Insurance Billing Automations [In Beta]

Healthie enables providers and organizations to create CMS 1500s and to optionally submit them to an RCM or Clearinghouse.

We are currently launching and beta testing new functionality that will streamline insurance billing processes by automating administrative tasks, including: 

• Automatically Create a CMS 1500 [Beta Test]

Automatically Create a CMS 1500 [Beta Test]

As part of our commitment to streamline billing workflows, we’re enabling the ability to auto-create a CMS 1500. This update will greatly reduce admin time previously spent manually creating each CMS 1500.

Note: This feature is currently available for beta and will only be available to paid plans once live.

You will now notice a new Automated Insurance Billing section in your Insurance Settings. Once there, you have the ability to enable the Automatically Create CMS 1500s setting. When toggled on, a CMS 1500 will be automatically created each night for any appointments that meet the following criteria:

• Insurance billing is enabled for that appointment type.
• Automated billing is selected for the scheduled appointment.
• Appointment status is set to "no status" or "occurred" at the end of the day.

To enable insurance billing for specific appointment types, head to Settings>Appointment Types>Edit where you will see a new Insurance Pricing toggle. Once applied, the setting will be automatically enabled for that appointment type for any future appointments created.  

Note: This setting is not available for Group Session appointment types. 

When you go to schedule a new appointment on the calendar, you will notice a new setting that will allow you to enable or disable this setting at the individual appointment level.

If an appointment status is marked as Occurred or the appointment end time has passed, a CMS 1500 will automatically be created. 

However, if the appointment status is marked with a Canceled, No-show, Late Cancellation, or Re-scheduled status, the Healthie system will not generate a CMS 1500. 

Note: The batch job to create all CMS 1500s runs at 12AM UTC for all applicable appointments that day.