Phiclaw is the HIPAA-compliant AI employee for medical practices. It answers patient calls, books appointments, handles intake and runs the practice's EHR and CRM. Insurance claims are part of the same job. Phiclaw builds the claim from the visit, and Stedi, the healthcare clearinghouse we partner with, delivers it to the payer.
Phiclaw is listed on Stedi's Platform Partners page. You can see all of our partners on the Phiclaw partners page.
What a clearinghouse does
A clearinghouse sits between a practice and the insurance companies. It takes a claim in the standard electronic format payers require, checks it for errors and routes it to the right payer. Stedi is an API-first clearinghouse that connects to payers across the Stedi payer network.
Phiclaw is not a clearinghouse. It does the work before and after that step, and Stedi handles the transmission.
From visit to claim, step by step
- Check coverage before the visit. Phiclaw can run a real-time eligibility check (the 270/271 transaction) through Stedi, so the front desk sees whether the payer reports active coverage on the date of service.
- Build the claim from the chart. After the visit, Phiclaw drafts the claim from the encounter in the Phiclaw EHR: patient, provider, diagnosis and procedure codes, and charges. Someone on your team reviews it and approves the submission.
- Send it through Stedi. The claim goes out as an 837P, the standard electronic format for professional claims. Stedi runs its claim edits first and rejects errors before the claim reaches the payer, so a problem shows up right away instead of weeks later.
- Track every response. Phiclaw records each acknowledgment separately, because "sent" does not mean "accepted." Stedi returns an initial claim acknowledgment (277CA) when the claim is submitted, and Phiclaw can ask the payer for the claim's current status in real time (the 276/277 transaction).
- Never send a claim twice. Every submission carries a unique key tied to the practice, the claim and its version. If the network drops and the request is retried, Phiclaw returns the original attempt instead of creating a duplicate claim.
What a practice needs before the first real claim
- A Stedi account for the practice, with a signed business associate agreement (BAA), the HIPAA contract that covers patient data.
- Billing details exactly as payers have them: the billing NPI, legal billing name, tax ID and billing address. A mismatch can cause rejections.
- Transaction enrollment with each payer that requires it. Start with claim submission (837P). Add eligibility (270) and claim status (276) only where a payer requires enrollment for them.
- A test run first. We start in Stedi's test mode with fictional patients, confirm duplicate protection and acknowledgments work, and only then switch the practice to live claims.
Two things practices often mix up
Transaction enrollment is not credentialing. Credentialing is the provider's contract with an insurer to get paid, and it has to be done first. Stedi transaction enrollment only authorizes electronic transactions, like claims, for a provider who is already credentialed. Neither Phiclaw nor Stedi does credentialing.
Payment reports usually go to one clearinghouse at a time. Electronic remittance advice (ERA, the 835 file) tells you what a payer paid and why. Moving ERA to a new clearinghouse can stop it at the old one, so pick a cutover date instead of switching in the middle of a billing cycle.
What it costs
Insurance claim submission is a Phiclaw add-on: $10 a month plus $0.30 per claim, on top of a Phiclaw plan. See every plan and add-on on the pricing page.
Frequently asked questions
Is Phiclaw a clearinghouse?
No. Stedi is the clearinghouse. Phiclaw builds the claim from the visit, has your team approve it, sends it through Stedi and tracks what comes back.
What kind of claims can Phiclaw send?
Professional claims, sent in the 837P format. That is the format for doctor and outpatient services.
Does Phiclaw check insurance eligibility?
Yes. Phiclaw can run a real-time eligibility check through Stedi before the visit, so the front desk sees whether the payer reports active coverage on the date of service.
Does Phiclaw do insurance credentialing?
No. Credentialing is the provider's contract with the insurer, and it has to be in place first. Stedi transaction enrollment only authorizes electronic transactions like claims after that.
How much does insurance claim submission cost?
It is a Phiclaw add-on: $10 a month plus $0.30 per claim, on top of a Phiclaw plan.
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