Automated CMS 1500 Claim Generation
Automatically generates CMS 1500 insurance claims overnight for every completed appointment — no manual claim creation required. Review and submit to Claim.MD, Office Ally, or your RCM partner the next morning.
The problem it solves
Billing teams at high-volume practices manually create CMS 1500 claims after each appointment — a repetitive, error-prone process that creates overnight backlogs. Claims built by hand are inconsistent across billers and delay submission to clearinghouses.
How it works
Enable the "Automatically Create CMS 1500s" setting under Settings → Insurance Settings → Automated Insurance Billing. CPT codes are linked to appointment types in advance. Each night at 12AM UTC, a batch job runs and generates a CMS 1500 for any appointment that: (1) has insurance billing enabled for its appointment type, (2) has automated billing selected, and (3) has a status of "Occurred" by end of day. Canceled, no-show, late cancellation, and rescheduled appointments are excluded. Claims are reviewable the next morning under Billing → CMS 1500s. On subsequent claims for the same patient, Healthie auto-fills from the prior claim for consistency.
Building on Healthie?
Talk to our team about API access, white-label, and enterprise architecture — or dive into the docs.