Credible API
Credible is an electronic health record (EHR) platform used by behavioral health providers to manage clients, appointments, treatment plans, documentation, authorizations, and billing to Medicaid and commercial payers. With an unofficial API, you could read and write client demogra
What is Credible?
Credible (by Qualifacts) is a behavioral health EHR used by community mental health centers, provider groups, and human services agencies. It supports intake and referrals, client demographics, treatment planning, clinical documentation, scheduling, authorization tracking, ePrescribing, outcomes, and comprehensive revenue cycle management spanning charge creation through claims submission and remittance reconciliation.
Core product areas include:
- Client intake and demographic management
- Scheduling and appointment management
- Clinical documentation (progress notes, encounters, treatment plans)
- Payer authorizations and service programs
- Charge capture and coding (CPT/HCPCS, modifiers, units, diagnosis)
- Claims generation and submission to Medicaid/MCOs and commercial payers
- Remittance (835) processing and reconciliation
- Reporting, audit trails, and compliance support
Common data entities:
- Clients (patients)
- Staff/Providers
- Appointments/Schedules
- Encounters/Progress Notes (time in/out, procedure codes, diagnoses, documentation)
- Authorizations (payer/program, service code, units, validity dates)
- Payers/Insurance policies
- Charges and claim line items (837P/I)
- Remittances (835) and adjustments/denials
The Credible Integration Challenge
Organizations rely on Credible daily, but turning portal-based clinical and billing workflows into automated pipelines is hard:
- Program- and payer-specific rules: Medicaid/MCOs and commercial payers use distinct service definitions, modifiers, units, and authorization logic
- Enterprise security: SSO/MFA and strict entitlements complicate headless automation and service account usage
- Portal-first delivery: Key documentation, authorization checks, and billing actions often live in web apps or batch exports rather than unified public APIs
- File interfaces and submission timing: SFTP/EDI feeds, batching constraints, and daily submission windows must be respected to avoid rejections
- Compliance nuances: Encounter edits require compliant reason codes and audit trails; documentation and retention rules vary by jurisdiction and program
How Supergood Creates Credible APIs
Supergood reverse-engineers authenticated browser flows, batch interfaces, and network interactions to deliver a resilient API endpoint layer.
- Handles username/password, SSO/OAuth, and MFA (SMS, email, TOTP) securely
- Maintains session continuity with automated refresh and change detection
- Normalizes client, authorization, encounter, and billing objects so you can integrate once across programs and payers
- Aligns with customer entitlements and licensing constraints to ensure compliant access
- Bridges batch exports and SFTP/EDI flows with signed URL retrieval and delivery where applicable
Getting Started
- Schedule Integration Assessment
Book a 30-minute session to confirm your Credible product mix, licensing, and authentication model.
- Supergood Builds and Validates Your API
We deliver a hardened Credible adapter tailored to your workflows and entitlements.
- Deploy with Monitoring
Go live with continuous monitoring and automatic adjustments as Credible evolves.
API Endpoints
Authentication
/sessionsEstablish a session using credentials. Supergood manages MFA (SMS, email, TOTP) and SSO/OAuth when enabled. Returns a short-lived auth token maintained by the platform.
Clients
/clientsRetrieve client demographics, insurance coverage, and identifiers. Use filters to scope by payer, date updated, or active status.
Authorizations
/authorizationsRetrieve payer/member service authorizations with allowed units, service codes, and date ranges. Use this to validate scheduling, documentation, and claim eligibility.
Encounters
/encountersCreate or update a clinical encounter/progress note with time in/out, coding, diagnoses, and authorization references. Supports compliant edit reason codes and audit fields.
Use Cases
EHR-to-RCM Synchronization
- Push client rosters from your intake or CRM into Credible - Create appointments automatically from your scheduling system - Keep demographics, insurance, and eligibility aligned across systems
Authorization-Aware Scheduling and Utilization
- Validate payer authorizations before appointment creation or encounter documentation - Track remaining units and prevent over-utilization - Surface program-specific rules to schedulers and care teams
Documentation-to-Charge Automation
- Map progress notes to CPT/HCPCS codes, units, and diagnosis codes - Apply compliant edit reason codes with audit trails for late entries or corrections - Route incomplete notes back for correction before charge creation
Claims and Reimbursement Automation
- Bundle validated encounters into 837P/I claims with payer-specific formatting - Submit via configured channels (state portals, MCO gateways, clearinghouses) - Track claim statuses and reconcile remittances alongside encounter evidence
Audit and Compliance
- Export complete encounter packets with timestamps, codes, signatures, and reason codes - Maintain machine-readable audit trails aligned to program requirements - Prove documentation integrity and claim provenance during reviews
Technical Specifications
Authentication
Username/password with MFA (SMS, email, TOTP) and SSO/OAuth where enabled; supports service accounts or customer-managed credentials
Response format
JSON with consistent resource schemas and pagination
Rate limits
Tuned for enterprise throughput while honoring licensing and usage controls
Session management
Automatic reauth and cookie/session rotation with health checks
Data freshness
Near real-time retrieval of clients, authorizations, encounters, and billing artifacts
Security
Encrypted transport, scoped tokens, and audit logging; respects Credible entitlements and compliance requirements
Webhooks
Optional asynchronous delivery for encounter creation, charge readiness, and remittance updates
Latency
Sub-second responses for list/detail queries under normal load
Throughput
Designed for high-volume documentation and batch claims pipelines
Reliability
Retry logic, backoff, and idempotency keys minimize duplicate actions
Adaptation
Continuous monitoring for UI/API changes with rapid adapter updates
Frequently asked questions
Supergood supports workflows across commonly used Credible modules subject to your licensing and entitlements. We scope coverage (e.g., client rosters, authorizations, encounters/notes, charge readiness, claim status, remittance retrieval) during integration assessment.
We support username/password + MFA (SMS, email, TOTP) and can operate behind SSO/OAuth when enabled. For batch flows, we manage SFTP/EDI timing windows, generate 837 files, and retrieve signed URLs or delivery confirmations programmatically.
Yes. You can check units remaining and service eligibility in real time before creating appointments or finalizing encounters, helping prevent denials and over-utilization.