Simple and Transparent Pricing

The only provider portal offering both paper-to-electronic appeals and EDI transactions

156K

Registered Users

193M+

Lives Supported

1.7T+

Billed Claim Value Processed (Annually)

5/5

Top US healthcare payers

4K+

Registered RCM Companies

278+

Plans Served

14.8M+

Charts Coded (Annually)

$34.8M+

Under Payment Identified

2.7K+

Medical Lockboxes

40+

Years of 
experience

Pricing Plans

Free Trial

$0/Month

  • Claims and Attachments 100 Documents for all Payers
  • User/Role ManagementUpto 10
  • Days in Cloud Storage30 Days
  • Reports & Analytics
Basic

$49/Month

  • Claims and Attachments 200 Documents for all Payers
  • ERA Files & Payer Enrollment25 ERA (Per Claim) including Payer Enrollment
  • Claim Status25 Real Time Claim Status Requests for all Payers
  • Eligibility Check 25 Real Time Eligibility & Benefit Inquiry for all Payers
  • Authorization & Referral Review
  • Claims Resubmission (For Exclusive Payers)
  • User/Role ManagementUpto 15
  • Days in Cloud Storage90 Days
  • Reports & Analytics
  • Print & Mail - Pay Per Use Attachments, Statements etc.
Premium

$99/Month

  • Claims and Attachments 500 Documents for all Payers
  • ERA Files & Payer Enrollment60 ERA (Per Claim) including Payer Enrollment
  • Claim Status60 Real Time Claim Status Requests for all Payers
  • Eligibility Check60 Real Time Eligibility & Benefit Inquiry for all Payers
  • Authorization & Referral Review
  • Claims Resubmission (For Exclusive Payers)
  • User/Role ManagementUnlimited
  • Days in Cloud Storage90 Days
  • Reports & Analytics
  • Print & Mail - Pay Per Use Attachments, Statements etc.
Advance

$199/Month

  • Claims and Attachments 1,000 Documents for all Payers
  • ERA Files & Payer Enrollment125 ERA (Per Claim) including Payer Enrollment
  • Claim Status125 Real Time Claim Status Requests for all Payers
  • Eligibility Check125 Real Time Eligibility & Benefit Inquiry for all Payers
  • Authorization & Referral Review
  • Claims Resubmission (For Exclusive Payers)
  • User/Role ManagementUnlimited
  • Days in Cloud Storage120 Days
  • Reports & Analytics
  • Print & Mail - Pay Per Use Attachments, Statements etc.
Advance +

Customized

Enterprise Services are Customized for Large Volume (over 1,000 Documents per Month) Transactions.

Supports Claims Edits and Correction Functionality.

Additional tech-enabled solutions

  • Claim Edit Resolution Claim Edit Resolution
  • Coding, Auditing & Consulting Services Coding, Auditing & Consulting Services
  • Denial Management Denial Management
  • Remittance Processing (XBP) Remittance Processing (XBP)
  • Medical Record Submission Medical Record Submission
  • Medical Lock Box Medical Lock Box
  • Revenue Integrity Services and Appeals Management Revenue Integrity Services and Appeals Management
  • Patient Billing & Payments (XBP) Patient Billing & Payments (XBP)
  • Patient or Insurance Collection Services Patient or Insurance Collection Services

Appeals & Claims submission and resubmission

Appeals & Claims submission and resubmission

Eligibility & benefits verification

Eligibility & benefits verification

Claim status check

Claim status check

Enroll for an ERA & receive ERA’s

Enroll for an ERA & receive ERA’s

Prior authorization

Prior authorization

Our all-payer electronic appeal & EDI transaction gateway

PCH Health provides a direct connection with a broad range of payers, facilitating the seamless electronic submission of paper appeals. This exclusive capability distinguishes us from major, traditional EDI clearing houses. We handle appeals, correspondence, and claims with 100+ plans.

Our single-point gateway efficiently manages both paper and EDI transactions for providers. Additionally, our team also prints and mails payer attachments or claims to payers not listed with us. Discover the limitless benefits of PCH Health – connect with us today.

Our all-payer electronic appeal & EDI transaction gateway

PLAN ADD-ON

Non-Expiring Transaction Available as Bundles

Rate Per BundleQty Per BundleService Type
$50.00250 DocumentsClaims & Attachments
$50.00400 ERA'sERA & Payer Enrollment
$50.00300 RequestsReal Time Claim Status
$50.00300 RequestsReal Time Eligibility & Benefit Inquiry
$50.00350 RequestsAuthorization & Referral

Attachments supported by PCH Health include but are not limited to

Claim

  • Professional, Institutional, & Dental Claims
  • Primary/Secondary/Tertiary Claims with EOB/EOMB
  • Corrected Claims
  • Resubmission Claims
  • Member Claims
  • Roster Claims
  • Vaccination Claims

Attachments for appeals and grievances

  • Appeals and Grievances
  • Medical Records
  • Clinical Records
  • Additional Information
  • Copy of EOB/EOMB
  • Critical Claim Information
  • Consent Form
  • Trauma Report
  • Claim Payment Dispute
  • Claim Payment Dispute-Proof of Timely Filing/Member
  • Cost Share/Claims Editing (CCI/LCD/NCD)

Other attachments

  • Copy of ID Card
  • Copy of Medicare Card
  • Date of Injury
  • Invoice
  • Itemized Bill
  • Pre-Certification/Authorization Information
  • Referral
  • W9
  • Cost Containment-Overpayment/Refund/COB & Hospice
  • Provider Information Change Form
  • DME Review

Simple and transparent services

100K+

Provider users

10M+

Yearly transactions

1M+

Daily appeals processed

50%

Direct administrative cost savings