknowledge the Privacy Policy. The organization administrator reviews the complete billing, security, HIPAA/BAA, and claims agreement bundle before entering the workspace. An applicable written BAA must be in effect before the practice uses SimpliClaim with production PHI.

SimpliClaim creates the practice only after Stripe confirms the payment. Once that clears, the portal admin receives the activation email right away.