Welcome to our blog
Your go-to source for insights and updates on the ever-evolving world of medical clearinghouses. As a vital intermediary between healthcare providers and insurance payers, we understand the complexities of claims processing and the importance of seamless data integration. Our blog is dedicated to providing you with the latest trends, best practices, and innovative solutions to optimize your revenue cycle management.
X12 5010 to 8060: What the Next EDI Migration Means for PM Vendors
HHS opened rulemaking on the next EDI standards migration in 2025. There is no deadline yet, but the last transition (4010 to 5010) touched every PM system in the market. Here is what to plan for.
Cost Per Patient vs Cost Per Transaction: The Number That Actually Matters
The per-transaction rate your clearinghouse quotes is misleading. Here is why cost per patient is the only pricing comparison that matters, with the math worked out.
A Portal Is Not a Clearinghouse
Portal-based claim submission works for a handful of payers. It breaks around payer 15 to 20. Here is what real multi-payer submission requires, and when platforms outgrow the portal approach.
Build vs Buy the Clearinghouse Layer
Every PM and EHR platform eventually faces the build vs buy decision on payer connectivity. Here is a framework for evaluating both paths, including the hidden costs vendors rarely price in.
Why Institutional Payer Knowledge Got More Valuable in 2026
CMS rolled back some payer transparency requirements in 2025. With less public payer data available, the institutional knowledge your clearinghouse holds got more valuable, not less.
Still Faxing Healthcare Documentation? 18 Months to Stop
The CMS Claims Attachments Final Rule took effect May 26, 2026. Compliance is due in 2028. If you are still faxing documentation, here is what 18 months actually looks like.