Healthie Insurance Claims and Medicare or Medicaid

Healthie's CMS 1500 feature makes it easy for you to create CMS 1500 claims and submit them (electronically or physically) to an insurance company for reimbursement for services.

For providers in-network with Medicare or Medicaid, Healthie can be used to quickly create claims that can exported and submitted to CMS.

Medicare and Medicaid Basics

You must be credentialed with Medicare or Medicaid before they will accept claims from you. Credentialing is a separate process that does not happen through Healthie. If you are not credentialed directly with Medicare or Medicaid, they will not accept your claims created in Healthie.

Credentialing can be done through the CMS website if you are eligible, learn more here.

Creating Medicare or Medicaid Claims in Healthie

Claims creation can be done in Healthie for any insurance payer, including Medicare and Medicaid. We follow CMS guidelines, to make claim creation a breeze. You'll find an up-to-date library of CPT codes and ICD-10 codes.

You can walk through the basics of creating an insurance claim here.

If Medicare has 2 NPI numbers on file for you (a billing NPI and a provider NPI), be sure to use your billing NPI when filing CMS claim forms.

Creating and Submitting Claims to CMS

CMS-1500 claims can be created in Healthie either manually or automatically. Once generated, you can export claims for your own processing or send them directly to a clearinghouse or RCM partner integrated with Healthie.

Collecting and storing insurance information

Healthie automatically collects client insurance details, including secondary insurance information, through your intake process. All insurance data is securely stored in compliance with HIPAA regulations, ensuring your clients' sensitive information remains protected while staying easily accessible for claims processing and verification.

Getting Started: Insurance Billing (CMS1500s)

Filing a Secondary Insurance Claim

Integration Best Practices: Billing and RCM

Become a Medicare Provider (external link)