Candid Health and Healthie

Healthie’s partnership with Candid Health helps organizations streamline insurance billing by connecting clinical documentation in Healthie to claim creation and billing workflows in Candid.

Candid + Healthie  

Candid Health is a revenue cycle automation platform that’s eliminating unnecessary human intervention from medical billing.

Candid and Healthie is offering an expanded integration, designed to create a deeply connected, end-to-end billing experience for our customers. This bidirectional integration reduces manual workflows, removes data silos, and bridges the gap between clinical and financial operations.

Please Note:

• The integration is directly enabled and configured inside Candid’s application (not inside Healthie).
• No engineering support is required for customers to enable the out-of-the-box integration.
• Neither Healthie nor Candid charges an additional fee to enable the integration.
• Pricing and contracting are handled directly with Candid. Additionally, if you have any questions about the integration please email Candid’s Support Team: support@joincandidhealth.com

V2 Integration Overview

At a high level, the integration supports:

• Automated claim generation (triggered from Healthie): When a clinician locks the configured chart note in Healthie, a claim is automatically generated in Candid and a corresponding CMS-1500 is created in Healthie. After the claim is generated in Candid, all claim processing and management should happen directly in Candid. The integration supports individual and group appointments (with individual claims generated per client in a group visit).
• Claim status visibility in Healthie: As claims move through Candid’s workflow, key claim statuses and statuses are pushed back to Healthie so teams can track progress from within Healthie’s CMS-1500 view (e.g., submitted, rejected, denied, paid). Please note: Candid should be your ultimate source of truth to understand where a claim is in the claim lifecycle. You should also work all claims directly in Candid.
• Bidirectional client data sync: Once enabled, client demographics, insurance information, and client tags will sync between systems to help keep client records aligned across clinical and billing teams.
• Streamlined invoicing & client payments: The integration supports common client payment workflows (e.g., collecting co-pays upfront and invoicing remaining balances after adjudication), with Candid serving as the system of record for claim-level financial workflows. Note: you cannot charge clients within Candid.

Watch a short demo of the Candid integration for Healthie here.

Walk through the integration in detail here: Overview of Candid’s Out-of-the-Box Healthie Integration, when signed into your Candid account.

Configuration Details

As described above, with this integration, once a provider locks the chart note, a claim will be generated in Candid, along with a corresponding CMS-1500 in Healthie.

Before getting started with the official integration set-up, please verify a few critical configurations in your Healthie Instance and take the steps outlined below.

If you do not review these steps, you will have various claim validation errors as claims are sent to Candid: 

• Healthie Payer List: Review which insurance payers are configured in your Healthie instance. Patient insurance must be selected from the Healthie dropdown — do not allow free-text entry. Custom insurance names will cause payer mapping issues in Candid. Share your complete Healthie payer list with your Candid Onboarding Representative for review before going live.
• Billing Provider Organization Configured: Confirm your billing provider is configured under Organization → Settings. Required fields: Name, NPI, TIN, and Address (include the +4 zip code extension).
  • Note: If you have multiple billing providers in Healthie, the integration will only capture the primary billing provider. Work with your Candid Onboarding Representative to set up rule logic that assigns the correct billing provider in Candid.
• Rendering Providers Configured: Verify that every rendering provider has an NPI in Healthie (Organization → Members → individual provider record). Any rendering provider listed on an appointment without an NPI will not generate a claim in Candid.
• Client Information Configured: Please ensure that you capture all required client information for existing and new client in their client profile: 
  • First Name 
  • Last Name 
  • Date of Birth (YYYY-MM-DD format) 
  • Sex/Biological Sex: Sex on file with client's insurance
  • Address/Location (This is the "Client" Address) 
  • Insurance: payer name and payer ID, selected from the Healthie dropdown only. Do not use free-text or custom plan names.
• Submit all previous claims: Submit All Prior Claims The integration is not retroactive. Only appointments from the activation date forward will be captured. Before enabling the integration, submit all existing claims using your current method.
  • Healthie v1 users: Manually click "Submit to Candid" for all prior encounters.
  • Custom integration / CSV users: Use your existing upload process for all appointments prior to the activation date.
  • Contact your Candid Onboarding Representative with any questions about navigating this transition.
• Disable Current Claim Submission Process: After submitting all prior claims, disable any existing automations related to claim submission or CMS-1500 generation between Healthie and Candid. Failing to do so will create duplicate claims in Candid. Healthie v1 users should not use the "Submit to Candid" button after the integration is live. Additionally, please ensure your team is trained on the new process of signing and locking a chart note. You can learn more about the workflow here.

Source of truth expectations:

Once a chart note is signed and locked, Candid is the source of truth for all claim data. The CMS-1500 in Healthie is informational only.

The only field that syncs from Candid back to the Healthie CMS-1500 is CPT Codes + Modifiers. Changes made to coverage, service facility, diagnosis codes, or any other fields in Candid will not sync back to Healthie. Do not make edits directly to the CMS-1500 in Healthie once a claim is active in Candid.

For the full configuration guide can be accessed here: How to Set Up The Candid’s Out-of-the-Box Healthie v2 Integration when signed into your Candid account.

How to Enable the Integration

After Candid approves you to enable the integration, you will be able to directly set up the integration in the Candid platform on the “Settings & Integrations” page.

At a high-level, to integrate with Candid, you will need to provide:

1. Your Healthie API keys for your organization.
   1. For customers with API access: : You can find your Healthie API keys within Healthie, following the instructions here.
   2. For all other Enterprise customers, please reach out to hello@gethealthie.com to request an API key for your Candid integration. The API is not required to use the Candid integration.
2. The Form ID for your standard chart note form. Select the chart note(s) that will be used to send claims to Candid. Please see instructions below on how to find your Form ID. 

• Open up the chart note template you will use to send claims to Candid.
• Copy the chart note ID which can be found in the URL 
• If you need more support identifying your Healthie charting form ID, reach out to hello@gethealthie.com for assistance.

What if I do not have an existing chart note in Healthie? 

• If you do not have any existing chart notes in Healthie, you can leave the form ID blank. 
• When you configure your API keys, Candid will automatically generate a Candid Chart Note template in the “Forms” section of Healthie. It will already have the required fields and you can then add any additional fields using the drag and drop feature. 

For the full guide to setting up this integration, please view How to Set Up The Candid’s Out-of-the-Box Healthie v2 Integration when signed into your Candid account.

Transitioning from v1 to v2 Integration

If you are a customer currently on Healthie v1 looking to transition to Healthie v2, please first email Candid Support: support@joincandidhealth.com before any further action. They will guide you through next steps.

A few configuration notes:  

• The “Send to Candid Health” button will remain on your Healthie screen, even after integration. It is critical that you train your team not to click this button after the integration is configured.
• Additionally, if you have any automation built on top of Healthie v1, you will need to disable this automation before integrating in the UI. If you continue using the “Send to Candid Health,” button or do not disable any additional custom automation, you will create duplicate claims in Candid. 
• You do not need to “disable” Healthie v1 in any way. As soon as you integrate with v2, you will be able to send claims automatically when chart notes are locked. You should ensure your team submits all outstanding claims before you turn this integration on, as this integration will only account for claims for new appointments after the integration is enabled. 

Candid for Sub-Organizations

Support for sub-organizations with the Candid v2 integration depends on your billing setup. Please review the scenarios below to understand how this may apply to you.

This integration may support your setup if:

• You have multiple sub-organizations funneling encounters into Candid
• Each sub-organization has its own Healthie API key
• All sub-organizations bill under the same Billing NPI and TIN
• You do not require billing data or PHI to be kept siloed across sub-organizations once it reaches Candid

This integration may not support your setup if:

• Your sub-organizations have unique NPIs or TINs
• You have separate billing teams per sub-organization
• You require strict data separation between sub-organizations within Candid

In either scenario, additional scoping is required. Please reach out to Candid at support@joincandidhealth.com to discuss your specific setup before proceeding.

Receiving Support

Because this integration is configured and maintained by Candid:

Contact Healthie Support if you need help with:

• Locating Healthie settings required for enablement (e.g., where to find API keys)
• General questions about where to find CMS-1500s and billing artifacts in Healthie
• Healthie-side workflow questions that are not specific to Candid configuration

Contact Candid Support if you need help with:

• Integration setup and configuration inside Candid
• Sync behavior (client/appointments/coverage) and troubleshooting claim creation
• Claim status mapping or claim processing questions inside Candid
• Payment/invoicing workflows supported through the integration

Candid Resources

For the most up-to-date setup instructions and technical details, refer to Candid’s documentation. You'll need to be logged into your Candid account in order to access these docs.

• Overview of Candid’s Out-of-the-Box Healthie Integration
• How to Set Up the Candid Out-of-the-Box Healthie Integration
• Healthie Payments ↔ Candid Patient Payment Integration
• Submit a request to Candid Support / View support tickets
• Integration Demo Video