Build, submit, and manage claims in SimpliClaim while keeping your existing clearinghouse.
From the first accepted claim. Your clearinghouse bills you separately.
Pro connects the work before submission with the follow-up that comes after it.
Bring appointments, patient information, and encounter documentation into your claim workflow.
Prepare 837P or 837I claims and review missing or inconsistent information before submission.
Review claims, generate the 837 file, and transmit through your configured clearinghouse connection.
Work with claim responses, ERA / 835 remittances, and recovery queues to organize your next steps.
With Starter and Pro, SimpliClaim provides your software workspace. Your clearinghouse continues to provide its processing services under your existing agreement.
Compare support optionsHelp with account access, platform features, and software issues.
Manage claim corrections, payer rejections, clearinghouse questions, and payer follow-up.
Prefer SimpliClaim to handle claim issues and trading partner coordination? Explore Premium.
For teams that manage their own claims, we recommend Pro.
837 Builder
Build and send claims while keeping your existing clearinghouse.
Additional claims from $0.50 each, then $0.40 and $0.30 in graduated bands.
Your team and clearinghouse handle payer rejections and clearinghouse claim issues. Clearinghouse fees are separate.
Claims Operations
For teams that manage their own claims and want one connected workflow.
From claim #1. No accepted claims included.
Your team and clearinghouse handle payer rejections and clearinghouse claim issues. Clearinghouse fees are separate.
Managed Claims & Clearinghouse
Let SimpliClaim handle claim issues, payer rejections, and clearinghouse coordination.
From claim #1, including clearinghouse processing. No accepted claims included.
SimpliClaim handles rejection troubleshooting, trading partner coordination, and resolution follow-up.
A monthly subscription plus accepted-claim usage.
Counts accepted claims confirmed by a matched 277CA acknowledgment.
Enter a whole number from 0 to 1,000,000.
Estimate for one billing cycle. Your clearinghouse bills you separately. Its fees are additional to SimpliClaim's charges.
Understand the workflow, the fees, and who handles support.
With Starter or Pro, you keep your existing clearinghouse agreement and pay its charges separately. We review your connection and workflow during setup. Premium includes clearinghouse processing, with SimpliClaim coordinating the service for you.
Starter covers claim-building essentials, including the 837P and 837I studios, validation, transmission, directories, and attachments. Pro adds appointments and visit-to-claim workflows, review and work queues, ERA / 835 remittances, recovery workflows, team access, and standard reports.
Starter and Pro include basic SimpliClaim platform support for account access, using features, and software issues. Your billing team and clearinghouse handle payer rejections and clearinghouse claim issues. With Premium, SimpliClaim handles rejection troubleshooting, trading partner coordination, and resolution follow-up.
For Pro and Premium, a production claim counts when an authoritative, exactly matched 277CA acknowledgment confirms acceptance. Rejected, ambiguous, and accepted-with-errors responses do not count. A 999 acknowledgment, ordinary 277 status response, or 835 remittance alone does not count. Acceptance does not guarantee payment.
Yes. You can enter claim information directly into SimpliClaim to build an electronic 837 file. This replaces the scan-to-EDI conversion step for those claims. Your team still reviews the claim information and supplies any required supporting documents.
Request a 15-minute workflow review. We will walk through your team's process, the clearinghouse connection, and which plan fits your needs before you get started.
See how your appointments, claims, and follow-up can work together in SimpliClaim Pro.