Transparent Clearinghouse-Cost Software (2026)

Short answer

Two kinds of software show the clearinghouse cost on the invoice. The first is the clearinghouse itself: Office Ally, Claim.MD, and EZClaim's separately contracted TriZetto all publish per-claim or per-transaction rates. The second is Medi, which routes through one clearinghouse (Stedi) and prints its per-claim EDI rate on the invoice ($0.70 per claim, ERA included). Captive-clearinghouse suites such as AdvancedMD and CollaborateMD fold the routing cost into the subscription and never break it out.

The difference matters because a buried clearinghouse cost is one you cannot shop, audit, or show a client. A visible rate lets you model claim volume, check the invoice each month, and see where the money goes. The cost of routing a claim never disappears; it either shows up as a published line or hides inside a per-provider seat fee.

Sources: G2 Medical Billing · Capterra Medical Billing Software · Software Advice Medical Billing

How to read this list

Clearinghouse-cost visibility sorts vendors into four groups: native clearinghouses with published per-transaction rates (Office Ally, Claim.MD), billing platforms that publish a per-claim EDI rate separately from the platform fee (Medi), billing platforms with bring-your-own clearinghouse on a separate contract (EZClaim with TriZetto), and captive-clearinghouse suites that fold the cost into a per-provider seat (CollaborateMD, AdvancedMD). The table's Category column maps each vendor to its group, and the section that follows explains what that means for the bill. Which group a vendor lands in is architecture, not a setting you can flip.

The main options

Office Ally

Office Ally runs its own clearinghouse, so claim routing is the product rather than a line hidden inside something larger. Submission to participating payers (Medicare, Medicaid, most major Blue plans) is included at no per-claim cost on the Service Center base plan. Non-participating payers cost $44.95 per month per unique Tax ID and Rendering NPI combination. ERA retrieval is included for participating payers; eligibility runs $10 per month for the first 100 checks, then $0.10 each.

Office Ally is not a billing-company operating layer. It has no cross-practice denial queue and no aggregated A/R across clients; Practice Mate, the bundled PM module, handles one practice at a time. Billing companies that outgrow that use Office Ally for transmission and run the operational work elsewhere. For the question "what does it cost to route a claim," Office Ally answers it directly.

Compare Medi vs Office Ally · Migrate from Office Ally

Claim.MD

Claim.MD has published tiered clearinghouse pricing for over forty years. Per its pricing page: $30 per month for Basic pay-per-use ($0.50 per claim), $60 for Small Volume (100 claims included, $0.30 overage), and $120 for Unlimited (unlimited claims and ERA, 1,000 eligibility checks). Extra Tax IDs on Unlimited are $30 per month each. No contracts, no setup fees.

Claim.MD holds SOC 2 Type 2, EHNAC accreditation, and CAQH CORE certification, a deeper compliance set than most billing platforms carry, Medi included at this point. It accepts batch uploads in 837P, 837I, 5010, 4010, CSV, XLS, XML, NSF, and Print Image, which makes it a useful interoperability layer for older systems.

Like Office Ally, Claim.MD is a clearinghouse and transaction tool, not an operating surface for a billing team. It handles transmission, rejection queuing, eligibility, and ERA delivery. Denial management, cross-practice queues, and team posting workflows live elsewhere. For low-cost, contract-free clearinghouse access, it earns its reputation.

Compare Medi vs Claim.MD

EZClaim

EZClaim does not bundle a clearinghouse at all. The software is priced by seat ($199 first user, $149 each additional per its published pricing), and clearinghouse access runs on a separate TriZetto contract; third-party estimates cite roughly $0.10 to $0.30 per claim by volume and payer (TriZetto does not publish rates). Two invoices means two cost lines, which keeps the routing cost visible even though the systems are not integrated at the price level.

The tradeoff is managing two vendor relationships. EZClaim's desktop-first, Windows-native design fits single-location operations and practices that want offline capability. For distributed teams working many client practices, a cloud work surface fits better. See best medical billing software for billing companies for the cloud operating-layer options.

CollaborateMD

CollaborateMD bundles its clearinghouse into the subscription and does not name the underlying vendor. The routing cost sits inside the per-provider fee structure, not as a separate line you can audit or negotiate. CollaborateMD does not publish pricing; a BestNotes partner price sheet lists about $0.38 per claim for 1-1,000 claims per month (declining with volume) and a roughly $54 per provider fee; higher billing-company tiers are quote-only.

CollaborateMD has sold to billing companies since the early 2000s, which shows in product maturity and reference customers. Its multi-client dashboard, role-based access, and cross-practice reporting were built for the billing-service model rather than bolted on, and it carries twenty-plus HL7 EHR connections. Its routing rate may well be competitive at its volume bands, but it stays inside the seat where you cannot see it. Per-megabyte document storage caps at some tiers are a separate friction point Capterra reviewers flag.

Compare Medi vs CollaborateMD · Migrate from CollaborateMD

AdvancedMD

AdvancedMD's clearinghouse is captive. Per its published pricing, plans start at $429 per provider per month (PM + Billing) up to $999 per provider per month (full PM + EHR bundle), bundling scheduling, patient engagement, claim scrubbing, clearinghouse submission, and ERA retrieval. What a billing company cannot see is how much of that seat is routing, because it is not disclosed. AdvancedMD added Waystar as a preferred clearinghouse partner after the 2024 Change Healthcare disruption, adding redundancy, but the clearinghouse choice stays under AdvancedMD's control, not yours.

Since the Francisco Partners acquisition, some billing companies report new fee categories and slower support. AdvancedBiller volume discounts are quote-only, so modeling cost against book size takes a sales conversation. The wholesale routing cost inside the seat is invisible, and per-provider pricing means the bill grows with every provider added to a client.

Compare Medi vs AdvancedMD · Migrate from AdvancedMD

Medi

Medi routes all claim traffic through one clearinghouse, Stedi, and that single connection is what makes the cost legible. The per-claim EDI rate is published at /pricing and prints on the invoice: $0.70 per claim whether it has one service line or twelve, with ERA retrieval included at no separate charge. Volume discounts graduate by billing company per month: $0.70 for the first 500 claims, $0.65 from 501 to 5,000, and $0.55 beyond 5,000. Eligibility inquiries are $0.25, claim status is $0.20, and COB, insurance discovery, and attachments are $1.50 each. 277CA acknowledgments are included.

The platform fee is separate and published: $20 per client practice per month, stepping down to $15 for practices 26 to 50 and $10 beyond 50. Adding providers inside a practice never changes it. The EDI invoice is additive, so you model both lines independently and reconcile each month against actual claim volume rather than trusting that a per-provider seat priced its routing fairly.

Medi is not an EHR and does no scheduling, clinical notes, or prior-authorization submission. It does not offer a choice of clearinghouse: Stedi is the connection, and payer enrollment runs through it. A billing company with trading-partner relationships tied to another clearinghouse moves those to Stedi during implementation. Medi also lacks SOC 2 Type II or HITRUST certification today, CollaborateMD's reference-customer history, and AdvancedMD's EHR breadth. Weigh those against the pricing model. The demo and pricing calculator are the place to model whether the economics fit, and best medical billing software for billing companies covers the broader platform decision.

How to choose

• **Do you need a clearinghouse or an operating layer?** Office Ally and Claim.MD are cheap and transparent for the EDI problem alone. If you also need denial queues, ERA review, and cross-practice A/R, you need a platform alongside or instead of one.
• **Can you see the routing cost on your invoice today?** A rate buried in a per-provider seat leaves you guessing at what you actually pay to route a claim, with no way to verify it against volume.
• **Does the vendor let you pick the clearinghouse?** EZClaim's BYO model gives visibility through separate invoicing but adds vendor-management overhead. Medi publishes the rate but routes only through Stedi.
• **How does cost scale as your book grows?** Per-provider models (AdvancedMD) grow with every provider added to a client. Per-practice models (Medi) grow only when you add practices. Native clearinghouses (Claim.MD, Office Ally) grow with claim volume regardless of provider count.
• **Does routing cost outweigh the operating layer?** For heavy denial and ERA work, the operating surface usually costs more than routing. For mostly pass-through claim volume, routing is the line that matters most.

Medi's fit is the billing company that wants the routing cost on the invoice and also needs a real operating surface for denials, ERA review, payment posting, and cross-practice team work. For the single question "cheapest way to route a claim," Office Ally and Claim.MD win.

Frequently asked questions

Why does clearinghouse cost transparency matter for a billing company?

You pay for claim routing whether or not it shows on the invoice. Buried inside a per-provider seat, the rate is impossible to check against your volume or pass through to a client with confidence. Wholesale per-claim routing across clearinghouses generally falls in the low tens of cents, so a $429-per-provider seat (per AdvancedMD's published pricing, as one example) routing 200 claims a month absorbs maybe $20 to $40 of routing inside a much larger fee. That math is invisible unless the rate is published on its own.

Are Office Ally and Claim.MD actually transparent on clearinghouse cost?

Yes, more consistently than any billing platform. Both publish per-transaction or per-tier rates that map directly to clearinghouse usage. Office Ally's non-par fee ($44.95/month per Tax ID + NPI) is the nuance to watch, since it triggers on a single non-par claim in the month. Claim.MD's $120/month Unlimited tier is the most predictable at high volume. Neither offers the operating layer a multi-practice book needs, but on routing-cost visibility they set the benchmark.

Does Medi use multiple clearinghouses?

No. Medi routes all claim traffic through one clearinghouse, Stedi. The published per-claim EDI rate reflects Stedi transactions. A billing company moving to Medi transitions payer trading-partner relationships and enrollment connections to Stedi during implementation.

How does CollaborateMD's clearinghouse cost compare to Medi's published EDI rate?

CollaborateMD does not publish its routing cost separately, so a per-claim comparison is not possible; the cost sits inside the per-provider fee, and billing-company tiers are quote-only. Medi publishes a flat $0.70 per claim (ERA included, volume discounts applied by tier) on top of the platform fee. Whether that runs higher or lower than CollaborateMD in aggregate depends on claim volume, payer mix, and the tier you negotiate. The point is not which rate is lower in every case; it is whether you can see the rate at all.

What should a billing company ask any vendor about clearinghouse cost?

Four things: which clearinghouse handles 837 submission, 835 ERA, 270/271 eligibility, and 277CA acknowledgments; what it charges per transaction at your volume; whether that cost is a separate invoice line or absorbed into the platform fee; and whether you can switch clearinghouses if rates or the vendor's partner change. A vendor that cannot answer the second or third question precisely is one whose routing cost you will not be able to see after you sign.

A note on the pricing figures here

Pricing for other vendors comes from their public pricing pages where they publish one, and from third-party aggregators, reseller materials, and customer reports where they do not. Several of these vendors do not publish pricing, so those figures are approximate, may not reflect negotiated or current rates, and can change without notice. Treat them as a starting point and confirm directly. Where a vendor does not publish, this page says so rather than stating an estimate as fact. Medi's own pricing is published in full at /pricing.

Sources: Capterra Medical Billing Software · G2 Medical Billing · Software Advice Medical Billing · Claim.MD Pricing · Office Ally Pricing · AdvancedMD Software Pricing