Claim.MD
Runs real-time insurance eligibility checks, submits claims, and tracks reimbursements without leaving Healthie. Claim.MD powers the clearinghouse connection behind the scenes, and Healthie manages the vendor account so no separate sign-up is required.
Built by Core Engineering
The problem it solves
Insurance claim submission is time-consuming and error-prone without a direct clearinghouse connection. Practices manually managing eligibility checks and claim status waste hours chasing denials that could be caught upfront.
What's included
- Real-time insurance eligibility checks on the client profile
- Claim submission (single or batch) directly to the clearinghouse
- Real-time claim status, including rejection reasons and remark codes
- Automated ERA delivery and payment reconciliation
- Healthie-managed Claim.MD account — no separate vendor sign-up
How it works
Customer submits Healthie's Claim.MD Integration Request Form and selects a plan tier, or transfers an existing Claim.MD account to Healthie. Healthie provisions the account and invites the admin to finish setup. Once enabled, admins turn on eligibility checks in Insurance Settings, and providers can run real-time eligibility checks directly from a client's profile. CMS 1500 claims — created manually or via auto-generation — submit to Claim.MD the same way, with status and ERAs syncing back automatically under Billing > CMS 1500s.
Example configuration
Claim.MD is the clearinghouse behind Healthie's core insurance billing workflow, giving practices real-time eligibility checks, claim submission, and remittance tracking without leaving the platform. It's available on Plus plans and above, and Healthie owns and administers the underlying account so customers don't manage a separate login. Real-time eligibility results display directly on the client profile, and submitted claims sync status — including rejection reasons — back automatically. Because ERA routing is exclusive to one clearinghouse per NPI, enrolling with Claim.MD redirects all remittances there, even for claims submitted elsewhere.
