Candid Health Integration

Planning this integration?

The RCM & Billing Decision Guide walks through requirements questions and FHIR modeling decisions for billing — charge capture, eligibility, claims, and remittance — use it alongside these docs.

Candid Health is a revenue cycle automation provider. This integration enables professional medical claim submission directly from FHIR resources.

Claim Submission

Submit professional medical claims to Candid Health from a FHIR Claim resource. The integration handles mapping patient demographics, provider information, diagnoses, and service lines into Candid's API format.

Eligibility Check

Run real-time, pre-encounter insurance eligibility checks via Candid's pre-encounter API. Returns a FHIR CoverageEligibilityResponse with benefit details mapped from the payer's 271 response.