Candid Health
Connects Healthie's clinical documentation to claim creation and billing workflows in Candid Health's revenue cycle automation platform. Locking a chart note in Healthie automatically generates a claim in Candid and a matching CMS-1500 in Healthie, with claim status synced back as it moves through Candid's workflow. Client demographics, insurance information, and tags sync bidirectionally between the two systems.
Built by Partner
The problem it solves
Revenue cycle management for modern healthcare organizations involves complex claim workflows, payer negotiations, and denial management that overwhelm internal billing teams. Manual RCM processes delay reimbursement and increase write-off rates.
What's included
- Automated claim generation in Candid, triggered when a clinician locks a chart note in Healthie, with a matching CMS-1500 created in Healthie
- Support for individual and group appointments, generating a separate claim per client in a group visit
- Claim status visibility in Healthie's CMS-1500 view (submitted, rejected, denied, paid) as claims move through Candid
- Bidirectional sync of client demographics, insurance information, and client tags between Healthie and Candid
- Streamlined client payment workflows, including collecting copays upfront and invoicing remaining balances
How it works
An organization enables and configures the integration directly inside Healthie; no engineering support is required for the out-of-the-box setup. Before going live, a Healthie admin reviews the account's insurance payer list to ensure every payer is selected from Healthie's standard dropdown rather than entered as free text, since custom payer names cause mapping errors in Candid, and shares that payer list with their Candid onboarding representative for review. Once configured, locking a chart note for a completed appointment automatically generates a claim in Candid and a corresponding CMS-1500 in Healthie; individual and group appointments are both supported, with a separate claim generated per client in a group visit. As the claim moves through Candid's workflow, status updates (submitted, rejected, denied, paid) sync back to Healthie's CMS-1500 view, though Candid remains the source of truth and all claim work should happen there. Client demographics, insurance information, and tags sync bidirectionally between the two systems once enabled. Candid released an updated (v2) version of this integration; customers on the legacy v1 integration can continue using it or transition to v2.
Candid Health is a revenue cycle automation platform that connects Healthie's clinical documentation directly to claim creation and billing in Candid, reducing manual work between clinical and financial teams. It's built for organizations already using or contracting separately with Candid Health, and the integration is enabled and configured entirely inside Healthie without engineering support. Once configured, locking a chart note automatically generates a claim in Candid and a corresponding CMS-1500 in Healthie, and claim status updates flow back into Healthie's CMS-1500 view as the claim moves through Candid's workflow. Candid, not Healthie, is the source of truth for claim status and where all claim work should ultimately happen.