Candid Health and Healthie

Healthie’s partnership with Candid Health enables digital health organizations to get ahead of claims faster. This partnership results in modern healthcare providers getting paid and scaling their products and organizations more efficiently.  

Our API offering is now live, and available for any Healthie customers with a Candid Health account. There is no fee from Healthie to enable this marketplace offering, and can be enabled for any paid subscription plan. While Healthie will enable integrations, it is still up to the partner to enter into an agreement with the customer. Some of our partners have minimum contract or practice sizes. Candid typically works with our Enterprise customers, but does serve a number of customers on our Group plan.

How to Connect Candid Health with Healthie

Please reach out to support@joincandidhealth.com to request Production Candid API keys to be sent to you for sharing with Healthie. Please see an example email below:

Once Candid sends you Production API keys for Healthie, please send these to the Healthie team via an encrypted email. The Healthie team will then enable the integration for your account and will notify you when you can send claims to Candid.

Leverage Healthie + Candid Health Together

Once enabled, this partnership allows providers to directly send (or batch send) CMS 1500 claims from Healthie to Candid Health. Once received by Candid Health, claims will be processed and managed via Candid directly. 

If a claim has errors and does not successfully send to Candid Health, an error notification banner will appear. 

This is an API offering to push claims data from Healthie to Candid Health. At this time, no data will pull back into Healthie. Please access your Candid Health account directly to check the status of your claim(s).

For any questions re: the status or issues with claims, we recommend reaching out to Candid Health directly via support@joincandidhealth.com. 

Once a claim is submitted to Candid, the claim status will automatically update as “Sent” within Healthie. We recommend manually updating the subsequent status of your claim in Healthie once processed, as needed to ensure accurate reporting within Healthie. More information on reporting here.  

To collect any client owed responsibility, an invoice can be created in Healthie, and tied to a specific claim.  

Walk through our quick tutorial video to learn how to submit a claim to Candid Health, and how to invoice clients for any client owed responsibility. 

FAQs 

When I click “Send to Candid Health” in Healthie, how long will it take for the CMS 1500s to show as claims in Candid?

Since the partnership is via API, data transfer is instantaneous, so you should see your claims in Candid immediately after clicking the “Send to Candid Health”. In some cases it could take a little longer, but if you don’t see the claims in Candid within 10 minutes of clicking the button, please reach out to hello@gethealthie.com for support.

How do I create a CMS 1500?

A CMS 1500 can be created directly within Healthie. Learn more here. 

Can I automatically create and send a claim to Candid after finishing the visit note?

Currently you’ll need to create a CMS 1500 first before you can send a claim to Candid. An upcoming release, will include a feature that allows for the auto creation and sending of a claim.

What clearinghouse does Candid use? 

Candid Health leverages Change Healthcare as a clearinghouse. As part of getting set up with Candid, they will manage the enrollment process with Change for you. 

What if I’m already using Change Healthcare as a clearinghouse? 

If you are already billing through CHC, Candid would handle transferring of your enrollments over to Candid. CHC does not allow two separate Change Submitter IDs to have access to the enrollments, so it is required to transfer your enrollments to Candid. 

What is the zip code+4 error message?

A zip code + 4 digits (so 9 digits total, with no spaces or characters) is required for provider/organization related zip codes (not the patient or policy holder address).

If you are experiencing this error message for a claim, here are some troubleshooting tips:

• Check that the address for the Billing Provider, and Service Facility all have the zip code in a 9 digit format, with no hyphens or spaces)
  • Correct: 123456789
  • Incorrect: 12345-6789
  • Incorrect: 12345 6789
• You can edit the Service Facility directly within the claim (Service Facility > View Details > Edit Facility)
• Resubmit your claim

Once correct, the addresses should auto-fill properly on all subsequent claims. If you are still receiving an error message, please issue a support ticket to hello@gethealthie.com

Why am I receiving an error message related to the Referring Provider?

For the referring provider, please check that you have filled out the First, Last Name for the provider OR the organization name. Candid does not support claims that have both sets of information added to a claim.

How do I designate a claim as Cash Pay, Self Pay or Do Not Bill when sending it to Candid?

If you wish to send Cash Pay, Self Pay or other claims that should not be billed to insurance to Candid, please list the Payer Name in Healthie as "CASH PAY" or "SELF-PAY". Candid will ingest any claims with payer names of "CASH PAY" or "SELF-PAY" into the Candid platform with a claim status of Not Billable so that customers can use Candid Reports for a complete view of all claims, both insurance and non-insurance.

This is optional for reporting purposes within Candid. Additional reporting can be leveraged within Healthie (ie. Payments Report and CMS 1500 Report).