POST
/
dental-claims
/
submission
cURL
curl --request POST \
  --url https://healthcare.us.stedi.com/2024-04-01/dental-claims/submission \
  --header 'Authorization: <api-key>' \
  --header 'Content-Type: application/json' \
  --data '{
  "usageIndicator": "T",
  "tradingPartnerServiceId": "52133",
  "tradingPartnerName": "United HealthCare Dental",
  "subscriber": {
    "paymentResponsibilityLevelCode": "P",
    "memberId": "123412345",
    "firstName": "John",
    "lastName": "Doe",
    "groupNumber": "1234567890",
    "gender": "F",
    "address": {
      "address1": "1234 Some St",
      "city": "Buckeye",
      "state": "AZ",
      "postalCode": "85326"
    },
    "dateOfBirth": "20180615"
  },
  "submitter": {
    "organizationName": "ABA Inc",
    "submitterIdentification": "<YOUR-SUBMITTER-ID",
    "contactInformation": {
      "phoneNumber": "3131234567",
      "name": "BILLING DEPARTMENT"
    }
  },
  "rendering": {
    "npi": "1999999992",
    "taxonomyCode": "106S00000X",
    "providerType": "RenderingProvider",
    "lastName": "Doe",
    "firstName": "Jane"
  },
  "receiver": {
    "organizationName": "United HealthCare Dental"
  },
  "payerAddress": {
    "address1": "PO Box 7000",
    "city": "Camden",
    "state": "SC",
    "postalCode": "29000"
  },
  "claimInformation": {
    "signatureIndicator": "Y",
    "toothStatus": [
      {
        "toothNumber": "3",
        "toothStatusCode": "E"
      }
    ],
    "serviceLines": [
      {
        "serviceDate": "20230428",
        "renderingProvider": {
          "npi": "1999999992",
          "taxonomyCode": "122300000X",
          "lastName": "Doe",
          "firstName": "Jane"
        },
        "providerControlNumber": "a0UDo000000dd2dMAA",
        "dentalService": {
          "procedureCode": "D7140",
          "lineItemChargeAmount": "832.00",
          "placeOfServiceCode": "12",
          "oralCavityDesignation": [
            "1",
            "2"
          ],
          "prosthesisCrownOrInlayCode": "I",
          "procedureCount": 2,
          "compositeDiagnosisCodePointers": {
            "diagnosisCodePointers": [
              "1"
            ]
          }
        },
        "teethInformation": [
          {
            "toothCode": "3",
            "toothSurfaceCodes": [
              "M",
              "O"
            ]
          }
        ]
      }
    ],
    "serviceFacilityLocation": {
      "phoneNumber": "3131234567",
      "organizationName": "ABA Inc",
      "npi": "1999999992",
      "address": {
        "address1": "ABA Inc 123 Some St",
        "city": "Denver",
        "state": "CO",
        "postalCode": "802383100"
      }
    },
    "releaseInformationCode": "Y",
    "planParticipationCode": "A",
    "placeOfServiceCode": "12",
    "patientControlNumber": "<YOUR-CLAIM-ID>",
    "healthCareCodeInformation": [
      {
        "diagnosisTypeCode": "ABK",
        "diagnosisCode": "K081"
      }
    ],
    "claimSupplementalInformation": {
      "priorAuthorizationNumber": "20231010012345678"
    },
    "claimFrequencyCode": "1",
    "claimFilingCode": "FI",
    "claimChargeAmount": "832.00",
    "benefitsAssignmentCertificationIndicator": "Y"
  },
  "billing": {
    "taxonomyCode": "106S00000X",
    "providerType": "BillingProvider",
    "organizationName": "ABA Inc",
    "npi": "1999999992",
    "employerId": "123456789",
    "contactInformation": {
      "phoneNumber": "3134893157",
      "name": "ABA Inc"
    },
    "address": {
      "address1": "ABA Inc 123 Some St",
      "city": "Denver",
      "state": "CO",
      "postalCode": "802383000"
    }
  }
}'
{
  "status": "SUCCESS",
  "controlNumber": "1",
  "tradingPartnerServiceId": "52133",
  "claimReference": {
    "correlationId": "01JDQMX92Q1T561BH8NKX750TQ",
    "patientControlNumber": "0U1LBRS4",
    "timeOfResponse": "2024-11-27T20:27:27.077Z",
    "payerID": "52133",
    "formatVersion": "5010",
    "rhclaimNumber": "01JDQMX92Q1T561BH8NKX750TQ",
    "serviceLines": [
      {
        "lineItemControlNumber": "a0UDo000000dd2dMAA"
      }
    ]
  },
  "httpStatusCode": "200 OK",
  "meta": {
    "traceId": "9b491769-052e-4738-93d6-e0b5f6d83f53"
  },
  "payer": {
    "payerName": "United HealthCare Dental",
    "payerID": "52133"
  }
}
This endpoint sends 837D dental claims to payers.
  1. Call this endpoint with a JSON payload.
  2. Stedi translates your request to the X12 837 EDI format and sends it to the payer.
  3. The endpoint returns a response from Stedi in JSON format containing information about the claim you submitted and whether the submission was successful.
Visit Submit dental claims for a full how-to guide.

Authorizations

​
Authorization
string
header
required

A Stedi API Key for authentication.

Headers

​
Stedi-Transaction-Setting-Id
string

The outbound transaction setting ID. This option only needs to be specified if you're using a non-default release of the Dental Claims guide.

Body

application/json

Response

DentalClaimsSubmission 200 response

The response is of type object.