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Claim.MD: pricing signals, access, and small-practice fit
Genuinely API-first and NOT sales-gated — rare for a US clearinghouse. Self-serve signup, user-generated API keys, free sandbox, public docs, and a transparent published price ladder from $25/mo. Eligibility via API requires no provider pre-enrollment (notably low-friction).
What it does
270/271 Eligibility & benefits837 Claim submission835 ERA / remittance276/277 Claim status278 Prior authorization
- 270/271 Eligibility & benefits — Real-time check of whether a patient's coverage is active and what it covers (X12 270 request / 271 response).
- 837 Claim submission — Submit professional/institutional/dental claims to payers (X12 837P/837I/837D).
- 835 ERA / remittance — Electronic remittance advice — how the payer adjudicated a claim and what it paid (X12 835).
- 276/277 Claim status — Ask a payer the status of a submitted claim (X12 276 request / 277 response).
- 278 Prior authorization — Request/inquire on prior authorization for a service (X12 278).
Real-time: yes · Batch: yes
Known pricing signals
| Item | What's public |
|---|---|
| basic | published Basic $25/mo, 0 included, $100 setup; add'l claim $0.30, add'l eligibility $0.30 Source: https://www.claim.md/pricing · verified 2026-06-22 |
| smallVolume | published Small Volume $50/mo (100 claims + 100 eligibility), $50 setup; add'l claim/elig $0.50 Source: https://www.claim.md/pricing · verified 2026-06-22 |
| unlimited | published Unlimited $100/mo (unlimited e-claims + 1,000 eligibility/mo), no setup; add'l elig $0.02–$0.10 One third-party review (choosingtherapy.com) lists $30/$60/$120 tiers — confirm on a live render. Source: https://www.claim.md/pricing · verified 2026-06-22 |
Access requirements
Self-serve signup, user-generated API keys, free test/sandbox (canned responses), public docs. Per-payer enrollment for some payers via staff forms or the /enroll/ API. Month-to-month implied.
Best-for-small-practice
Strongly accessible to solo/small practices and therapists ($25–$50 tiers; widely used via TherapyNotes/Jane). Small-dev friendly: self-serve REST API, free sandbox, public docs, eligibility without pre-enrollment.
Best-for-small-practice + dev candidate with the most transparent published pricing of the full-clearinghouse vendors.
Our recommender ranks all vendors against your exact functions, dev needs, and budget — transparently, with the reasoning shown.
Find the right one →Independent transparency directory. Pricing and access details are compiled from public vendor pages and practitioner reports and are dated and confidence-tagged — published = vendor's own public page, reported = third-party/forum estimate, no public price = none found. We do not invent numbers. Last verified 2026-06-22. Not affiliated with any vendor; verify current terms directly before contracting. Some outbound links may be referral links.