POST
/
change
/
medicalnetwork
/
claimstatus
/
v2
/
raw-x12
cURL
curl --request POST \
  --url https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/claimstatus/v2/raw-x12 \
  --header 'Authorization: <api-key>' \
  --header 'Content-Type: application/json' \
  --data '{
  "x12": "ISA*00*          *00*          *ZZ*SENDER         *ZZ*RECEIVER       *240710*2300*^*00501*000000001*0*T*>~GS*HR*SENDERGS*RECEIVERGS*20240710*230011*000000001*X*005010X212~ST*276*0001*005010X212~BHT*0010*13*ABC276XXX*20050915*1425~HL*1**20*1~NM1*PR*2*UNITEDHEALTHCARE*****PI*3429~HL*2*1*21*1~NM1*41*2*XYZ SERVICE*****46*X67E~HL*3*2*19*1~NM1*1P*2*BEHAVIORAL SERVICES P.C.*****XX*123456789~HL*4*3*22*0~DMG*D8*19301210*M~NM1*IL*1*JANE*DOE****MI*111222333~TRN*1*222222222~REF*BLT*111~REF*EJ*SM123456~AMT*T3*238.44~DTP*472*RD8*20050831-20050906~HL*5*2*19*1~NM1*1P*2*BEHAVIORAL SERVICES P.C.*****XX*1999999984~HL*6*5*22*1~NM1*IL*1*DOE*JANE****MI*345678901~HL*7*6*23~DMG*D8*19951101*M~NM1*QC*1*DOE*JOHN~TRN*1*222222222~REF*EJ*MA345678~SVC*HC>99203*238.44*****1~DTP*472*D8*20050501~SE*28*0001~GE*1*000000001~IEA*1*000000001~"
}'
{
  "claims": [
    {
      "claimStatus": {
        "amountPaid": "95.55",
        "claimServiceDate": "20240325",
        "effectiveDate": "20240329",
        "paidDate": "20240329",
        "patientAccountNumber": "3333333",
        "statusCategoryCode": "P5",
        "statusCategoryCodeValue": "Pending/Payer Administrative/System hold",
        "statusCode": "3",
        "statusCodeValue": "Claim has been adjudicated and is awaiting payment cycle.",
        "submittedAmount": "238.44",
        "trackingNumber": "222222222",
        "tradingPartnerClaimNumber": "5332034153-KK"
      },
      "serviceDetails": [
        {
          "service": {
            "amountPaid": "95.55",
            "procedureId": "90837",
            "serviceIdQualifier": "Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes",
            "serviceIdQualifierCode": "HC",
            "submittedAmount": "238.44",
            "submittedUnits": "1"
          },
          "status": [
            {
              "effectiveDate": "20240329",
              "statusCategoryCode": "P5",
              "statusCategoryCodeValue": "Pending/Payer Administrative/System hold",
              "statusCode": "3",
              "statusCodeValue": "Claim has been adjudicated and is awaiting payment cycle."
            }
          ]
        }
      ]
    }
  ],
  "controlNumber": "222222222",
  "meta": {
    "applicationMode": "production",
    "traceId": "bf27223e-46c3-451e-b2b4-46f3f0b6fe3b"
  },
  "payer": {
    "organizationName": "UNITEDHEALTHCARE",
    "payerIdentification": "3429"
  },
  "providers": [
    {
      "organizationName": "Behavioral Services P.C.",
      "providerType": "BillingProvider",
      "taxId": "123456789"
    },
    {
      "npi": "1999999984",
      "organizationName": "Behavioral Services P.C.",
      "providerType": "ServiceProvider"
    }
  ],
  "reassociationKey": "000000001",
  "status": "success",
  "subscriber": {
    "firstName": "JANE",
    "lastName": "DOE",
    "memberId": "111222333"
  },
  "tradingPartnerServiceId": "3429"
}
You may need to submit a 276 real-time claim status request when you don’t receive a 277CA or 835 ERA response from the payer within your expected timeframe. This endpoint is ideal if you have an existing system that generates X12 EDI files and you want to send them through Stedi.
  1. Call this endpoint with a payload in 276 X12 EDI format.
  2. Stedi validates the EDI and sends the transaction to the payer.
  3. The endpoint returns a synchronous 277 claim status response from the payer in JSON format. The response contains information about the claims matching the criteria you provided in the request and their current status.
The response may contain information about more than one claim, if the payer has multiple claims on file that match the information you provided.
Visit Check claim status for a complete how-to guide.

Authorizations

​
Authorization
string
header
required

A Stedi API Key for authentication.

Body

application/json

Response

ClaimStatusRawX12 200 response

The response is of type object.