Setting up your clearinghouse

A clearinghouse is the service your organization transacts with for insurance work in Ona. In the left sidebar, click Settings. In the settings menu, under Insurance, click Clearinghouse to choose and manage it.

How do I choose a clearinghouse?

In Settings → Insurance → Clearinghouse, choose a clearinghouse to tell Ona which service your organization transacts with.

The page shows the clearinghouses available to your organization. Ona is managed by Ona and does not require a separate account. Claim.MD is for practices that bring their own Claim.MD account. Use the Ona (1) and Claim.MD (2) cards to pick the clearinghouse, and read the Enrollments section (3) below for the payer list.

1. In the left sidebar, click Settings. In the settings menu, under Insurance, click Clearinghouse.
2. Select the clearinghouse card you want to use.
3. If this is your first clearinghouse selection, wait for the selection to save.
4. If you already have a clearinghouse selected, review the confirmation message.
5. Select Cancel to keep the current clearinghouse, or select Switch to Claim.MD or Switch to Ona to confirm the change.

After the clearinghouse is saved, its configuration and payer enrollment section appear below the cards.

How do I connect Claim.MD?

On the same page, connect Claim.MD when your practice uses its own Claim.MD account. The Claim.MD API key section shows Not configured until an API key is saved. The Claim.MD card (1) shows the API key field (2), and Not configured (3) means no key is on file yet.

1. Select Claim.MD as the clearinghouse.
2. In Claim.MD API key, select API key.
3. In Claim.MD, open your account settings and copy the API or account key.
4. Paste the key into API key.

The key saves automatically. When it is saved, the section shows Saved and the value is masked.

How do I replace a Claim.MD API key?

On the same page, replace the Claim.MD key when your Claim.MD credentials change.

1. Confirm Claim.MD is the selected clearinghouse.
2. In Claim.MD API key, select API key.
3. Enter the new Claim.MD API or account key.

The new key saves automatically. After it saves, the section shows Saved and the key is masked again.

If the key cannot be saved, Ona shows an error message to check the key.

What happens when I switch clearinghouses?

In Settings → Insurance → Clearinghouse, switch clearinghouses only when you are ready to transact through the new clearinghouse. Ona asks you to confirm because credentials and enrollments are specific to each clearinghouse.

When you confirm the switch, nothing is deleted. Your billing profile, saved credentials, and existing enrollments for the previous clearinghouse are kept. Payers still need to be enrolled through the new clearinghouse before you can transact with them there. The dialog names the new clearinghouse (1) and gives you Cancel (2) or Switch to Claim.MD (3) to back out or confirm.

If the switch cannot be saved, Ona shows an error message.

How do payer enrollments work with clearinghouses?

In Settings → Insurance → Clearinghouse, see payer enrollments after you select a clearinghouse. Enrollments belong to the selected clearinghouse, so switching clearinghouses does not make the previous clearinghouse’s enrollments usable with the new one. Use Search payers (1) to narrow the table, scan each payer row (2) for its enrollment status, and read the Claims column (3) for claim enrollment.

For enrollment-specific steps, see Payer enrollment.

What can't I do here?

In Settings → Insurance → Clearinghouse, review clearinghouse settings. Access and actions are limited in these ways:

• Staff and clinicians cannot manage clearinghouse settings from Settings.
• You cannot configure Claim.MD without a Claim.MD API or account key.
• Switching clearinghouses does not transfer payer enrollments to the new clearinghouse.
• Selecting a clearinghouse does not enroll payers by itself.

Common questions

Which clearinghouse should I choose?

Choose Ona if you want the clearinghouse managed by Ona and do not have a separate account. Choose Claim.MD if your practice uses its own Claim.MD account.

Why does Claim.MD show Not configured?

Not configured means no Claim.MD API key is saved for your organization. Paste your Claim.MD API or account key into API key. When the key saves, the section changes to Saved.

Are my old enrollments deleted if I switch clearinghouses?

No. Ona keeps your existing enrollments for the previous clearinghouse. Enrollments are specific to each clearinghouse, so you need enrollments through the new clearinghouse before transacting there.

Can I switch back to a previous clearinghouse?

Yes, if that clearinghouse is still available to your organization. The switch confirmation says saved credentials and existing enrollments are kept when you switch.

Where do I set up claim rules after choosing a clearinghouse?

Use billing rules after your insurance and clearinghouse setup are in place. See Scrubbing claims with billing rules.