How many clearinghouses are there?

There is no single global count for clearing houses, as hundreds operate worldwide across different industries like finance, commodities, and healthcare.

Financial and Securities Clearing Houses

• United States: There are a handful of major central clearing agencies registered or exempt with the SEC, including the National Securities Clearing Corporation (NSCC) for equities, the Fixed Income Clearing Corporation (FICC) for debt, and The Options Clearing Corporation (OCC) for options.
• Global/Regional: Major international powerhouses include Euroclear in Europe, Clearstream, and LCH SA. Futures exchanges like the CME Group also run their own dedicated clearing houses.
• Banking Payments: "The Clearing House" (TCH) is a specific private-sector payment and banking association in the U.S. owned by major commercial banks.

Healthcare Clearing Houses

• In medical billing, there are dozens of electronic clearing houses that translate and route insurance claims between medical providers and payers.
• Prominent national examples include Availity, Change Healthcare, and Waystar.

The largest healthcare clearinghouses by transaction volume and network reach are Optum (Change Healthcare), Waystar, Availity, and Cognizant TriZetto. In the financial sector, The Depository Trust & Clearing Corporation (DTCC) is the largest financial services clearinghouse.

Major Healthcare Clearinghouses

• Optum (Change Healthcare): Processes over 15 billion transactions every year and links providers to more than 2,500 insurance networks. It suits large hospitals and massive health systems best.
• Waystar: Handles more than 7.5 billion transactions with a strong focus on cloud automation and AI. It works well for large, growing medical practices.
• Availity: Operates one of the largest multi-payer web networks in the country. It offers strong free basic entry tools and high acceptance rates for major insurance plans.
• Cognizant TriZetto: Connects thousands of insurance payers. It handles complex, high-volume data traffic for large medical groups.

Major Financial Clearinghouse

• The Depository Trust & Clearing Corporation (DTCC): Tops the financial industry. It provides clearing, settlement, and information services for equities, corporate bonds, and government securities globally.

The best medical billing clearinghouse depends on your practice size, claim volume, and budget, with Claim.MD ranking as the top value for small practices, and Waystar or Optum Change Healthcare leading for large organizations.

Top Clearinghouses by Practice Type

• Solo and Small Practices: Claim.MD offers transparent, low-cost monthly tiers starting around $30 to $120 without forcing you to switch your electronic health record (EHR) software. Office Ally is another popular budget choice with free baseline claim submissions for many payers.
• Free Multi-Payer Options: Availity Essentials provides a robust, health-plan-sponsored portal that connects providers to multiple major insurance payers at no direct subscription cost for basic transactions.
• Growing and Mid-Sized Groups: Waystar delivers advanced automation, real-time eligibility verification, and powerful AI-driven denial prevention tools.
• Enterprise and Hospital Networks: Optum (including Change Healthcare and TriZetto Provider Solutions) handles massive national claim volumes and complex, multi-specialty institutional billing rules.

Factors to Check Before Signing

• Payer Mix: Confirm the clearinghouse actively supports your specific regional or niche insurance carriers.
• EHR Integration: Verify whether the clearinghouse integrates cleanly with your current practice management software or requires manual file uploads.
• Hidden Fees: Check if eligibility checks, secondary claims, electronic remittance advices (ERAs), or patient statements incur extra per-transaction costs.

The Clearing House is owned by the world's largest commercial banks, including 20 major financial institutions.

Ownership and Structure

• Bank Consortium: It is jointly owned by leading global and national commercial banks operating in the United States.
• Market Share: These owner banks hold more than half of all U.S. deposits.
• Operations: The organization runs core payment systems like CHIPS and the RTP network through The Clearing House Payments Company.

No, J.P. Morgan is not a clearing house itself, but it is a major participant, owner, and provider of Global Clearing Solutions.

Distinction Between J.P. Morgan and a Clearing House

• J.P. Morgan (JPMorgan Chase & Co.): A massive global financial services firm and commercial bank that processes trillions of dollars in transactions, trades securities, and acts as a clearing broker/dealer (such as through J.P. Morgan Clearing Corp).
• A Clearing House: An independent organization or separate legal entity that stands between two parties in a financial transaction to ensure smooth and final settlement (reducing counterparty risk). Examples include central clearinghouses like the DTCC or payment networks like The Clearing House.

J.P. Morgan’s Relationship with Clearing Houses

• Co-owner: The Clearing House, a well-known U.S. payments company and banking association, is co-owned by J.P. Morgan along with other major global banks (like Bank of America and Citigroup).
• Participant: J.P. Morgan entities (like J.P. Morgan Securities and JPMorgan Chase Bank) act as direct clearing members of major external clearing houses, such as the Fixed Income Clearing Corporation (FICC).
• Provider: J.P. Morgan operates its own proprietary global clearing and payment infrastructure for processing international wires, Automated Clearing House (ACH) payments, and foreign exchange, moving roughly $10 trillion daily for institutional clients.