Setting up your clearinghouse

A clearinghouse sits between your practice and the payers. It takes the claims Ona builds, translates them into the format each payer expects, transmits them, and brings back responses. You can't submit claims electronically without one.

Choosing a clearinghouse

Go to Settings → Clearinghouse — "choose the clearinghouse your organization transacts with and manage its settings".

Two options are available today:

• Stedi — "managed by Ona — no separate account". Ona holds the relationship; you don't sign up separately or manage credentials.
• Claim.MD — "bring your own Claim.MD account". You contract with Claim.MD directly and connect it to Ona.

Waystar and Office Ally are listed as Coming soon.

The selected option is outlined, with a control in its corner to disconnect.

Which to pick depends on whether you already bill. A practice starting fresh usually wants Stedi, since there's no separate account, contract, or credential to manage. A practice already submitting through Claim.MD usually wants to keep it — existing payer enrollments carry over, and re-enrolling with a new clearinghouse takes weeks per payer.

Connecting Claim.MD

If you choose Claim.MD, you need an API key. The field explains it "authenticates your organization with Claim.MD for claims and related transactions", and tells you where to find it: "In Claim.MD, open your account settings and copy the API / account key."

Paste the key and it saves, showing a Saved badge with the value masked.

Treat this key like a password. Anyone holding it can submit claims as your practice.

Enrollments

Enrollments authorize your organization to transact with specific payers through the clearinghouse. Being connected to a clearinghouse isn't enough on its own — most payers require you to be enrolled with them before they'll accept your claims.

This section is gated. Until insurance setup is complete, it shows Complete insurance setup first with a Go to Insurance settings link, because enrollments are built from the NPI, Tax ID, and legal name recorded there.

Enrollment is the slowest part of getting billing live. Payers process requests on their own timelines, often two to six weeks, and some require paper forms. Start enrollments as early as you can rather than waiting until you have claims to send.

The full billing chain

Electronic claim submission needs four things configured, in order:

1. Insurance — NPIs, Tax ID, legal name.
2. Clearinghouse — this page.
3. Enrollments — per payer, through the clearinghouse.
4. Billing rules — what Ona checks before a claim goes out. See Billing rules and claim scrubbing.

Services also carry their own CPT codes and place-of-service defaults, and locations carry facility NPIs. A claim assembles data from all of these, which is why a gap in any one of them surfaces as a rejection later.