List of Clearinghouses in Medical Billing

A list of clearinghouses in medical billing is useful only when it is paired with selection context. Clearinghouses differ by payer coverage, claim type, transaction support, integration method, pricing model, support model, and whether they serve providers directly or mostly through software partners.

Commonly researched clearinghouse and payer-connectivity options include Change Healthcare/Optum, Availity, Waystar, Office Ally, Claim.MD, Stedi, Experian Health, Inovalon, TriZetto/Cognizant, and regional or state-specific EDI networks. This list should be treated as a research starting point. Payer connectivity, product names, and supported routes can change, so always verify with the vendor and payer before implementation.

Clearinghouse categories

Category	Typical fit
Enterprise clearinghouse	Health systems, large groups, high transaction volume, broader RCM suite needs
Payer-portal network	Practices that rely on payer portals, eligibility, claims status, or prior authorization workflows
Low-cost provider clearinghouse	Small practices or billing companies optimizing per-claim cost
API-first EDI platform	Engineering-led teams building custom payer connectivity or embedded workflows
EHR/PMS-embedded route	Practices that want claim submission inside the software they already use
Specialty or state network	Medicaid, workers' compensation, behavioral health, dental, or local payer routes

What to record in your shortlist

For every vendor, document payer support, transaction types, claim formats, ERA handling, eligibility support, claim status support, attachment support, enrollment process, service-level expectations, pricing model, data export options, and outage communication. The exercise prevents a superficial list from becoming a procurement mistake.

QuickIntell's role is to make that routing information operational. If a claim is rejected, the response should point to a specific owner and evidence gap. If an ERA posts with an underpayment or denial, the adjustment should connect back to the claim, payer, contract, and appeal workflow.

Related QuickIntell pages

• What is a medical clearinghouse?
• Medical billing clearinghouse
• QuickEHR clearinghouse workflow
• Clearinghouse rejection vs payer denial

Frequently Asked Questions

Can I use more than one clearinghouse?

Yes. Some organizations maintain a primary and secondary route for resilience, payer coverage, or specific transaction types.

Is a payer portal a clearinghouse?

Usually no. A payer portal is a payer-specific channel. A clearinghouse aggregates transactions across many payers, though some payer networks also provide portal-like workflows.

How often should the list be reviewed?

At least annually, and sooner after an acquisition, outage, payer enrollment change, Medicaid program change, or material EHR/PMS migration.