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: Please review your Healthie payer list that includes which insurances are configured on a Patient Profile. You should NOT allow free text fields for a patient to enter in their own insurance. You should be using the Healthie drop-down. If you allow a customer to input their own insurance plans, you may have issues with how claims are sent to Candid. Send your complete Healthie payer list to your Candid Onboarding Representative so they can review this with you. 
• Billing Provider Organization Configured: Please verify that your billing provider is set-up by going to Organization → Settings. You should have all required information including the Name, NPI, TIN, and Address. Additionally, please make sure you include a +4 in the zipcode. 
  • Note: If you have multiple billing providers in Healthie, this integration will only capture the primary billing provider. Please talk to your onboarding representative so you can create a rule-logic to assign the correct billing provider in Candid. 
• Rendering Providers Configured: Please make sure that each of your rendering providers have an NPI in Healthie. You can verify this by going to Organization → Members → Viewing each individual provider. Any rendering provider listed on an appointment should have an NPI. If they do not, a claim will not be created 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: Please confirm that the client's insurance (payer name and payer ID) is configured within Healthie using the Healthie payer drop-down. You should NOT be using any custom insurance plan naming. If you use the free-text fields, it will create payer mapping issues within Candid. 
• Submit all previous claims: Once the integration is enabled, you will only be able to submit claims for any appointments that occur from that day moving forward. The integration is NOT retroactive. Therefore, prior to proceeding, please ensure that you use your current claim submission method to send all existing claims from Healthie to Candid that must be submitted to the payer. 
  • Healthie v1 Users: Manually click the “Submit to Candid” button within Healthie for all previous encounters.
  • Custom Integrations/CSV Users: Use your existing upload process for all appointments prior to the activation date.
  • Please make sure to consult your onboarding representative about navigating this transition and best practices if you have any questions. 
• Disable Current Claim Submission Process: AFTER sending all existing claims to Candid (if applicable), you will need to disable ANY automation regarding claim submission and/or CMS-1500 generation between Healthie and Candid. If you do not disable, you will create duplicate claims in Candid. If you are on Healthie v1, you should NOT use the “Submit to Candid,” button once this 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:

Candid should be treated as the source of truth for claim workflows and claim balances.Edits made to claims in Candid typically do not sync back to the CMS-1500 in Healthie.

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

Healthie customers with an active Candid account can enable the integration using Candid’s self-serve integration tool. No engineering or developer support is required. This integration is designed to be configured entirely by you within the Candid and Healthie platforms. Please make sure you email Candid Support if you are interested.

After emailing support, 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. You can find your Healthie API keys, following the instructions here. If you need help finding the keys, please connect directly with Healthie. 
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. 

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