Overview

zHealth is upgrading our clearinghouse from Office Ally to Claim.MD. Claim.MD is fully integrated into zHealth, which means faster claim submission, electronic remittance (ERA) posting, and one place to go for support — our team, instead of a separate clearinghouse help line.

Pricing: Claim.MD is billed at $40/month per Tax ID (compared to Office Ally's $44.95/month per Tax ID + Rendering Provider combination), added directly to your zHealth subscription. Your first month of Claim.MD is free, so you won't be charged by both clearinghouses in the same month.

Follow the five steps below in order to complete your transition.

Step 1: Confirm Your Details

Once you are set to move forward, we’ll create a ticket and confirm the following information for verification and enrollment:

• Your Tax ID

• Whether you bill using your Individual NPI, Group NPI, or both

Once confirmed, zHealth will enable Claim.MD on your account so phone verification can be completed.

Step 2: Complete Phone Verification

Before Claim.MD can become your active clearinghouse, each billing NPI must complete a one-time phone verification. This confirms that the name on the call matches the provider’s name on file with NPPES.

How to verify:

1. Go to Facility Settings → Insurances.

2. Click Available / Quick Enroll.
   

3. Click the Enroll button.
   

4. A new tab will open with a phone-number drop-down pulled from NPPES. Select your number and click Call.  4a. If an extension is needed to reach a live person, you may enter that under the “Extension     (optional)” field

5. You'll receive an incoming call from a Claim.MD bot — answer it, confirm your participation, and state your name exactly as it appears on NPPES.

If the phone number on NPPES is incorrect or outdated, you'll need to update it first before verification will succeed — see How to Update Your Phone Number in NPPES for a full walkthrough. Log in to NPPES, PECOS, or CMS (the same username and password work across all three), update your phone number under Contact Information, and the change typically reflects within a few minutes. It's also worth double-checking your practice address at the same time, since outdated addresses are a common source of enrollment errors later on.

Full verification details: Verifying Your Provider on Claim.MD.

Step 3: Enroll Each Insurance in EDI and ERA

Once your phone verification is complete, you’ll be automatically enrolled for most/all commercial insurance. If you have Medicare, Veteran Affairs in region 4 or 5, or certain Highmark insurance enrolment for claim submission (EDI) and electronic remittance (ERA) will be needed separately:

6. Go to Facility Settings → Insurances.

7. For each payer, check the Claim Submission and ERA columns.
   

   Step 3A: Enroll in ERA

   For each payer, check the ERA column. You'll see one of two statuses:

   Status	What it means	What to do
   Available / Quick Enroll	Enrollment is instant — nothing further needed from you.	Click it, then click the Quick Enroll button on the page that opens. Your ERA enrollment is completed immediately.
   Available / Enrollment	This payer requires manual enrollment.	Click the link, then follow that payer's specific instructions shown on the page to complete enrollment.

   Step 3B: Complete EDI Enrollment (Medicare, Highmark, Veteran Affairs and similar payers)

   For payers that require EDI enrollment, check the Claim Submission (EDI) column:

   Status	What it means	What to do
   Available / Enrollment	This payer (e.g., Medicare, Highmark,Veteran Affairs) requires EDI enrollment. This flow often lets you enroll in ERA for the same payer at the same time.	Click the link and follow the instructions shown to complete enrollment.
   Available / Quick Enroll	Shown for some EDI payers, but doesn't always mean action is required.	Clicking it may simply show a "NO ENROLLMENT" confirmation — meaning there's nothing further for you to do for that transaction type.

   
   

We recommend enrolling in ERA wherever it's available, so payments display electronically in zHealth's green remittance bubble instead of being entered manually. You'll continue receiving ERAs from Office Ally until your Claim.MD ERA enrollment for that payer is approved, so there's no gap in your remittances.

Detailed guides:

• How To Complete Payer EDI Enrolment

• How To Complete Payer ERA Enrolment

• How To Complete Payer Benefit & Eligibility Verification Enrolment

Medicare Enrolment with EDISS Connect

If your Medicare Administrative Contractor is Noridian (serving CA, HI, NV and territories, or AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY), you'll instead log directly into EDISS Connect and change your clearinghouse selection to Claim.MD.: How to Complete Payer Enrollment for Claim.MD via EDISS Connect.

Important: do not check any "I will" boxes — that indicates there's no clearinghouse connection for that transaction.

Approval timing:

• Regular Medicare: approximately 1–5 days

• Railroad Medicare: approximately 5–10 days

Once approved by Medicare, please forward your confirmation email to support@zhealthehr.com so we can switch your default clearinghouse from Office Ally to Claim.MD and stop future Office Ally charges.

Step 4: Confirm Your Transition Is Complete

Once you've completed verification and enrollment:

• Submit claims and post payments as you normally would — no change to your day-to-day workflow.

• Send us a ticket and we'll confirm all your insurances are set to Claim.MD, so you won't continue to be charged by Office Ally.

• Once confirmed, you're free to cancel your Office Ally account or remove your SFTP credentials if you no longer need them.

Frequently Asked Questions

What happens if I don't complete phone verification in time?

You have 48 hours from when Claim.MD is enabled on your account to complete phone verification. We’ll be switching your your clearinghouse to Claim.MD at that time, so it's best to complete verification as soon as possible to avoid any disruption to claim submission. Please reach out to support@zHealthehr.com if you have any questions.

Will I be charged by both clearinghouses at once?

You should not be. Office Ally bills after the month of service ($44.95 per Tax ID + Rendering Provider combination), while zHealth bills Claim.MD fees on the 1st of the current month ($40 per Tax ID). Because of this timing, you may see a $44.95 Office Ally charge on Aug 1 for July, alongside a $40 Claim.MD charge for August — but you shouldn't be billed by both for the same month of service. Your first month of Claim.MD is free to help avoid overlap, so we recommend completing your transition and stopping Office Ally submissions within 30 days.

I got a rejection on CPT codes 97139 or 97039 or 97032 — why?

Office Ally allowed these claims through without additional notes. Claim.MD requires a note in Box 19 of the patient's insurance tab whenever these codes are billed. Adding that note should resolve the rejection.