Dental Clearinghouses: DentalXChange, Stedi, Availity, Vyne

A dental claim leaves your practice management system (PMS) as one file and reaches the payer as a different one, and the company that does that translation in between is your clearinghouse. Most offices never see it work. They see what it sends back: an eligibility answer, a rejected claim, a payment that posts or doesn’t. In the revenue cycle workflows I’ve mapped, it’s the one system nobody looks at until a claim comes back wrong, and by then the fix means a resubmission and another wait.

Two kinds of reader end up here. Someone running billing at a practice or dental group, deciding whether to stay, add a second clearinghouse or switch. And someone building dental software, picking the clearinghouse the product will depend on for years. Both start from the same map of what goes through a dental clearinghouse, transaction by transaction. To see eligibility run end to end, our dental eligibility automation webinar, co-presented with Stedi’s product team, demos our Open Dental build live.

What Does a Dental Clearinghouse Actually Do?

A dental clearinghouse is the company that takes claims and eligibility requests from your PMS, checks them against payer rules, converts them into the HIPAA-standard electronic format, sends each one to the right payer by its payer ID, and returns the payer’s responses to your system. One connection from the practice reaches hundreds of payers.

HIPAA defines the role precisely. A health care clearinghouse is an entity that takes health information in a nonstandard format and turns it into a standard transaction, or does the reverse for the receiving party (45 CFR 160.103). That makes a clearinghouse a HIPAA covered entity in its own right, alongside health plans and providers. When it handles claims on your practice’s behalf, it also acts as your business associate, which is why it signs a business associate agreement with you.

One phrase on vendor-selection lists is worth correcting. You’ll see advice to choose a “HIPAA-certified” clearinghouse. HHS states that it does not require or recognize a HIPAA “certification”, and a third-party certificate doesn’t change an organization’s obligations. The useful questions are about the business associate agreement, the security controls and the audit reports a clearinghouse will share.

Three jobs happen between your PMS and the payer:

1. Edits. The clearinghouse checks the claim for missing or invalid data (subscriber ID format, provider NPI, procedure code by number, tooth and surface where required) before the payer sees it.
2. Translation. It builds the X12 file the payer expects, or accepts one your PMS already built.
3. Routing. It uses the payer ID, the electronic address each payer publishes, to send the transaction to the right place, then routes the responses back.

Which Transactions Run Through a Dental Claims Clearinghouse?

Six transaction sets do almost all the work, and most front desks only ever see their results. Here’s each one in front-desk terms, with the HIPAA rule that names it and the share of dental-plan transactions that ran fully electronically, from the 2025 CAQH Index.

Transaction	What it answers	HIPAA standard	Share of dental-plan volume fully electronic (2025 CAQH Index)
270 / 271 eligibility	Is this patient covered today, and what are the benefits?	45 CFR 162.1202	80%
837D dental claim	Here is what we did; please pay	45 CFR 162.1102	90%
999 / 277CA acknowledgments	Did the file arrive, and did the claim pass front-end edits?	Operating step behind claim submission	not measured separately
276 / 277 claim status	Where is this claim now?	45 CFR 162.1402	23%
835 remittance (ERA)	What did the payer pay, adjust or deny, and why?	45 CFR 162.1602	39%
275 attachments	Here are the X-rays, perio chart or narrative behind the claim	Adopted 2026, compliance 2028 (below)	28%

Two numbers stand out. Dental claims themselves go electronic 90% of the time, so submission is largely solved. Claim status sits at 23%, which suggests most offices still check where a claim is by portal or phone. That’s where staff time goes after the claim leaves.

Three edge cases belong in the same table even though they’re rarer:

Rejected or Denied: Which One Did the Clearinghouse Catch?

A rejected claim never reached the payer’s adjudication system. A denied claim did, and the payer decided not to pay all or part of it. The difference decides who fixes it and how fast.

• Rejection. The clearinghouse’s edits or the payer’s front door stopped the claim. It comes back on an acknowledgment (a 999 for a file problem, a 277CA for a claim problem), often within hours. Fix the data and resubmit. Nothing was adjudicated, so there’s nothing to appeal.
• Denial. The payer processed the claim and refused some or all of it. The reason arrives on the 835 as a claim adjustment reason code, often with a remark code. That’s a correction, a narrative, a corrected claim or an appeal, and it usually lands on the billing team.

A clearinghouse that reports rejections clearly saves the most time, because rejections are the cheapest problems to fix and the easiest to miss. A rejected claim that nobody opens is a claim that was never filed. Denials and aging A/R across locations are a revenue cycle job of their own, covered in dental revenue cycle management.

DentalXChange, Stedi, Availity and Vyne: How the Dental Clearinghouse Companies Differ

They all move dental transactions, and each describes itself for a different user. Everything below comes from each company’s own pages, as published on 25 October 2026. Products and prices change, so treat it as a dated snapshot and check the source before you sign. One disclosure: our team has built on Stedi (the build is below) and co-presented a webinar with its product team, so weigh our Stedi detail with that in mind.

Clearinghouse	Who it describes serving	How you connect	Dental transactions it lists	Network figure it publishes	Published pricing (as published 25 Oct 2026)
DentalXChange	Practices, payers and PMS “channel partners”	From inside a partner PMS, its web portal, or its XConnect APIs	Eligibility, claims, attachments, claim status, ERA	“Nearly 1,400” dental payers	None; a “Get Pricing” form
Vyne Dental	Dental practices, through its Trellis billing platform	Trellis, which connects to “your PMS appointment book”	Claims, attachments, eligibility and benefits, ERA	“Over 800” attachment connections	“One low monthly fee”, no figure
Availity	Providers and health plans, medical and dental	Essentials web portal, batch EDI, or APIs	Dental claims (listed under its paid Essentials Pro tier), predeterminations, eligibility, claim status, ERA	Per plan, on its payer list	Essentials free for plans that sponsor it; paid tiers for others
Stedi	Software teams building on its APIs	JSON or raw X12 APIs, SFTP, or a web portal	Eligibility, dental claims, claim status, ERA, attachments	Per payer and per transaction, on public payer pages	Per transaction, no monthly minimum (below)
Electronic Dental Services (EDS)	Dental practices, with help centers for Open Dental and Eaglesoft users	From inside the PMS	Claims, real-time eligibility, real-time claim status, ERA, attachments (through NEA)	“Over 800 payers”; open payer lists per transaction	None published
Dentrix eClaims	Dentrix practices (Henry Schein One)	“Integrated directly into Dentrix”	Eligibility, claims and attachments, ERA, a submitted-claims dashboard	“Over 1,300” payors	None published
Office Ally	Medical and dental providers	Service Center web portal, or its EDI clearinghouse	Claims and acknowledgments (837P, 837I, 837D), eligibility, attachments, ERA	Not stated on the pricing page	Service Center “Start for Free”, transaction fees may apply; eligibility $10/month for the first 100, then $0.10 each; attachments $0.55 each; EDI clearinghouse “Customized Pricing”

A few details from those pages answer the questions people type into search:

• What is DentalXChange? A dental clearinghouse that has run for more than 35 years by its own count. ClaimConnect is the name of its claims and clearinghouse application, which is why you’ll see “ClaimConnect” and “DentalXChange” listed as if they were two companies. It publishes a payer list and lists XConnect APIs for software partners; one PMS vendor announced in August 2024 that it was the first partner on those APIs for claims, eligibility and ERA (press release).
• Is Vyne Dental a clearinghouse? Yes. Its Trellis platform routes claims “through Vyne Dental’s Clearinghouse”, and FastAttach is its attachments service. Its page lists 84,000+ dental offices and the ERA footnote “requires provider enrollment”.
• Availity for dental providers. Availity runs a multi-payer portal and an EDI clearinghouse. Essentials is free for health plans that sponsor it, and its claims page lists dental claims among the features of Essentials Pro. Some dental plans run their provider tools on it (Premera Dental is one), so check the plan’s own page.
• Stedi. An API clearinghouse whose dental claims API became generally available in January 2025, and which reports CAQH CORE certification for eligibility and, more recently, for claims, claim status and ERAs (changelog). Its published prices include eligibility checks from $0.30 down to $0.08 by monthly volume, dental claims from $0.30 down to $0.10, and $0.75 per claim attachment, plus payer-added fees in a few cases.
• EDS and Dentrix eClaims. Both run from inside the PMS. EDS publishes its payer lists as open PDFs, one per transaction, which is rare enough that we used them for the payer count below.

You’ll also meet the e-claims services bundled into other PMS products, and Change Healthcare, part of UnitedHealth Group. If you’re comparing claims software rather than clearinghouses, our claims processing software guide covers that decision.

How Should a Dental Practice Choose a Clearinghouse?

Start with your PMS, because it decides which clearinghouses you can even send from. Then check payer coverage one transaction at a time. Everything else comes after those two.

1. Your PMS’s current supported list. What each PMS’s vendor, or a clearinghouse working with it, publishes (October 2026):

PMS	What’s published	Source
Open Dental	A manual page of recommended clearinghouses (DentalXChange’s ClaimConnect and EDS), additional ones, and “not recommended” (Change Healthcare, noting the early-2024 cyberattack)	Open Dental manual
Dentrix	Dentrix eClaims, built into Dentrix by Henry Schein One	Dentrix
Eaglesoft	EDS runs a help center for Eaglesoft users; Patterson markets its own eClaims service for Eaglesoft, so ask Patterson for its current list	EDS
Denticon	Planet DDS announced DentalXChange’s XConnect APIs for claims, eligibility and ERA in August 2024	press release
Curve	Claims, attachments and ERA inside Curve; the clearinghouse isn’t named on the page	Curve billing

Lists like these change, so read the current version, not last year’s. On Open Dental and want other software connected to it? See our Open Dental integration page. If you’re connecting software to another PMS, our dental PMS integration page covers the access routes.

1. Payer coverage per transaction. A payer count tells you how many payers a clearinghouse reaches for something. It doesn’t tell you which transactions work with each one. We checked the same 20 large dental payers on two public payer lists on 25 October 2026: Stedi’s payer network and EDS’s per-transaction payer PDFs:

Transaction listed	Stedi (of 20)	EDS (of 20)
Eligibility (270/271)	20	20
Remittance (835)	19	20
Dental claims (837D)	15	20
Claim status (276/277)	9	14
Attachments	2	11
Coordination of benefits checks	2	not listed

Both lists carry eligibility for all 20. After that they part: four regional Delta Dental plans listed eligibility and remittance but not dental claims on Stedi’s directory, and all four were on EDS’s claims list; EDS listed attachments for 11 payers and claim status for 14. EDS lists several plans under one payer name, so read the two columns as directional.

What it does show is that the same payer can look different depending on whose list you read, so ask any clearinghouse for its list by transaction for your top payers, and don’t accept a single payer count. Payers also publish their own lists; Blue Cross NC’s 2024 notice names the clearinghouses its dental providers can submit through.

1. Attachments. Ask how X-rays, perio charts and narratives travel, and whether that’s included or priced separately.
2. ERA enrollment support. Electronic remittance usually needs payer-side enrollment. A clearinghouse that files it for you saves staff time.
3. A second route. When Change Healthcare went down in February 2024, clearinghouse services weren’t fully restored until November 2024. Know how you’d submit if your clearinghouse stopped tomorrow: a second clearinghouse, a payer portal, or paper for your top payers. If the backup is a second clearinghouse, ask which of your top payers it connects to directly and which it passes through another network, and what its contract says about availability.
4. Exit terms. Contract length, notice period, and whether you can export your claim history and payer setup when you leave.

On security, ask for the business associate agreement, the security controls, and recent audit reports. A “HIPAA certificate” doesn’t exist, as above.

Want eligibility answers to land in your PMS fields without anyone retyping them? See the dental insurance verification software we build.