> ## Documentation Index
> Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Clearinghouses explained

> The middleman between your EHR and every payer: what it does with claims, remittances, and eligibility.

A clearinghouse is the postal service of medical billing: it takes claims from
your EHR in one format, translates and scrubs them for each payer's quirks,
routes them, and carries the responses back.

```mermaid theme={null}
%%{init: {'themeVariables':{'fontFamily':'inherit','fontSize':'14px'}}}%%
flowchart LR
    E[EHR / PM] -->|837 claim| C[Clearinghouse]
    C -->|payer-formatted claim| P[Payers]
    P -->|999/277 acks + rejections| C
    P -->|835 remittance| C
    C -->|posts back| E
    E <-->|270/271 eligibility| C
```

## What flows through it

**Claims out (837):** scrubbed against payer edits before submission, so
errors bounce in minutes instead of denying in weeks. The
acknowledgment trail (accepted, rejected, pending) is your early-warning
system; a rejected claim never even entered the payer's system, and nobody
tells you unless you read the reports. **Remittances back
([835s](/concepts/what-is-an-835)):** ERA delivery is routed by enrollment,
which is why clearinghouse choice and
[ERA enrollment](/guides/set-up-payers) are entangled. **Eligibility
(270/271)** and **claim status (276/277)** ride the same pipe.

## What it is not

It's not the payer (a clearinghouse acceptance is not a payment decision),
and it's not your bank (money moves by EFT directly from payer to your
account; the 835 is just the explanation,
[reassociation](/concepts/eft-reassociation) ties the two together).

Choosing and setting one up:
[Choose your clearinghouse](/guides/choose-your-clearinghouse).

## Related

* [Choose and set up your clearinghouse](/guides/choose-your-clearinghouse)
* [What is an 835?](/concepts/what-is-an-835)
* [The claim lifecycle](/concepts/claim-lifecycle)
* [EFT reassociation](/concepts/eft-reassociation)