Healthie and ClaimMD Integration (In Beta Testing)
Streamline your insurance billing workflows with Healthie's direct integration with ClaimMD. This integration enables Healthie members to:
- Run real-time eligibility checks with ease
- Submit claims directly through Healthie to ClaimMD
The V1 of this integration is currently in beta testing with a select number of customers. To be notified when this integration is available for your plan, please subscribe to our Portal Card for updates here.
In this article we'll review:
Activate ClaimMD for your Healthie Account
Healthie offers a direct integration with ClaimMD which means you do not need to set up your own personal account with ClaimMD — Please do not create a new ClaimMD account. We will help you get set up with ClaimMD through the integration enablement process!
This integration is currently in beta testing and is not yet available for all Healthie customers. Select Healthie Enterprise and Group Plan customers can request to join the beta period by emailing your Customer Success Manager. Your CSM will send you a Healthie + ClaimMD Addendum to sign.
To be notified when this integration is available for your plan, please subscribe to our Portal Card for updates here.
When signing the addendum, you will select the plan you would like to move forward with. Basic, Small, and Unlimited are the only options offered by ClaimMD. They do not offer different structures even if you only plan to submit claims or only submit eligibility checks. There is an additional cost for ClaimMD, which will be billed to your Healthie account.
Please do not create your own ClaimMD account from their website.
After you sign the Healthie + ClaimMD Addendum, Healthie will initiate the account creation process for you. Your designated account admin will receive an email from ClaimMD inviting them to finish setting up the account.
Integration Next Steps
When signing your ClaimMD addendum, you will write down the name and email address for the person you would like to be the designated ClaimMD account admin. This person will receive an invite directly from ClaimMD to finish setting up your account — if you are a solo provider, you will designate yourself as the admin.
Once the admin has created their account, please follow the instructions in the ClaimMD quick start guide to create additional users, add providers, and any provider enrollment.
Healthie + ClaimMD Eligibility Checks
Today, Healthie's integration with ClaimMD runs real-time eligibility checks and returns results back into your Healthie account.
When viewing a Healthie patient chart, scroll down to Insurance Eligibility and click "Check Eligibility." In the beta release of this integration, the results return as seen below. In future iterations of the integration, the discrete data will populate into the correct fields.
Healthie + ClaimMD Claim Submissions
Today, Healthie's integration with ClaimMD's claim submission allows you to submit claims via Healthie to your ClaimMD dashboard.
Once you are ready to send a claim:
- From the Healthie CMS1500s page, select the claim(s) you want to submit
- Click Send to ClaimMD to push the claims to your ClaimMD dashboard
To learn more about managing claims once they are received in ClaimMD, read more here.
In the first version of this integration, "Send to ClaimMD" only sends the claims from Healthie to ClaimMD. In order to submit the claims to insurance, you will need to login to ClaimMD and submit them there.
The initial version of this integration does not return any information back to Healthie.
To fully transmit your claims to the payer for processing:
- When logged into ClaimMD > Select Manage Claims from the left sidebar.
- The CMS1500s that you sent from Healthie to ClaimMD will be in Pending Approval (shown above).
- In order to send these claims to insurance, you will need to click Approve Transmit.
