Switching Clearinghouses to Claim.MD

Our recommended clearinghouse is Claim.MD because it's fully integrated into your Healthie account - making it a seamless billing experience. The Healthie + Claim.MD integration makes it easy to run real-time eligibility checks, submit and track claims, receive ERAs, and invoice clients for unpaid portions directly in Healthie.

In this article, we share steps and guidance for transitioning to Claim.MD to ensure a smooth experience with no disruption to your cash flows.

Step 1 - Complete the Claim.MD Integration Request Form

Claim.MD is a clearinghouse that you can use for electronic claim submission in the USA. If you don’t have a Claim.MD account, Healthie will get you setup with one (please do not create an account directly via Claim.MD).

• Submit an Integration Request Form to get started.

Step 2 - Complete the enrollment process in Claim.MD

Healthie will send the user indicated in your integration request form an email with instructions on completing your Claim.MD account setup.

Once the admin has created their account, please follow the instructions in the Claim.MD quick start guide for Healthie customers to create additional users, add providers, and any provider enrollment.

1. Adding Users
2. Provider Enrollment
3. Manage Users (detailed)

Here are a few tips as you complete enrollment:

• Keep Office Ally (or your existing clearinghouse) open until you see claims and date moving over to Claim.MD (you’ll need at least 10 business days to transition over to Claim.MD fully). 
• Complete your enrollment based on how you are credentialed with the insurance company (As an “individual” or as a “group” enrollment)
• Create your tracking sheet using the Claim.MD payer list – this will help you stay on top of following up on enrollments 
• If you're not sure if Claim.MD will be the best fit for you, you can always start with one payer — there is no contract and no commitment.
• Some insurance companies require a few extra steps, so pay attention to the requirements at the bottom of each form. For example, Some providers will send you an approval or denial when your enrollment is accepted, and you are required to contact Claim.MD and let them know it was approved. Those instructions are listed at the bottom of each enrollment form.
• For more information on enrollment in Claim.MD, check out this Claim.MD help article. 
• A note for Claim Corrections / Resubmissions: Currently, ClaimMD automatically sets the Original Reference Number as long as the claim was initially submitted via ClaimMD. As you transition from Office Ally or another clearinghouse, you are going to need to manually set this in Claim.MD for re-submissions. 

Step 3 - Start billing through Healthie and Claim.MD 

Enjoy the benefits of a fully integrated solution with all your EOBs automated by Healthie so you do not have to leave the platform.

You'll find steps on how to send claims to Claim.MD from Healthie here.