# Candid Setup and Configuration

Welkin Health integrates with Candid Health to streamline medical billing and claims submission. The integration allows clinical data captured in Welkin to flow automatically into Candid for eligibility verification, claim generation, and revenue cycle management.

## What is Candid Health?

Candid Health is a medical billing and RCM (revenue cycle management) platform that automates insurance claim submission, eligibility checks, and payment reconciliation. The Welkin-Candid integration connects clinical documentation in Welkin directly to the billing workflow in Candid.

## What the integration enables

* **Automatic claim creation** – encounter data from Welkin is sent to Candid to generate insurance claims
* **Eligibility verification** – verify patient insurance coverage before or at the time of service
* **Claims tracking** – monitor claim status (submitted, accepted, denied, paid) from within Welkin
* **ERA/EOB processing** – electronic remittance advice and explanations of benefits are processed automatically
* **Denial management** – receive denial reasons in Welkin for faster follow-up

## Prerequisites

* An active Candid Health account
* Welkin Admin access
* Clinical data fields (diagnoses, CPT codes, provider NPI, facility info) configured in Welkin CDTs
* Review the [Candid Integration Required Fields](/integrations/billing-candid/candid-integration-required-fields.md) to ensure all necessary data is captured

## Setting up the Candid integration

### Step 1: Obtain Candid API credentials

Contact your Candid Health account manager to obtain:

* **Client ID**
* **Client Secret**
* **API environment** (sandbox or production)

### Step 2: Configure in Welkin Admin

1. Log in to the Welkin Admin portal
2. Navigate to **Integrations → Candid Health**
3. Enter your **Client ID** and **Client Secret**
4. Select the **Environment** (Sandbox for testing, Production for live use)
5. Click **Save and Test Connection**
6. Confirm the status shows **Connected**

### Step 3: Map Welkin fields to Candid fields

Clinical data must be mapped from Welkin CDTs to the corresponding Candid claim fields:

1. In the Candid integration settings, click **Field Mapping**
2. Map required fields (see [Candid Integration Required Fields](/integrations/billing-candid/candid-integration-required-fields.md) for the complete list)
3. Map provider information: rendering provider NPI, billing provider NPI, tax ID
4. Map diagnosis codes (ICD-10) and procedure codes (CPT) from the appropriate Welkin CDT fields
5. Save all mappings

### Step 4: Configure claim submission triggers

Decide when claims are sent to Candid:

* **Manual trigger** – a care team member or biller manually clicks "Submit Claim" after reviewing the encounter
* **Automatic trigger** – claims are submitted automatically when an encounter reaches a specific status (e.g., "Completed" or "Signed")

Configure the trigger in **Integrations → Candid → Submission Settings**.

## Testing the integration

1. Create a test encounter in a Welkin staging environment with all required fields populated
2. Trigger a test claim submission
3. Verify the claim appears in the Candid sandbox with correct data
4. Confirm eligibility verification returns a valid response for a test patient
5. Review the field mapping if any required fields are missing in the Candid claim

## Monitoring and troubleshooting

The Candid integration dashboard in Welkin Admin shows recent claim submissions and their statuses. If claims are being rejected, review the error codes against the [Candid Integration Required Fields](/integrations/billing-candid/candid-integration-required-fields.md) to identify missing or incorrectly mapped data.


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