Healthie

  • Publicado el Mar 3, 2025
  • 9 minuto(s) leído(s)
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Welcome to Claim.MD! 
Please carefully follow each of the steps below on this Quick Start Guide.
If you need assistance, please open a Support Ticket with our support team.

Getting Started - Creating an Account

Before you create an account, make sure you have the following on hand:

  • The business or account owner will need to create the account.
  • A valid form of U.S. identification, and a computer or phone with a camera.
  • A credit card, or valid EFT routing # and checking account information.
  • Up-to-date contact information in the NPPES database for any providers you'll be billing for. Make sure to let them know to expect a call from Claim.MD.


Each individual that has access to Claim.MD, or that may need to speak with our support team, will need their own login credentials. 

From the left hand menu, click Manage Users.

Note, you must have administrative privileges to access the Manage Users menu.

  1. First select a user type: 
    • Administrative users are able to control all access to the system, including adding/removing users and their privileges.
    • Standard Users can be limited to access specific areas of the system.
    • Eligibility Only users can only run benefits and eligibility and can be limited to a specific NPI.
    • Accounting/Invoices users can only see invoices from Claim MD as well as make payments or change the payment method for Claim.MD services.
  2. Next click .
  3. You’ll need to complete at minimum the contact name and email address for a new user.
  4. Review the access privileges available to them.
  5. Once you click   , we’ll send an email with a setup link to the email address given. The new user will need to follow that link to select a username and password.
HIPAA Compliance Warning
Please note that when entering user information it is required to provide the actual first and last name of the individual user rather than generic titles (e.g. Billing Staff, Accounting, etc.). To comply with HIPAA regulations, each user must be provided with unique login credentials for Claim.MD. The login information should be exclusive to Claim.MD and not used for other systems. It is important that users keep their credentials confidential. Sharing Claim.MD usernames and passwords is strictly prohibited under HIPAA standards to protect personal health information.  


Adding Users - More Information

For more detail on adding users, visit the Manage Users article. 

Step two - Provider Enrollment


Some payers will require enrollment before you can submit electronic claims. This segment will show you how to quickly complete these enrollment steps.


More Information
Please note, you must be Credentialedwith a payer before completing enrollments within Claim.MD. Contact the payer's “provider support department”  for guidance on steps to credential with them.

From the left hand menu, Click Provider Enrollment.

Pending Approval

When a provider record requires additional approval, a "Pending Approval" indicator will appear on the provider enrollment screen (see screenshots below). This indicates that a verification request has been initiated and an automated phone verification message will be sent to the contact information on file with NPPES. The designated contact must confirm or decline the request to proceed.

The approval request is sent to the provider’s registered contact in the NPPES database. It is important to ensure that this contact information is current and that someone is available to respond. If the approval is confirmed, the enrollment process will continue, and the necessary documents will be processed and submitted. Until the approval is received, the enrollment will remain in a pending state.

If the group is listed first and all NPIs share the same tax ID, the robocaller will contact the group's authorized official only once. If NPIs have different tax IDs, each will receive a separate call. To avoid multiple calls, it is highly recommended to list the group NPI first.

PLEASE NOTE
Users can still proceed with completing and submitting all enrollments even while the "Pending Approval" marker is on the account. However, the enrollment documents will not be submitted from our system until that approval is received.

Add Providers

  1. Each organization you bill for will need to be added to Claim.MD. If you do not see your organization’s information listed, click   .
  2. Enter your NPI and Tax ID.

A-typical provider (those not required to have an NPI), can leave the NPI blank.

  1. The provider information screen will be used to auto populate any upcoming enrollment paperwork. Once you’ve verified the information is accurate on this popup, save the provider record.

Enrollment for Claim Submission

Now lets review which payers require enrollment before submitting claims, and how to set up electronic payment notifications.

  1. Click on the provider name to review enrollments specific for this provider.
    Common payers for your provider's state will be shown by default, but you can use the search box to look up any specific payer you will be billing to.
  2. Review the claims column to determine if enrollment is required to submit to a given insurance.
    If submitting institutional or claims, change the drop down menu above.
    • No Enrollment Required means you can begin sending electronic claims to this payer immediately.
    • Not Available means the payer does not support this type of claim. 
    • If Enrollment Required is shown, then additional steps will need to be completed before you can send electronic claims to this payer.

      • When clicking the   button, you will either be prompted with instructions to complete enrollment steps through an external enrollment portal, or with the pre-populated paperwork that you need to complete.

      • When instructions are given, make sure you follow each step carefully. Once those steps are completed, click the button to finalize the enrollment request.

      • When paperwork is shown, carefully review the forms and pre-filled boxes. You may make adjustments to these forms before submitting. Some required fields may be highlighted for you to complete, for example a signature may be required.
        In most cases we are able to mail or fax these forms for you. If additional steps are required, these instructions may be shown after you submit the form.

Enrollment for ERA

Now that we’ve enrolled for claim submission, let’s set up Electronic Remittance Advice, or E.R.A. ERA is how the payer sends you an electronic summary of what was paid on the claims you’ve submitted. If your billing software supports automatic payment posting, you will need to setup ERA for each payer so it has the data necessary to complete this process.

  • On the provider enrollment page, the ERA column will give you instructions to activate ERA.
    • Quick Enroll - Means we are able to submit an online enrollment request with no additional paperwork or steps.
    • Auto-Enroll - Means the payer automatically returns their remittance summary to the send of the claim.
    • Like the claim enrollments, Enrollment Required for ERA will either have instructions for enrolling online with the payer, or pre-filled forms that need to be submitted.

ALERT

ERA can only be returned to one clearinghouse. When you enroll for ERA, all electronic remittance for the selected NPI/Tax ID will be re-routed to Claim.MD regardless of where the claims are originally submitted from.



Enrollment for Eligibility

Finally, we’ll want to activate eligibility for any payers we want to check benefits and eligibility for. Use the Eligibility column to turn this option on.

Step three - Submitting Claims

File transfer to a Practice Management System or other software can also be accomplished using the API. Users have the ability to generate their own API Account Key, which must be obtained, copied, and entered into the desired Practice Management System.

To generate this key:

Navigate to the Settings page. Click the Account Settings tab.

  1. Scroll down to the the API Key (Account Key) section, click the    button (see image below). 
  2.  Enter the same Claim.MD password used to login to the Claim.MD system. Click   button. 
  3. The API will display. If needed. copy the API Key using the clipboard icon to transfer it to the Practice Management System or other system.
    Ensuring proper handling and security of this password is crucial.

To Delete an API Key:

If the API Key is lost, the current one will have to be deleted and another one would have to be generated and entered into the PMS or other software system. 

  1. In Settings > Account Settings, scroll down to the API Key (Account Key) section and click the    button. 
  2.  Enter your Claim.MD account password and select the    button.
  3. The window should display Success-Removed API Key. Close this window. 
  4. Scroll back down to the API Key (Account Key) section and the    button is now available if a new API Key needs to be created (see steps above).

Healthie integrates with Claim.MD to help you submit claims, receive remittance advice (ERA), and check eligibility in real time. Below are the key steps and links to get started.

1. Submitting Claims

To send claims to Claim.MD:
✅ Batch your claims in Healthie
✅ Submit them directly through the integration

➡ Step-by-Step Guide to Sending Claims

2. Receiving ERAs (Electronic Remittance Advice)

Once your claims are processed, you can download ERA files in Healthie to review payment details.

➡ How to Access ERA & Payment Details

3. Viewing Real-Time Claim Status Updates

Easily track the status of submitted claims to see approvals, rejections, or pending claims.

➡ How to Check Claim Status in Healthie

4. Checking Real-Time Eligibility

Verify patient insurance eligibility instantly before submitting claims.

➡ How to Check Eligibility in Healthie

For additional support, visit Healthie’s Help Center or contact support.

Other Important Articles

Once the steps above have been completed, it is highly recommended to review the articles below to familiarize yourself with the functionalities and features of the rest of the Claim.MD software.

Articles for All Users

Provider Enrollment

Article to read: Provider Enrollment.

More detailed information on the provider enrollment process. 

Manage Claims

Article to Read: Manage Claims. 

Understand how to manage your claims that need your attention such as rejected claims (either from Claim.MD, third-party EDI, or payers), missing claim acknowledgements, missing ERA, and reminders. You can do this all on the Manage Claims page. 

Receive ERA

Article to Read: View ERA. 

If you are using Claim.MD for ERA, make sure your enrollment has been submitted with each payer. ERA enrollments generally process between 3 and 30 days. Contact the payer if you are not receiving your ERA by this time. The View ERA page is where you can view ERA transmissions from your payers.

Eligibility

Article to Read: Eligibility. 

Reporting

Article to Read: Reporting. 

Reporting allows you to view an overview of all past history. 

Search

Article to Read: Search. 

You may need to search for claims that have already been transmitted and are not on your Manage Claims page. You can do this in the Search page.  

View/Pay Invoices

Article to Read: View/Pay Invoices. 

This is where your organization will make payments and review service fees to Claim.MD.

Support Tickets

Article to Read: Support Tickets. 

You may need to contact support on an issue related to Claim.MD. There are convenient shortcuts to tickets from the claim form, and the View ERA page, and the Eligibility screen that will automatically attach your example to the ticket. You can also send a general or missing ERA ticket through the Support Tickets page.

Articles for Administrative Users

Article to Read: Manage Users. 

Articles to Read: