Claim Submission Workflow
Clearinghouse vs Direct Claim Submission
Understand the difference between sending electronic claims through a clearinghouse and connecting directly to a payer or trading-partner channel.
Reviewed September 2026 · Educational reference — verify payer and program requirements.
Step-by-step workflow
- Step 1. Clearinghouses can validate/route transactions
- Step 2. Direct submission may require payer trading-partner setup
- Step 3. Companion-guide requirements still matter
- Step 4. Acknowledgment routing depends on the channel
Submission rules vary. The correct payer address, portal, clearinghouse, trading-partner connection, companion guide, enrollment and acknowledgment process depend on the payer and program. Use this workflow to organize the process, then follow the payer’s current instructions.