The Intelligent Clearinghouse Platform
Your billing team works rejections all day.
Most never had to happen.
ClearClaimPro validates every claim before it leaves the building, turns 277CA responses into searchable rejection data, and shows every claim’s status in one workspace.
Sample dashboard
- Microsoft-governed on Azure
- BAA before any PHI flows
- ClearClaimPro is included in Saisystems Technology’s SOC 2 Type II audit, currently in progress, with regular vulnerability assessments and penetration testing.
Built for billing companies, RCM firms, physician groups, behavioral health, and community hospitals
What is ClearClaimPro?
An intelligent clearinghouse, not just a pipe between you and the payer
ClearClaimPro (CCP) is a healthcare clearinghouse platform developed and operated by Saisystems Technology. It sits between your practice-management system and the payers, moving claims and remittances over standard EDI — and adds the validation, structured rejection data, and single-workspace visibility that a basic clearinghouse leaves out.
Claim Validation & Scrubbing
Structured 277CA Data
ERA Delivery
Analytics Included
Azure-governed Security
The Problem You Live With
Most clearinghouses are a pipe, not a partner
Claims go in. 277CA responses come back as raw CSC and EIC codes.
Your team sorts them by hand and checks status by logging into ten payer portals. The cost is measurable and it compounds every billing cycle.
Preventable rejections
Rework you pay for twice. Denial rates run 10–15%, and each reworked claim costs $25–30 in staff labor. Up to 90% of those denials were preventable at submission.
No real-time visibility
Status lives in spreadsheets and people's heads. Claims aging past 90 days breach timely-filing windows, and 65% of denied claims are never reworked at all.
Single-vendor risk
One outage stalls every claim. A national clearinghouse outage in 2024 delayed $2.87 billion in provider cash flow. Most mid-market operations still have no documented backup clearinghouse.
What ClearClaimPro Does
Claim performance, not just claim routing
Validates Before Submission
Payer-aware edits and client-specific rules catch eligibility, demographic, and coding errors at the desk — not at the payer. Claims fail in your hands, where they are cheap to fix.
Turns 277CA into Answers
Every rejection parsed into searchable, filterable data by payer, CSC and EIC code, NPI, and claim type. Fix root cause once instead of reworking the same rejection every cycle.
Shows Every Claim in One View
Submission, 277CA, and ERA status in a single workspace. Your team stops logging into ten payer portals to answer a routine status question.
How it Works
Claim performance, not just claim routing
Connect & enroll
We onboard your organization, providers, and NPIs, then handle payer, EDI, and ERA enrollment so claims and remittances flow to the right places.
Validate & scrub
Every claim runs through payer-aware edits and your client-specific rules before submission — errors surface at the desk while they're still cheap to fix.
Submit & track
Clean claims go to the payer. 277CA acknowledgments come back as structured, searchable data — with real-time status in a single workspace.
Receive & improve
ERA (835) remittances are delivered back for your team to post, and analytics surface the rejection patterns behind your denials — highlighting root causes and suggesting next steps so your team can lift the next cycle's clean-claim rate.
What Makes it Different
Built around the work your team actually does
Parallel run, no cutover risk
Run ClearClaimPro next to your current clearinghouse for two to four weeks. Compare on your own claims. Switch only when the data says so. Zero revenue gap during the evaluation.
Analytics included as standard
Clean claim benchmarks, rejection trends, payer scorecards, and Power BI–ready exports come in the base subscription — not gated behind a premium tier.
Primary or documented secondary
Run it as your primary clearinghouse, or as the board-defensible backup the last two years made non-negotiable. Tested in parallel run, not promised on a slide.
Microsoft-governed on Azure
TLS 1.2 and AES-256 encryption, Azure Entra ID with SSO and MFA, and audit logging built to pass hospital and enterprise vendor-risk review on first submission.
Connectivity & Standards
Speaks the transactions your payers expect
Standards-based EDI end to end with Medicare via direct connectivity, direct connections to major commercial payers, and broader commercial reach through established upstream connectivity.
Claim submission
Professional claims sent to payers.
Acknowledgments
Interchange (TA1), functional (999), and claim (277CA) acknowledgments — with 277CA parsed into structured, searchable rejection data.
Claim status
Real-time status without logging into payer portals.
Electronic remittance
ERA (835) delivered back for your team to post and reconcile.
Eligibility & benefits
Verify coverage up front — the #1 denial-prevention lever.
Insurance Discovery & AI Denial Prediction
Coming soon — automated coverage discovery and predictive denial scoring to flag at-risk claims before submission.
Exact transaction availability is confirmed against your priority payer list during discovery before any commitment.
A Different Class of Clearinghouse
Basic Clearinghouse vs. ClearClaimPro
Basic Clearinghouse vs. ClearClaimPro
| Capability | Basic Clearinghouse | ClearClaimPro |
|---|---|---|
| Routes claims to payers | ✓ | ✓ |
| Pre-submission validation with payer-specific rules | Limited | ✓ |
| 277CA rejections as structured, searchable data | ✗ | ✓ |
| Submission, 277CA & ERA in one workspace | ✗ | ✓ |
| Analytics & payer scorecards included as standard | Add-on | ✓ |
| Parallel-run evaluation on your own claims | ✗ | ✓ |
| Board-defensible documented backup posture | ✗ | ✓ |
| Azure Entra ID identity, MFA & audit logging | Varies | ✓ |
The Numbers Behind the Case
What the industry data says
95%
HFMA clean claim rate benchmark for high performers
$25-30
MGMA cost to rework one denied claim
90%
of denials are preventable at submission
Medicare+
Direct Medicare connectivity plus major commercial payers, with broader reach through established upstream connectivity
Sources: HFMA MAP Keys · MGMA · industry reporting
Who It’s For
Operations that have outgrown a basic clearinghouse
Billing companies & RCM firms
Managing multiple clients across many NPIs and Tax IDs, with per-client reporting.
Multi-specialty physician groups
A complex Medicare and commercial payer mix across locations.
Behavioral health organizations
High administrative burden and attachment-heavy claim workflows.
Community hospitals
Centralizing billing across facility NPIs and many payers.
Operations processing 3,000 or more claims a month with measurable rejection burden and no documented backup clearinghouse.
Built for Your IT and Compliance Review
Security your vendor-risk team can sign off on
BAA first
Executed before any PHI flows. Security documentation provided with the MSA.
Encrypted end to end
PHI encrypted in transit with TLS 1.2 and at rest with AES-256 on Azure.
Governed identity
Azure Entra ID with SSO, MFA, role-based access, and audit logging.
ClearClaimPro is included in Saisystems Technology's SOC 2 Type II audit
Architecture aligned to AICPA Trust Services Criteria today; attestation on our near-term roadmap.
A healthcare technology partner, not just a vendor
ClearClaimPro is developed and operated by Saisystems Technology, the technology division of the Saisystems group. We build application, data, and automation solutions for healthcare organizations — and we run ClearClaimPro on Microsoft Azure with the same governance our enterprise clients require.
- ✓ Healthcare-focused engineering — revenue cycle, EDI, and data analytics under one roof
- ✓ Microsoft-governed cloud, built to pass enterprise vendor-risk review
- ✓ A team that stays in the room — onboarding, discovery, and support are ours, not outsourced
Why operators choose us
Common Questions
Before you book the demo
Is ClearClaimPro a clearinghouse or software?
Both. It’s a healthcare clearinghouse — it moves your claims and remittances to and from payers over standard EDI — with an intelligence layer on top: validation, structured 277CA data, unified status, and analytics. It’s developed and operated by Saisystems Technology.
Do we have to replace our current clearinghouse?
No. Run ClearClaimPro as an intelligence and backup layer next to your incumbent, or as your primary. You decide after the parallel run, on your own data.
How long does onboarding take?
Billing companies typically reach first live claim in four to six weeks. Provider groups run six to eight weeks, including the parallel-run period.
How does pricing work?
Transaction pricing tiered by monthly volume. You pay for what you process. We confirm your exact per-claim rate during discovery.
Which payers do you support?
Medicare via direct connectivity, plus direct connections to major commercial payers, with broader commercial reach through established upstream connectivity. We validate your priority payer list during discovery before any commitment — so you know exactly what’s covered before you decide.
How is our data secured?
Azure infrastructure, encryption in transit and at rest, Azure Entra ID identity with MFA, audit logging, and a BAA executed before any PHI flows.
See your own rejection data in a 20-minute demo
We'll walk the claim lifecycle dashboard and show how structured 277CA data changes your team's week. No rip-and-replace, no commitment to switch.
Book a 20-minute demo Typically a 20-minute call · No prep required