Automated CMS 1500 Claim Generation
Automatically generates CMS 1500 insurance claims overnight for every completed appointment. Review and submit to your clearinghouse or RCM partner the next morning — no manual claim creation required.
Built by Core Engineering
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.
What's included
- Nightly automated batch job (12AM UTC) scanning all Occurred appointments
- CPT-code-to-appointment-type linkage for auto-populated claim data
- Automatic exclusion of canceled, no-show, late-cancellation, and rescheduled appointments
- Auto-fill from a patient's prior claim on repeat billing
- Pre-submission review queue under Billing → CMS 1500s
How it works
Appointment completed
Insurance billing enabled
Generate claim
Example configuration
Automated CMS 1500 Claim Generation removes the manual step of building insurance claims one at a time after every appointment. It's built for billing teams and solo practitioners at insurance-based practices who bill frequently and need consistent, timely claim submission. Once enabled, Healthie runs a nightly batch job that generates a CMS 1500 for every appointment that qualifies, skipping cancellations and no-shows automatically. Claims appear the next morning for review before being submitted to a clearinghouse or RCM partner.
