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We do the grunt work for you. As our data on how and where to send claims grows, Candid Health reverse-engineers payer-specific rules. Get paid faster with less manual intervention.
The Candid Health platform ships with built-in payer routing rules to handle carve outs and other payer-specific routing requirements, and we're constantly reverse-engineering new payer routing rules so that you don't have to.
The Candid Health platform monitors claims 24/7 by validating all of your billing data—from credentialing to provider information. With our rules engine, the data you send now is valid and up-to-date—at all times.
Our rules engine can distinguish and automatically fix claims when payer requirements and IDs differ in contracts and credentialing data.
Impose custom business logic, add unique credentialing rules, enforce your own workflows, and more—all directly in the Candid Health configurable rules engine. Manage your claims at scale with control and precision.
Enforce your own medical coding policies directly in Candid Health. Trigger auto-hold on claims if CPT codes do not meet certain criteria.
