POST
/
change
/
medicalnetwork
/
institutionalclaims
/
v1
/
submission
cURL
curl --request POST \
  --url https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/institutionalclaims/v1/submission \
  --header 'Authorization: <api-key>' \
  --header 'Content-Type: application/json' \
  --data '{
  "usageIndicator": "T",
  "tradingPartnerName": "UnitedHealthcare",
  "tradingPartnerServiceId": "87726",
  "submitter": {
    "organizationName": "Test Facility",
    "contactInformation": {
      "name": "Test Facility",
      "phoneNumber": "2225551234"
    },
    "taxId": "123456789"
  },
  "receiver": {
    "organizationName": "UnitedHealthcare"
  },
  "subscriber": {
    "memberId": "98765",
    "paymentResponsibilityLevelCode": "P",
    "firstName": "JANE",
    "lastName": "DOE",
    "groupNumber": "67890"
  },
  "claimInformation": {
    "claimFilingCode": "ZZ",
    "patientControlNumber": "<YOUR-CLAIM-ID>",
    "claimChargeAmount": "500.00",
    "placeOfServiceCode": "11",
    "claimFrequencyCode": "0",
    "planParticipationCode": "C",
    "benefitsAssignmentCertificationIndicator": "Y",
    "releaseInformationCode": "Y",
    "principalDiagnosis": {
      "qualifierCode": "ABK",
      "principalDiagnosisCode": "R45851"
    },
    "serviceLines": [
      {
        "assignedNumber": "0",
        "serviceDate": "20241015",
        "serviceDateEnd": "20241015",
        "lineItemControlNumber": "111222333",
        "institutionalService": {
          "serviceLineRevenueCode": "90",
          "lineItemChargeAmount": "500.00",
          "measurementUnit": "UN",
          "serviceUnitCount": "1",
          "procedureIdentifier": "HC",
          "procedureCode": "H0001"
        }
      }
    ],
    "claimCodeInformation": {
      "admissionTypeCode": "3",
      "admissionSourceCode": "9",
      "patientStatusCode": "30"
    },
    "claimDateInformation": {
      "admissionDateAndHour": "202409091000",
      "statementBeginDate": "20241015",
      "statementEndDate": "20241015"
    }
  },
  "providers": [
    {
      "providerType": "BillingProvider",
      "npi": "1999999976",
      "employerId": "123456789",
      "organizationName": "Test Facility",
      "address": {
        "address1": "123 Mulberry Street",
        "city": "Seattle",
        "state": "WA",
        "postalCode": "111135272"
      },
      "contactInformation": {
        "name": "Test Facility",
        "phoneNumber": "2065551234"
      }
    },
    {
      "providerType": "AttendingProvider",
      "npi": "1999999976",
      "firstName": "Doctor",
      "lastName": "Provider",
      "contactInformation": {
        "name": "name"
      }
    }
  ]
}'
{
  "status": "SUCCESS",
  "controlNumber": "123456789",
  "tradingPartnerServiceId": "87726",
  "claimReference": {
    "correlationId": "01JABEX6DPF4FCT2J0Y0SGFCY8",
    "patientControlNumber": "00001111222233334444",
    "timeOfResponse": "2024-10-16T20:04:32.962Z",
    "formatVersion": "5010",
    "claimType": "INST",
    "rhClaimNumber": "01JABEX6DPF4FCT2J0Y0SGFCY8"
  },
  "httpStatusCode": "200 OK",
  "payer": {
    "payerName": "UnitedHealthcare",
    "payerID": "87726"
  },
  "meta": {
    "traceId": "a742ab42-a6f3-4232-a88c-197d341afdbe"
  }
}
This endpoint sends 837I institutional 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 institutional 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 Institutional Claims guide.

Body

application/json

Response

InstitutionalClaimsSubmission 200 response

The response is of type object.