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Claim.MD Quick Start Guide

Use this guide to complete the three main steps for getting started with Claim.MD. Each section includes a video and a short text version so you can use the format that works best for you.

If you need assistance at any point, open a Support Ticket.

Getting Started - Creating an Account

Before you create an account, make sure you have the following on hand:

The business or account owner will need to create the account.
A valid form of U.S. identification, and a computer or phone with a camera.
A credit card, or valid EFT routing # and checking account information.
Up-to-date contact information in the NPPES database for any providers you'll be billing for. Make sure to let them know to expect a call from Claim.MD.

Prefer text? Continue below for a condensed, screen-reader-friendly version of the same setup process.

Step 1: Add Users

Every person who accesses Claim.MD or may need to work with Claim.MD Support should have their own user account.

From the left menu, select Manage Users.
Select the appropriate user type and click Add User.
Enter at least the user's actual first and last name and email address.
Review the user's access privileges.
Click Add New. The user will receive an email with instructions to create their username and password.

Administrator access required Only an administrative user can access Manage Users and manage other users.

HIPAA Compliance Each individual must have unique Claim.MD login credentials. Do not create accounts using generic names such as Billing Staff or Accounting, and do not share usernames or passwords.

View complete Manage Users instructions

Step 2: Provider Enrollment

Prefer text? The essential enrollment steps are summarized below. Detailed payer-specific instructions remain available within Provider Enrollment.

Add Your Provider

From the left menu, select Provider Enrollment.
If the organization is not listed, click Add Provider.
Enter the provider's NPI and Tax ID, then review and save the provider information.

Atypical Providers Atypical providers that are not required to have an NPI may leave the NPI field blank.

Before enrolling with a payer The provider must already be credentialed with that payer. Contact the payer's provider support department if credentialing has not been completed.

Claim Submission Enrollment

Select the provider and review the Claims column for each payer you plan to bill.

No Enrollment Required: You may begin sending claims to the payer immediately.
Enrollment Required: Follow the instructions or complete the forms shown.
Not Available: The payer does not support that claim type through Claim.MD.

Provider Validation If Validation Required appears, begin the enrollment workflow and select Call Now when prompted. Provider validation calls are initiated on demand and are not started automatically by Claim.MD.

Learn more about Provider Validation.

ERA Delivery Options After Validation

After completing validation for the first time, providers may see a prompt if another account already has active ERA enrollments for the same NPI/Tax ID. This allows providers to choose whether future ERA should route to the newly validated account.
If ERA is redirected, any existing provider records with active ERA enrollments will move to a Pending Validation status until validation is completed again on those records.
After completing validation, if another account has active ERA enrollments, you will will see this prompt:

ERA Enrollment

Review the ERA column for each payer from which you want to receive Electronic Remittance Advice.

Quick Enroll: Claim.MD can submit the enrollment electronically.
Auto-Enroll: The payer automatically returns ERA to the claim sender.
Enrollment Required: Follow the payer-specific instructions or complete the provided forms.

Important ERA Routing Information ERA can only be routed to one clearinghouse. Enrolling an NPI/Tax ID for ERA through Claim.MD may redirect electronic remittance to Claim.MD even when the original claims were submitted elsewhere.

Eligibility Enrollment

If you plan to check patient benefits and eligibility through Claim.MD, review the Eligibility column and activate eligible payers as needed.

View complete Provider Enrollment instructions

Step 3: Submit Claims

Choose the claim submission method supported by your workflow or billing software.

Direct Data Entry

Create claims directly within Claim.MD when you are not submitting them from another billing application.

Direct Data Entry instructions

Manual File Upload

Upload a claim file that was created and saved by your billing software.

Manual Upload instructions

SFTP

Use an automated file connection when your billing application supports SFTP.

Configure SFTP

API

Integrate your billing application directly with Claim.MD using the API.

Configure an API connection

Review Claims Before Transmission

By default, claims require approval on the Manage Claims page before they are transmitted. We recommend keeping this setting enabled for your first several submissions so you can verify that claim data is arriving correctly.

Administrative users who do not require final approval can disable this setting from Settings > Account Settings by clearing Transmit Approval Required.

Administrator permission required Only administrative users can access Account Settings.

Next Steps

You do not need to read every Claim.MD article before getting started. After completing the three steps above, use these resources as needed.

Manage Claims Review rejected claims, claims requiring attention, acknowledgements, and reminders.

View ERA View electronic remittance received from enrolled payers.

Eligibility Check patient eligibility and benefit information.

Reporting Review claim activity and reporting data.

Search Find claims and transactions that are no longer displayed on Manage Claims.

View/Pay Invoices Review invoices, service fees, and payment information.

Support Tickets Contact Claim.MD Support when you need assistance.

Manage Users Manage account users and permissions.

Additional Settings for Administrative Users

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