Managing insurance billing is one of the most time-consuming administrative tasks for healthcare providers. Whether you're a solo practitioner or part of a growing healthcare practice, handling eligibility checks, claim submissions, and tracking reimbursements can be complex and overwhelming. That’s why Healthie is excited to announce our direct integration with Claim.MD, a leading clearinghouse that streamlines insurance billing workflows.

With Healthie’s Claim.MD integration, you can now manage the entire insurance billing process from one platform—reducing administrative burdens and improving revenue cycle efficiency.

Why insurance integration matters

Using a clearinghouse like Claim.MD for insurance billing in private practice streamlines the claims submission process, reducing administrative burdens and improving reimbursement timelines. Clearinghouses act as intermediaries between providers and payers, ensuring claims are formatted correctly, catching errors before submission, and reducing the risk of denials. They also provide real-time claim tracking, electronic remittance advice, and faster payment processing, allowing private practice owners to focus more on patient care rather than paperwork. By automating and simplifying billing, a clearinghouse helps maximize revenue while minimizing time spent on claim resubmissions and follow-ups.

Integrating insurance billing into your Electronic Health Record (EHR) simplifies the claims management process, minimizes errors, and ensures real-time access to eligibility information. With insurance data consolidated within Healthie, providers can:

• Reduce manual data entry and claim errors
• Submit claims seamlessly to insurers
• Improve cash flow with faster reimbursements
• Enhance patient satisfaction with transparent billing

What Healthie's Claim.MD integration offers

The Healthie + Claim.MD integration is designed to make insurance billing more efficient and accurate. With this integration, Healthie members can:

• Run real-time eligibility checks directly within Healthie, ensuring accurate coverage information before providing services.
• Automated claims creation within Healthie, enable this billing setting to automatically create claims that can then be reviewed and sent to Claim.MD – saving hours of administrative work a week. 
• Batch Submit claims seamlessly to Claim.MD from within Healthie’s platform, eliminating the need for multiple logins and manual data transfers.
• Track claim status updates and receive remittance data directly in Healthie, reducing the time spent following up on payments.
• Enroll with payers in Claim.MD effortlessly, streamlining the credentialing and enrollment process.‍
• Automate ERA processing, allowing payments and adjustments to be recorded without manual input.

If you’re new to Healthie, the first step is to get started with a free trial – once you’ve completed your trial and selected a plan, we can enable the Claim.MD integration for your account. Please note, you’ll need to be on our Essentials Plan or above to support this integration. 

Healthie will handle the setup process for you—no need to create a separate Claim.MD account. After completing the Healthie + Claim.MD Integration Request form, Healthie will initiate your account creation, and your designated account admin will receive an invite to finalize the setup.

Plan options with Claim.MD

Healthie offers several plan options with Claim.MD, allowing providers to choose the best fit for their practice:

• Basic Plan: Pay-as-you-go, ideal for providers with a small number of claims.
• Small Volume Plan: Covers up to 100 claims per month, perfect for solo practices.‍
• Unlimited Plan: Best for high-volume practices, offering unlimited claims and ERAs.

Learn more about Claim.MD.

Integrating Claim.MD into your billing workflows 

Before you begin, ensure that you have enabled the Claim.MD integration to your Healthie account. This will allow you to submit and manage insurance claims directly from the platform.

Step 1: Collect client insurance information

Before you can bill insurance, you’ll need to make sure you have your client information ready. Make sure that your client information and documentation are correct in your client records. This will save tons of time in the future and prevent mistakes – collecting client information can be done securely and electronically during the onboarding process.  

Step 2: Manually or automatically create a claim in Healthie

Before you can bill your insurance providers with Claim.MD, you’ll need to create a claim within Healthie. This can be done either manually, or you can configure your account settings to automatically create claims on your behalf post-session.  

Learn how to enable automated claims processing. 

Step 3: Submit your claim(s) 

You can do this as individual claims or as a batch claim submission.

Step 4: Check your claim’s status

The status details for each claim will automatically update within Healthie as ERA (Electronic Remittance Advice) file data is received from Claim.MD. This information originates from Claim.MD and is pushed into Healthie. This prevents you from having to log into Claim.MD directly to reconcile claims status, saving time in your billing workflows.

You can review your claims statuses by going to Billing > CMS 1500. All insurance claims will be listed, and you may filter accordingly.

• Sent
• Not sent
• Rejected by clearinghouse
• Denied by insurance
• Client deductible applies
• Partially-Paid
• Fully-Paid 
• Closed

Statuses will automatically update within Healthie accordingly, eliminating the need to toggle between both platforms.

Viewing claim details and ERAs in Healthie with the Claim.MD integration

Electronic Remittance Advice (ERA) is a digital version of a paper Explanation of Benefits (EOB) that provides detailed information about claims submitted to insurance payers, including payment status, adjustments, and denials. When using a clearinghouse like Claim.MD, ERAs streamline the reimbursement process by automatically sending claim responses and payment details back into your EHR. This integration reduces manual data entry, speeds up payment reconciliation, and helps you track claim statuses in real time, ensuring accuracy and efficiency in your billing workflow.

Each claim can be opened up to view further details about it, including message history (where you can see why something may have been rejected by Claim.MD). This feature helps you track and manage your claims more efficiently.

A note for Office Ally users

When you enroll for ERA with Claim.MD, all electronic remittance for the selected NPI/Tax will be re-routed to Claim.MD regardless of where the claims are originally submitted from. Essentially, ERAs can only be returned to one clearinghouse. This should ensure all ERAs are still pulling back into Healthie, making for an easy transition for customers migrating from Office Ally to Claim.MD for insurance billing. 

A more efficient future for insurance billing

With Healthie’s direct integration with Claim.MD, providers can say goodbye to cumbersome billing processes and focus more on patient care. This integration simplifies insurance workflows, reduces errors, and enhances financial operations for healthcare practices.

Ready to streamline your insurance billing?  

Existing customers can request to enable the integration with our Integration Request Form.

If you’re new to Healthie, the first step is to get started with a free trial – once you’ve completed your trial and selected a plan, we can enable the Claim.MD integration for your account. Please note, you’ll need to be on our Essentials Plan or above to support this integration.

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