Migrating from Kareo

Short answer

Kareo is Tebra. The merger closed November 2, 2021, and the Kareo website redirected to tebra.com on December 5, 2024. If you are still searching for "Kareo migration," you are on a legacy Kareo-branded contract, working from documentation that predates the rebrand, or both. The migration playbook is the same either way, because the product is the same product.

For planning, we usually estimate around one business day per practice for the Medi cutover once exports and payer-enrollment inputs are ready, while payer enrollment and legacy A/R continue in parallel. Tebra's documented exports are real: patient demographics, charges, unpaid insurance claims, A/R aging, and fee schedules all come out in Excel or CSV. Clinical history exports as XML Summary of Care files. What does not move cleanly is everything in flight, the open-claim working notes, unposted 835 ERA files, in-progress appeals, and the EDI enrollment ties that keep claims routing to the right clearinghouse. The pattern that protects revenue is a forward-only Medi cutover with legacy A/R closeout running in parallel inside Tebra.

Migration to Medi is free with a 12-month commitment, or a one-time $100 per client practice (capped at $3,000) month-to-month. Data export from Medi is always free in standard formats. There is no termination fee; the annual commitment is the only lock-in.

Kareo is Tebra now — does that change the migration?

Operationally, no. The product you used as "Kareo" and the product now branded "Tebra" share the same claim submission infrastructure, the same clearinghouses (Trizetto Provider Solutions for medical and institutional claims, Jopari Solutions for workers' comp and auto), and the same help center. The old helpme.kareo.com URLs 301-redirect to helpme.tebra.com. Your EDI enrollments, payer connections, and data all live inside what is now the Tebra platform, regardless of which name is on your contract.

Three things are worth checking if you are on a legacy Kareo contract rather than a current Tebra agreement.

1. **Termination notice window.** Tebra's pricing policy requires 60 days written notice before the end of the current term. A legacy Kareo contract may have set different terms. Pull the contract and find the non-renewal clause before you commit to a cutover date. A missed notice window locks you into another renewal period no matter what the new platform is ready to do. 2. **Support and data rights.** Kareo customers who never formally moved to the Tebra product may be on a support tier that predates Tebra's current packaging. If your account manager came through kareo.com before December 2024, confirm which contract terms govern your data export rights and closeout window. 3. **Historical documentation.** Older PDFs and training materials that say "Kareo" may describe menu paths since reorganized under the Tebra brand. Trust current helpme.tebra.com content over any PDF with "Kareo" in the header.

Beyond those, the mechanics are identical to a current Tebra migration. See the full Tebra migration guide for the complete cutover playbook. This page covers the Kareo-specific framing a billing company needs before the tactical work starts.

Estimate around a day per practice

As a working estimate, a clean Medi cutover is often around one business day per practice once the Kareo/Tebra export, provider identifiers, payer inventory, and user list are ready. Payer enrollment and A/R handoff run in parallel around that cutover. The revenue risk is not speed by itself; it is moving without ownership for aged claims and enrollment follow-up.

For a billing company on a legacy Kareo contract, the clock starts from your written non-renewal notice, not from when you first contact Medi. If the contract renews annually and you are 60 days out, you either have a year to pace the migration or a hard deadline to hit the notice window before the next term. Which one is a contract-reading question, not a software question, and it is the first decision to make.

Two terms the outgoing Tebra/Kareo arrangement needs to include:

• The outgoing party works all claims with dates of service before cutover for at least 60 days, with monthly performance reporting and A/R aging reconciliation delivered to the billing company.
• The billing company owns its trailing A/R outright and keeps documented access to claim history during and after the transition.

The second clause is the one billing companies most often discover they negotiated away. The Medical Billers and Coders playbook reports that practices missing it pay four to eight weeks of unnecessary fees just to retrieve their own claim history after termination.

What the Kareo/Tebra export actually captures

The Tebra Help Center's practice information export guide documents five recommended reports for account closure or data backup:

• Patient Demographic Export: complete patient information with balance details, via Reports > Patients
• Charges Export: encounter-based charge data scoped to a custom date range
• Unpaid Insurance Claims Export: outstanding insurance claim inventory at the time of export
• Accounts Receivable Aging: broken out by insurance and patient, in Excel, CSV, and PDF
• Standard Fees and Contract Rates: fee schedules and insurance contract rates, exported per schedule to Excel

Clinical history comes through a separate path. The Tebra Help Center export documentation describes bulk XML Summary of Care files, scoped by provider and date range, delivered as a ZIP with patient documents bundled in. One-time and recurring exports are both available.

Two known gaps. First, author attribution does not carry through the clinical XML export. When the Summary of Care files import into another system, chart entries default to a generic Admin Account instead of the original provider. For compliance audits that attribute a clinical decision to a specific clinician, keep read-only Tebra access for the historical chart rather than relying on the imported copy.

Second, the export inventory above covers structured data only. The working state of revenue cycle operations does not come out cleanly through any per-practice system's bulk export: open-claim follow-up notes, mid-investigation denial threads, in-flight appeal documents, and the unposted 835 ERAs sitting in the queue. This is not a Tebra-specific limitation. It is why the forward-only parallel-run pattern exists.

Migration planning checklist

EDI enrollment is the long pole

Payer enrollment, not data migration, is usually the constraint that sets the cutover date. Tebra's enrollment FAQ puts claim submission enrollment at "typically between one to eight weeks" per payer, and 835 ERA enrollment longer at "typically between two to eight weeks," because ERA enrollment is a separate process from 837 claim submission. Miss the ERA enrollment and cash posts from paper EOBs while you wait, a real operations cost in an otherwise clean cutover.

Tebra routes medical and institutional claims through Trizetto Provider Solutions, and workers' comp and auto claims through Jopari Solutions. Medi uses Stedi, so every payer connection moves to a new trading partner. The CMS Electronic Billing and EDI Transactions guidance documents how to update EDI submitter relationships, and the variance by payer is wide.

Enrollment realities specific to the Kareo/Tebra population that bite during a switch:

• Anthem and Elevance plans route through Availity as their EDI gateway. If your Kareo deployment used Availity for Anthem claims, that connection is between your practice's Tax ID and Availity. You re-register the same Tax ID under the new clearinghouse; you do not inherit the old Trizetto relationship.
• BCBS plans vary enrollment by state. Texas BCBS is a different form and timeline from Florida BCBS, and each state plan processes independently.
• Medicare and Medicaid require separate EDI agreements per state Medicaid plan, and Medicaid timelines run weeks longer than commercial payers.
• 835 ERA enrollment is separate from 837 claim submission in every payer's system. Completing claim enrollment does not trigger ERA enrollment.
• 270/271 eligibility and 276/277 claim status are separate enrollments too, not bundled with claim submission.

Start enrollment the day the contract is signed. For a billing company moving eight client practices, enrolling all of them at once is overwhelming, which is part of why the practice-by-practice rollout below paces the work.

Parallel-run plan

The legacy A/R closeout and the forward-only Medi cutover run side by side for two weeks at minimum. The shape that protects revenue:

• New billing on Medi starts the day after cutover for any encounter with a date of service after the cutover date.
• Tebra keeps receiving and posting 835 ERAs for claims with dates of service before cutover, for 60 to 90 days.
• Both systems post ERAs for at least the first two weeks so totals reconcile payer by payer, day by day.
• The outgoing Tebra arrangement reports A/R aging weekly until the legacy claims are paid or written off.
• Reconciliation meetings between the two teams run daily for the first two weeks, weekly thereafter.

Reconciliation catches 835 files that land in Tebra after cutover for claims that should have routed to Medi, and payer responses that come back to Medi for dates of service that belong in Tebra's closeout. In a Kareo-era migration there may also be historical ERAs that were never fully posted. Check the Tebra unposted ERA queue before cutover and post anything that resolves cleanly, so it is not orphaned when Medi goes live.

A practice-by-practice rollout protects everyone

Migrating eight client practices at once compresses every problem into a single weekend. The shape that recovers from issues:

• Pick the smallest client with the simplest payer mix and cleanest enrollment for cutover one.
• Run that client end to end in Medi for two weeks before moving the next.
• Apply what you learn (payer enrollment delays, posting rule gaps, user training gaps) to the next cutover.
• Move the largest, most complex clients last, after the pattern is stable.

For a ready book, around a day per practice is a reasonable cutover estimate. Larger books are still sequenced practice by practice. For a billing company on a legacy Kareo contract, the separate timing constraint is the notice window, not the Medi migration duration.

Under Medi's multi-practice workspace, the practice-by-practice rollout is also the right onboarding shape. Each client practice is a scoped tenant inside the billing company workspace, with permissions, payer rules, and reporting configured per practice.

What does not migrate, and what to do about it

• Author attribution on historical chart entries does not survive Tebra's XML export. Keep read-only Tebra access for compliance audits rather than relying on the imported copy.
• Open-claim follow-up notes do not export cleanly. For any claim still open at cutover, screenshot the working notes in Tebra or copy them into a structured handoff document before cutover day.
• In-flight appeals do not migrate. Document each open appeal with payer reference number, submission date, appeal level, supporting documentation sent, and next-action date.
• Unposted 835 ERAs in the Tebra queue at cutover belong in Tebra. Post them there before cutover, not in Medi.
• Per-payer scrub rules, write-off tolerances, and automatic posting rules do not copy through any export. Re-implement them in Medi.
• The BPR segment in incoming 835 files carries the check or EFT total. Confirm Medi's ERA review queue surfaces BPR check totals before going live with payment posting.
• CARC reason codes on denied lines and RARC remark codes on adjusted lines are standard X12 codes. The meaning is identical in Medi; the display and workflow routing may differ from Tebra.

What absolutely must move

• Patient demographics, including all active insurance coverages and authorizations.
• Provider NPIs, taxonomy codes, and billing identifiers for every provider across every client practice.
• Active payer enrollment status and the clearinghouse trading-partner relationships that transfer.
• User roles and practice-level access permissions, translated into Medi's permission model before cutover day.
• Custom fee schedules where they differ from Medicare allowables, from Tebra's fee schedule export into Medi.
• The last twelve months of paid claims and posted payments for reporting continuity, from the Charges Export and A/R Aging reports.

Day-zero cutover checklist

The day cutover happens for a given practice:

• Confirm Tebra is read-only for new claim creation for the migrated practice.
• Confirm Medi has accepted the patient and provider imports for that practice and the data looks correct.
• Confirm payer enrollment in Medi is active for at least the top three payers by claim volume.
• Confirm the first 837 claim submission test in Medi passes scrub and reaches Stedi's clearinghouse acknowledgment.
• Confirm the first 835 ERA can be received in Medi for at least one test payer.
• Confirm 270/271 eligibility is live for the highest-volume payer before the first live appointment date.
• Notify the practice and payer-facing staff that Tebra is read-only for new work as of today.
• Set the Tebra legacy closeout reporting cadence: weekly A/R aging to the billing company starting the following Monday.

Frequently asked questions

Is Kareo the same as Tebra?

Yes. Kareo and PatientPop merged on November 2, 2021, to form Tebra. The Kareo website fully redirected to tebra.com on December 5, 2024, completing the brand transition. The products, clearinghouse relationships (Trizetto for medical claims, Jopari for workers' comp and auto), and help center are all under the Tebra name. Legacy Kareo contracts may still use Kareo language but they govern access to the Tebra platform. The comparison of Medi and Tebra has more on the product history.

How long does a Kareo-to-Medi migration take?

Use around one business day per practice as the Medi cutover estimate once exports and payer-enrollment inputs are ready. For a multi-client billing company, practices still move in waves. The separate clock starts from your written non-renewal notice to Tebra, which the current pricing policy sets at 60 days before the end of the term. Check your contract, because legacy Kareo agreements may differ.

What does migration to Medi cost?

Migration is free with a 12-month commitment. Month-to-month, the fee is $100 per client practice migrated, capped at $3,000 regardless of practice count. Data export from Medi is always free in standard formats, and there is no termination fee. The only lock-in on the annual path is the commitment itself.

Medi's platform fee is $20 per client practice per month, with volume pricing available. There is no per-provider fee and no contract. EDI transaction pricing is separate and unchanged by practice count.

Do we have to re-enroll with every payer when leaving Kareo/Tebra?

In most cases, yes. Tebra routes claims through Trizetto Provider Solutions; Medi routes through Stedi. Changing clearinghouses means new trading-partner relationships for every payer without a direct EDI connection to your billing Tax ID independent of the clearinghouse. Claim submission enrollment takes one to eight weeks per payer; 835 ERA enrollment is separate at two to eight weeks. Anthem and Elevance plans route through Availity, which needs its own setup. Start enrollment the day the new contract is signed.

Can we import open Kareo claims into Medi rather than working them in Tebra?

The default pattern is to leave open claims in Tebra under the legacy A/R closeout rather than make them active in Medi on day one. The working state of a denied or appealed claim (follow-up notes, CARC codes worked, appeal documents, biller comments) does not transfer cleanly through any bulk export. Medi can import historical Kareo/Tebra claim ledgers as reference-only records when source evidence is strong: they land as Historical, keep their true historical balance, and stay out of active A/R, aging, statements, Money In, denial queues, and work queues. If a biller later needs Medi to work one, a guarded Make Operational action raises balance, aging, payer, provider, and setup warnings before the claim enters active operations.

What about unposted ERAs sitting in Kareo/Tebra when we switch?

Post them in Tebra before cutover. An unposted 835 ERA in Tebra's queue at cutover belongs to Tebra's ledger, not Medi's. The BPR segment in each ERA carries the check or EFT total; reconcile those totals against the unposted queue during the pre-cutover audit so nothing is orphaned. If an ERA arrives in Tebra after cutover for a date of service now in Medi, the parallel-run reconciliation catches it and routes the posting decision to the right system.

How current is this guide?

Last reviewed 2026-06-07. The Kareo-to-Tebra rebrand completed December 2024, and all help documentation now lives at helpme.tebra.com. Tebra's export capabilities, clearinghouse relationships, and contract terms change. Primary sources for current export documentation are the Tebra Help Center Data Management section and the Tebra practice information export guide. EDI enrollment timelines come from the Tebra Enrollments FAQ and the CMS Electronic Billing and EDI Transactions guidance. Transition-risk benchmarks come from the Medical Billers and Coders transition playbook. Verify current Tebra contract terms and export capabilities directly before making any migration decision.