Clearinghouse Vendor Guide

Last Updated March 2026

Guide Contents
Quality Options

Change Healthcare

Largest U.S. clearinghouse by volume — but the 2024 breach changed everything.

Overview

Change Healthcare operates the largest medical claims clearinghouse in the United States, processing approximately 15 billion transactions annually and connecting to virtually every U.S. payer. Now a subsidiary of Optum (UnitedHealth Group) following the 2022 acquisition, Change Healthcare remains the backbone of electronic claims for a significant portion of the U.S. healthcare system.

The February 2024 cyberattack on Change Healthcare disrupted claims processing nationwide for weeks, highlighting both the platform's dominance and the systemic risk of single-clearinghouse dependency. Many practices lost the ability to submit claims entirely. Some waited weeks for resolution. The breach was a wake-up call for the entire industry and the single strongest argument for maintaining a backup clearinghouse.

Despite the breach, Change Healthcare's network reach remains unmatched. It's also the back-end for ChiroTouch's CT MaxClear integration. For practices that need maximum payer connectivity and process high volumes, it remains part of the claims infrastructure — but it should never be your only clearinghouse.

Pros & Cons

Strengths

  • Largest payer network. Connected to 5,500+ payers — the most comprehensive network in the U.S. If a payer accepts electronic claims, Change likely connects to them.
  • Massive transaction volume. 15B+ transactions/year means the platform is battle-tested at scale. Rare claim routing issues.
  • Deep EMR integration library. 900+ integrations covering virtually every practice management and EHR system on the market.
  • Robust batch processing. Handles very large batch submissions efficiently — critical for billing companies processing thousands of claims daily.

Weaknesses

  • 2024 cybersecurity breach. The February 2024 ransomware attack disrupted nationwide claims processing for weeks. The most significant healthcare IT failure in recent history.
  • Optum ownership concerns. UnitedHealth Group ownership raises conflict-of-interest questions for practices billing UHC-affiliated plans.
  • Single point of failure risk. Over-reliance on one clearinghouse — especially one this dominant — creates systemic risk, as the 2024 breach demonstrated.
  • Customer service challenges. Large organization means support can be slow. Escalation paths are not always clear for smaller clients.
  • Post-acquisition price increases. Some clients have reported rate increases during contract renewals since the Optum acquisition.

EMR Integrations

Change Healthcare integrates with many EMR and practice management systems, including:

  • ChiroTouch (CT MaxClear)
  • eClinicalWorks (via SFTP)
  • PracticeSuite (as intermediary)
  • Epic
  • Cerner (Oracle Health)
  • Athenahealth
  • NextGen
  • Allscripts (Veradigm)
  • Greenway
  • MEDITECH
  • AdvancedMD
  • Kareo (Tebra)
  • DrChrono
  • Practice Fusion
  • CureMD

Pricing

Transaction Price
Claims Pricing upon request
Eligibility Checks Pricing upon request
ERA Retrieval Pricing upon request
Claim Status Pricing upon request

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