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
​
x12
string
required

Response

ClaimStatusRawX12 200 response

​
controlNumber
string

The control number the payer provided in the claim status response. This is used to identify the transaction.

​
tradingPartnerServiceId
string

An ID for the payer you identified in the original claim status request. This value may differ from the tradingPartnerServiceId you submitted in the original request because it reflects the payer's internal concept of their ID, not necessarily the ID Stedi uses to route requests to this payer.

​
payer
object

Information about the payer listed in the referenced claim.

​
providers
object[]

Information about the billing and/or service providers related to the referenced claim.

​
subscriber
object

Information about the subscriber listed in the referenced claim.

​
dependent
object

Information about the dependent listed in the referenced claim.

​
claims
object[]

The status information for the claim referenced in the original claim status request.

The payer may return multiple claims in the response if they have more than one claim on file that matches the information you provided.

​
reassociationKey
string

The control number for the transaction.

​
errorResponse
object
​
status
string

The status of the entire claim.

​
transactionSetAcknowledgement
string

The acknowledgment code in the 999 Implementation Acknowledgment, an EDI file generated by the payer to acknowledge receipt of the claim status request. It indicates whether the claim status request was accepted or rejected due to errors in the EDI request syntax.

​
implementationTransactionSetSyntaxError
string

The syntax error code in the 999 Implementation Acknowledgment. It indicates the type of error (if present) in the EDI request syntax. Visit IK502 in the Implementation Acknowledgment specification for a complete list.

​
x12
string

The raw X12 response from the payer.

​
meta
object

Metadata about the response.