{ "info": { "name": "Claim.MD API", "description": "REST API for the Claim.MD medical-claims clearinghouse: claim submission (837P/837I), claim status, ERA/remits (835), eligibility (270/271), and reference endpoints. Authenticated with an AccountKey.", "schema": "https://schema.getpostman.com/json/collection/v2.1.0/collection.json" }, "variable": [ { "key": "baseUrl", "value": "https://svc.claim.md/services" }, { "key": "AccountKey", "value": "" } ], "item": [ { "name": "Claims", "item": [ { "name": "Upload a batch claim file", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/upload/", "host": ["{{baseUrl}}"], "path": ["upload", ""] }, "body": { "mode": "formdata", "formdata": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "File", "type": "file", "src": [] } ] }, "description": "Upload 1-2000 claims in 837P, 837I, CSV, JSON, XML, XLS, or XLSX format." } }, { "name": "List uploaded files", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/uploadlist/", "host": ["{{baseUrl}}"], "path": ["uploadlist", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "Page", "value": "", "type": "text", "disabled": true } ] }, "description": "List previously uploaded claim files with counts and amounts." } } ] }, { "name": "Claim Status", "item": [ { "name": "Retrieve claim status responses", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/response/", "host": ["{{baseUrl}}"], "path": ["response", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "ResponseID", "value": "0", "type": "text" } ] }, "description": "Incrementally retrieve claim status responses. Use ResponseID=0 initially." } }, { "name": "Retrieve claim modification events", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/modify/", "host": ["{{baseUrl}}"], "path": ["modify", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" } ] }, "description": "Incrementally retrieve claim field modification history." } }, { "name": "Retrieve claim notes", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/notes/", "host": ["{{baseUrl}}"], "path": ["notes", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" } ] }, "description": "Incrementally retrieve user notes attached to claims." } }, { "name": "Archive a claim", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/archive/", "host": ["{{baseUrl}}"], "path": ["archive", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "claimid", "value": "", "type": "text" } ] }, "description": "Archive or delete one or more claims by claim identifier." } } ] }, { "name": "ERA", "item": [ { "name": "List electronic remittance advice", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/eralist/", "host": ["{{baseUrl}}"], "path": ["eralist", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "NewOnly", "value": "1", "type": "text" } ] }, "description": "List ERA (835) with payment details and incremental retrieval via ERAID." } }, { "name": "Retrieve raw 835 ERA", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/era835/", "host": ["{{baseUrl}}"], "path": ["era835", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "eraid", "value": "", "type": "text" } ] }, "description": "Retrieve the raw X12 835 transaction for a single ERA." } }, { "name": "Retrieve structured ERA detail", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/eradata/", "host": ["{{baseUrl}}"], "path": ["eradata", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "eraid", "value": "", "type": "text" } ] }, "description": "Retrieve claim-level remittance detail as structured XML or JSON." } }, { "name": "Retrieve ERA as PDF", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/erapdf/", "host": ["{{baseUrl}}"], "path": ["erapdf", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "eraid", "value": "", "type": "text" } ] }, "description": "Retrieve a printable remittance report as a Base64-encoded PDF." } } ] }, { "name": "Eligibility", "item": [ { "name": "Submit eligibility request (270 file)", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/elig/", "host": ["{{baseUrl}}"], "path": ["elig", ""] }, "body": { "mode": "formdata", "formdata": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "File", "type": "file", "src": [] } ] }, "description": "Submit a real-time eligibility request as an X12 270 file (one per patient)." } }, { "name": "Submit eligibility request (field data)", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/eligdata/", "host": ["{{baseUrl}}"], "path": ["eligdata", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "ins_name_l", "value": "", "type": "text" }, { "key": "ins_name_f", "value": "", "type": "text" }, { "key": "payerid", "value": "", "type": "text" }, { "key": "pat_rel", "value": "18", "type": "text" }, { "key": "fdos", "value": "", "type": "text" }, { "key": "prov_npi", "value": "", "type": "text" }, { "key": "prov_taxid", "value": "", "type": "text" } ] }, "description": "Submit a real-time eligibility request using structured field data." } } ] }, { "name": "Reference", "item": [ { "name": "Retrieve the payer directory", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/payerlist/", "host": ["{{baseUrl}}"], "path": ["payerlist", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" } ] }, "description": "Look up payers and their supported service capabilities." } }, { "name": "Request provider enrollment", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/enroll/", "host": ["{{baseUrl}}"], "path": ["enroll", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "payerid", "value": "", "type": "text" }, { "key": "enroll_type", "value": "era", "type": "text" }, { "key": "prov_taxid", "value": "", "type": "text" } ] }, "description": "Initiate a provider enrollment request and receive an enrollment link." } }, { "name": "Request a claim appeal", "request": { "method": "POST", "header": [ { "key": "Accept", "value": "application/json" } ], "url": { "raw": "{{baseUrl}}/appeal/", "host": ["{{baseUrl}}"], "path": ["appeal", ""] }, "body": { "mode": "urlencoded", "urlencoded": [ { "key": "AccountKey", "value": "{{AccountKey}}", "type": "text" }, { "key": "claimid", "value": "", "type": "text" } ] }, "description": "Initiate a claim appeal and receive an appeal form link." } } ] } ] }