openapi: 3.0.3 info: contact: email: healthcare@stedi.com license: name: Proprietary url: https://stedi.com title: Stedi Healthcare Claims Claim acknowledgments API version: '2025-03-07' servers: - description: Production url: https://claims.us.stedi.com/2025-03-07 security: - httpApiKeyAuth: [] tags: - name: Claim acknowledgments paths: /change/medicalnetwork/reports/v2/{transactionId}/277: get: description: Retrieve a 277CA claim acknowledgment in JSON format operationId: ConvertReport277 parameters: - description: A unique identifier for the processed 277 transaction within Stedi. This ID is included in the transaction processed event, which you can receive automatically through Stedi [webhooks](https://www.stedi.com/docs/healthcare/configure-webhooks). You can also retrieve it through the [Poll Transactions endpoint](https://www.stedi.com/docs/healthcare/api-reference/get-poll-transactions) or from the transaction's details page within the Stedi portal. examples: ConvertReport277_example1: description: '' summary: Accepted claim value: d567c2ae-f073-4725-8b8c-06c473b738a6 ConvertReport277_example2: description: '' summary: Denied claim value: 71716ec5-0e96-462f-bb77-869941bb27ab in: path name: transactionId required: true schema: description: A unique identifier for the processed 277 transaction within Stedi. This ID is included in the transaction processed event, which you can receive automatically through Stedi [webhooks](https://www.stedi.com/docs/healthcare/configure-webhooks). You can also retrieve it through the [Poll Transactions endpoint](https://www.stedi.com/docs/healthcare/api-reference/get-poll-transactions) or from the transaction's details page within the Stedi portal. maxLength: 36 minLength: 36 pattern: ^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$ type: string responses: '200': content: application/json: examples: ConvertReport277_example1: description: '' summary: Accepted claim value: meta: transactionId: 71716ec5-0e96-462f-bb77-869941bb27ab transactions: - controlNumber: '1001' payers: - claimStatusTransactions: - claimStatusDetails: - patientClaimStatusDetails: - claims: - claimStatus: claimServiceBeginDate: '20240101' claimServiceEndDate: '20240101' clearinghouseTraceNumber: 01J1SNT1FQC8ABWD44MAMBDYKA informationClaimStatuses: - informationStatuses: - healthCareClaimStatusCategoryCode: A1 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Receipt - The claim/encounter has been received. This does not mean that the claim has been accepted for adjudication. statusCode: '20' statusCodeValue: Accepted for processing. statusInformationEffectiveDate: '20240702' totalClaimChargeAmount: '109.20' patientAccountNumber: '11122233' referencedTransactionTraceNumber: '11122233' subscriber: firstName: JOHN lastName: ANON memberId: U7777788888 providerOFServiceInformationTraceIdentifier: '0' serviceProvider: npi: '1235600834' organizationName: THERAPY ASSOCIATES claimTransactionBatchNumber: 01J1SNRJ0FP4ZE6EFWM4G4XB3N provider: etin: '1235600834' organizationName: TEST DATA HEALTH SERVICES, INC. providerClaimStatuses: - providerStatuses: - healthCareClaimStatusCategoryCode: A1 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Receipt - The claim/encounter has been received. This does not mean that the claim has been accepted for adjudication. statusCode: '20' statusCodeValue: Accepted for processing. statusInformationEffectiveDate: '20240702' organizationName: STEDI INC referenceIdentification: '1511096803' transactionSetCreationDate: '20240702' transactionSetCreationTime: 0815 ConvertReport277_example2: description: '' summary: Denied claim value: meta: transactionId: 71716ec5-0e96-462f-bb77-869941bb27ab transactions: - controlNumber: '1001' payers: - claimStatusTransactions: - claimStatusDetails: - patientClaimStatusDetails: - claims: - claimStatus: claimServiceBeginDate: '20250101' claimServiceEndDate: '20250109' clearinghouseTraceNumber: NA informationClaimStatuses: - informationStatuses: - healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '21' statusCodeValue: Missing or invalid information. statusInformationEffectiveDate: '20250201' totalClaimChargeAmount: '3459.3' patientAccountNumber: AAA11111 referencedTransactionTraceNumber: AAA11111 serviceLines: - beginServiceLineDate: '20250101' lineItemControlNumber: ABCD1234 service: chargeAmount: '379.39' procedureCode: '97153' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '11' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250101' lineItemControlNumber: DCBA4321 service: chargeAmount: '206.94' procedureCode: '97155' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '6' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250101' lineItemControlNumber: WXYZ1234 service: chargeAmount: '413.92' procedureCode: '97154' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '16' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250101' lineItemControlNumber: ZYXW4321 service: chargeAmount: '138.72' procedureCode: '97156' procedureModifiers: - GT - '59' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '4' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250101' lineItemControlNumber: EFGH5678 service: chargeAmount: '413.92' procedureCode: '97154' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '16' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250102' lineItemControlNumber: HGFE8765 service: chargeAmount: '413.92' procedureCode: '97154' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '16' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250105' lineItemControlNumber: IJKL1234 service: chargeAmount: '137.96' procedureCode: '97155' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '4' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250105' lineItemControlNumber: LKJI4321 service: chargeAmount: '388.05' procedureCode: '97154' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '15' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250107' lineItemControlNumber: MNOP5678 service: chargeAmount: '138.72' procedureCode: '97156' procedureModifiers: - GT - '59' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '4' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250107' lineItemControlNumber: PONM8765 service: chargeAmount: '413.88' procedureCode: '97153' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '12' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. - beginServiceLineDate: '20250109' lineItemControlNumber: QRST6789 service: chargeAmount: '413.88' procedureCode: '97153' serviceIdQualifierCode: HC serviceIdQualifierCodeValue: Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes submittedUnits: '12' serviceClaimStatuses: - serviceStatuses: - entityIdentifierCode: IL entityIdentifierCodeValue: Insured or Subscriber healthCareClaimStatusCategoryCode: A3 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Returned as unprocessable claim - The claim/encounter has been rejected and has not been entered into the adjudication system. statusCode: '164' statusCodeValue: Entity's contract/member number. subscriber: firstName: JOHN lastName: DOE memberId: XYZ1234567 providerOFServiceInformationTraceIdentifier: '0' serviceProvider: npi: '1234567890' organizationName: Provider Organization Name claimTransactionBatchNumber: 387DKEO986DMGN98733S provider: etin: '1234567890' organizationName: Provider Organization Name providerClaimStatuses: - providerStatuses: - healthCareClaimStatusCategoryCode: A1 healthCareClaimStatusCategoryCodeValue: Acknowledgement/Receipt - The claim/encounter has been received. This does not mean that the claim has been accepted for adjudication. statusCode: '20' statusCodeValue: Accepted for processing. statusInformationEffectiveDate: '20250201' organizationName: AZ BLUE payerIdentification: BCBSAZ referenceIdentification: '94846578362' transactionSetCreationDate: '20250201' transactionSetCreationTime: '1439' schema: $ref: '#/components/schemas/ConvertReport277ResponseContent' description: ConvertReport277 200 response '400': content: application/json: schema: $ref: '#/components/schemas/ValidationExceptionResponseContent' description: ValidationException 400 response '403': content: application/json: schema: $ref: '#/components/schemas/AccessDeniedExceptionResponseContent' description: AccessDeniedException 403 response '404': content: application/json: schema: $ref: '#/components/schemas/ResourceNotFoundExceptionResponseContent' description: ResourceNotFoundException 404 response '429': content: application/json: schema: $ref: '#/components/schemas/ThrottlingExceptionResponseContent' description: ThrottlingException 429 response '500': content: application/json: schema: $ref: '#/components/schemas/InternalFailureExceptionResponseContent' description: InternalFailureException 500 response '503': content: application/json: schema: $ref: '#/components/schemas/ServiceUnavailableExceptionResponseContent' description: ServiceUnavailableException 503 response '504': content: application/json: schema: $ref: '#/components/schemas/GatewayTimeoutExceptionResponseContent' description: GatewayTimeoutException 504 response tags: - Claim acknowledgments components: schemas: ReportsClaimAcknowledgmentResponse: properties: controlNumber: description: The control number the payer provided in the claim status response. This is used to identify the transaction. type: string payers: description: Information about the payer (or intermediary clearinghouse) and the claim status transactions included in the response. items: $ref: '#/components/schemas/ClaimAcknowledgmentPayer' type: array referenceIdentification: description: A number the payer assigns to the transaction to identify it within their system. type: string transactionSetCreationDate: description: The date the payer created the transaction. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string transactionSetCreationTime: description: 'The time the payer created the transaction, expressed in 24-hour clock time. May be formatted as HHMM, HHMMSS, HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99).' pattern: ^([01]\d|2[0-3])[0-5]\d$|^([01]\d|2[0-3])[0-5]\d[0-5]\d$|^([01]\d|2[0-3])[0-5]\d[0-5]\d\d$|^([01]\d|2[0-3])[0-5]\d[0-5]\d\d\d$ type: string type: object ClaimAcknowledgmentServiceLines: properties: beginServiceLineDate: description: The starting date of the service. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string endServiceLineDate: description: The ending date of the service. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string lineItemControlNumber: description: A unique identifier for the service line that matches the `providerControlNumber` submitted in the original claim. You can use this value to correlate the payer's response with specific service lines from the original claim. type: string service: $ref: '#/components/schemas/ClaimAcknowledgmentServiceLinesService' serviceClaimStatuses: description: The status of the specific service line. items: $ref: '#/components/schemas/ServiceClaimStatus' type: array serviceLineDate: description: The date of the service. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string type: object ReportsClaims: properties: claimStatus: $ref: '#/components/schemas/ClaimsClaimStatus' description: Status information for the claim. This object includes the `referencedTransactionTraceNumber` you can use to correlate the 277CA with the original claim. serviceLines: description: Information about specific services within a claim. This object is only included in the 277CA when the claim is rejected because of errors with the service line information provided. items: $ref: '#/components/schemas/ClaimAcknowledgmentServiceLines' type: array type: object Meta: description: Metadata that helps Stedi track and debug the response. properties: applicationMode: description: Whether this is a test or production ERA. type: string senderId: description: An identifier for the most recent sender of the ERA. This is usually not the original sender, so this value is unlikely to be a payer ID. When Stedi processes and delivers ERAs through the clearinghouse, this value is always `STEDI`. type: string traceId: description: Not currently used. type: string transactionId: description: The Stedi transaction identifier. maxLength: 36 minLength: 36 pattern: ^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$ type: string type: object HealthCareClaimStatusCategoryCode: description: Code indicating the status category of the `statusCode` property. Visit [277CA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-status-category-code) for a complete list. enum: - A0 - A1 - A2 - A3 - A4 - A5 - A6 - A7 - A8 - DR01 - DR02 - DR03 - DR04 - DR05 - DR06 - DR07 - DR08 - P0 - P1 - P2 - P3 - P4 - P5 - F0 - F1 - F2 - F3 - F3F - F3N - F4 - R0 - R1 - R3 - R4 - R5 - R6 - R7 - R8 - R9 - R10 - R11 - R12 - R13 - R14 - R15 - R16 - R17 - E0 - E1 - E2 - E3 - E4 - D0 type: string ProviderStatus: properties: entityIdentifierCode: $ref: '#/components/schemas/ProviderEntityIdentifierCode' description: Code indicating the entity that the status is related to. entityIdentifierCodeValue: $ref: '#/components/schemas/ProviderEntityIdentifierCodeValue' description: The description of the `entityIdentifierCode`. healthCareClaimStatusCategoryCode: $ref: '#/components/schemas/HealthCareClaimStatusCategoryCode' healthCareClaimStatusCategoryCodeValue: description: Description of the `healthCareClaimStatusCategoryCode` property. Visit [277CA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-status-category-code) for a complete list. type: string statusCode: $ref: '#/components/schemas/HealthCareClaimStatusCode' description: Code indicating the status. statusCodeValue: description: The description of the `statusCode`. type: string type: object ProviderClaimStatus: properties: providerStatuses: description: The status of the entire claim. items: $ref: '#/components/schemas/ProviderStatus' type: array statusInformationEffectiveDate: description: The date the claim status information is effective. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string type: object PatientClaimStatusDetailsDependent: description: Information about a dependent who received services related to the claim. properties: firstName: deprecated: true description: The first name of the dependent. Can be up to 35 characters. type: string lastName: deprecated: true description: The last name of the dependent. Can be up to 60 characters. type: string middleName: deprecated: true description: The middle name or initial of the dependent. Can be up to 25 characters. type: string suffix: deprecated: true description: The suffix of the dependent, such as Jr or III. Can be up to 10 characters. type: string type: object ServiceEntityIdentifierCodeValue: description: Human-readable descriptions for service entity identifier codes enum: - Dependent - Employer - Receiver - Submitter - Attending Physician - Operating Physician - Other Physician - Service Location - Rendering Provider - Billing Provider - Pay-to Provider - Provider - Home Health Care - Ordering Physician - Referring Provider - Supervising Physician - Facility - Other Insured - Subscriber - Insured or Subscriber - Independent Lab - Mammography Screening Center - Payer - Primary Payer - Purchase Service Provider - Patient - Responsible Party - Secondary Payer - Testing Laboratory - Tertiary Payer - Third Party Repricing Organization (TPO) type: string ServiceProviderClaimStatus: properties: serviceProviderStatuses: description: The status of claims related to this provider. items: $ref: '#/components/schemas/ProviderStatus' type: array statusInformationEffectiveDate: deprecated: true description: The date the status information is effective. type: string type: object ServiceUnavailableExceptionResponseContent: description: The server is temporarily unavailable. properties: code: description: Classification of the exception type. type: string message: description: Human readable exception message. type: string required: - message type: object ClaimAcknowledgmentServiceIdQualifierCode: description: Code identifying the source of the procedure code in claim status reports. enum: - AD - ER - HC - HP - IV - NU - WK type: string HealthCareClaimStatusCode: enum: - '0' - '1' - '2' - '3' - '6' - '12' - '15' - '16' - '17' - '18' - '19' - '20' - '21' - '23' - '24' - '25' - '26' - '27' - '29' - '30' - '31' - '32' - '33' - '34' - '35' - '37' - '38' - '39' - '40' - '41' - '42' - '44' - '45' - '46' - '47' - '49' - '50' - '51' - '52' - '53' - '54' - '55' - '56' - '57' - '59' - '60' - '61' - '64' - '65' - '66' - '72' - '73' - '78' - '81' - '83' - '84' - '85' - '86' - '88' - '89' - '90' - '91' - '92' - '93' - '94' - '95' - '96' - '97' - '98' - '99' - '100' - '101' - '102' - '103' - '104' - '105' - '106' - '107' - '109' - '110' - '111' - '114' - '116' - '117' - '121' - '123' - '124' - '125' - '126' - '127' - '128' - '129' - '130' - '131' - '132' - '133' - '134' - '135' - '136' - '137' - '138' - '139' - '140' - '141' - '142' - '143' - '144' - '145' - '146' - '147' - '148' - '149' - '150' - '152' - '153' - '154' - '155' - '156' - '157' - '158' - '159' - '160' - '161' - '162' - '163' - '164' - '165' - '166' - '167' - '168' - '170' - '171' - '172' - '173' - '174' - '175' - '176' - '177' - '178' - '179' - '180' - '181' - '182' - '183' - '184' - '185' - '186' - '187' - '188' - '189' - '190' - '191' - '192' - '193' - '194' - '195' - '196' - '197' - '198' - '199' - '200' - '201' - '202' - '203' - '204' - '205' - '206' - '207' - '208' - '209' - '210' - '211' - '212' - '213' - '214' - '215' - '216' - '217' - '218' - '219' - '222' - '223' - '224' - '225' - '226' - '227' - '228' - '229' - '230' - '231' - '232' - '233' - '234' - '235' - '236' - '237' - '238' - '239' - '240' - '241' - '242' - '243' - '244' - '245' - '246' - '247' - '249' - '250' - '251' - '252' - '254' - '255' - '256' - '257' - '258' - '259' - '260' - '261' - '262' - '263' - '264' - '265' - '266' - '267' - '268' - '269' - '270' - '271' - '272' - '273' - '274' - '275' - '276' - '277' - '279' - '281' - '282' - '283' - '284' - '286' - '287' - '288' - '290' - '291' - '292' - '293' - '294' - '295' - '296' - '297' - '298' - '299' - '300' - '301' - '305' - '306' - '307' - '308' - '310' - '311' - '312' - '313' - '314' - '315' - '316' - '318' - '319' - '320' - '322' - '323' - '324' - '325' - '326' - '327' - '329' - '330' - '331' - '333' - '334' - '335' - '336' - '337' - '339' - '340' - '341' - '342' - '343' - '344' - '345' - '346' - '352' - '353' - '354' - '360' - '363' - '364' - '365' - '366' - '374' - '375' - '380' - '382' - '383' - '384' - '385' - '386' - '387' - '388' - '389' - '390' - '391' - '394' - '395' - '396' - '397' - '398' - '400' - '401' - '402' - '403' - '406' - '407' - '408' - '409' - '414' - '417' - '419' - '420' - '428' - '430' - '431' - '432' - '433' - '434' - '435' - '441' - '442' - '443' - '449' - '450' - '451' - '452' - '453' - '454' - '455' - '456' - '457' - '458' - '459' - '460' - '464' - '465' - '466' - '467' - '468' - '469' - '470' - '471' - '472' - '473' - '474' - '475' - '476' - '477' - '478' - '479' - '480' - '481' - '483' - '484' - '485' - '486' - '487' - '488' - '489' - '490' - '491' - '492' - '493' - '494' - '495' - '496' - '497' - '498' - '499' - '500' - '501' - '502' - '503' - '504' - '505' - '506' - '507' - '508' - '509' - '510' - '511' - '512' - '513' - '514' - '515' - '516' - '517' - '518' - '519' - '520' - '521' - '522' - '523' - '524' - '525' - '526' - '527' - '528' - '529' - '530' - '531' - '532' - '533' - '534' - '535' - '536' - '537' - '538' - '539' - '540' - '541' - '542' - '543' - '544' - '545' - '546' - '547' - '548' - '549' - '550' - '551' - '552' - '553' - '554' - '555' - '556' - '557' - '558' - '559' - '560' - '561' - '562' - '563' - '564' - '565' - '566' - '567' - '568' - '569' - '571' - '572' - '573' - '574' - '575' - '576' - '577' - '578' - '579' - '580' - '581' - '582' - '583' - '584' - '585' - '586' - '587' - '588' - '589' - '590' - '591' - '592' - '593' - '594' - '595' - '596' - '597' - '598' - '599' - '600' - '601' - '602' - '603' - '604' - '605' - '606' - '607' - '608' - '609' - '610' - '611' - '612' - '613' - '614' - '615' - '616' - '617' - '618' - '619' - '620' - '621' - '622' - '623' - '624' - '625' - '626' - '627' - '628' - '629' - '630' - '631' - '632' - '633' - '634' - '635' - '636' - '637' - '638' - '639' - '640' - '642' - '643' - '644' - '645' - '646' - '647' - '648' - '649' - '650' - '651' - '652' - '653' - '654' - '655' - '656' - '657' - '658' - '659' - '660' - '661' - '662' - '663' - '664' - '665' - '666' - '667' - '668' - '669' - '670' - '671' - '672' - '673' - '674' - '675' - '676' - '677' - '678' - '679' - '680' - '681' - '682' - '683' - '684' - '685' - '686' - '687' - '688' - '689' - '690' - '691' - '692' - '693' - '694' - '695' - '696' - '697' - '698' - '699' - '700' - '701' - '702' - '703' - '704' - '705' - '706' - '707' - '708' - '709' - '710' - '711' - '712' - '713' - '714' - '715' - '716' - '717' - '718' - '719' - '720' - '721' - '722' - '723' - '724' - '725' - '726' - '727' - '728' - '729' - '730' - '731' - '732' - '733' - '734' - '735' - '736' - '737' - '738' - '739' - '740' - '741' - '742' - '743' - '744' - '745' - '746' - '747' - '748' - '749' - '750' - '751' - '752' - '753' - '754' - '755' - '756' - '757' - '758' - '759' - '760' - '761' - '762' - '763' - '764' - '765' - '766' - '767' - '768' - '769' - '770' - '771' - '772' - '773' - '774' - '775' - '776' - '777' - '778' - '779' - '780' - '781' - '782' - '783' - '784' - '785' - '786' - '787' - '788' - '789' - '790' - '791' - '792' - '793' - '794' - '795' - '796' - '798' - '799' - '800' - '801' - '802' - '803' type: string ClaimLevelStatus: properties: entityIdentifierCode: $ref: '#/components/schemas/ClaimLevelEntityIdentifierCode' description: A code indicating the entity that is responsible for the claim. entityIdentifierCodeValue: $ref: '#/components/schemas/ClaimLevelEntityIdentifierCodeValue' description: The description of the `entityIdentifierCode`. healthCareClaimStatusCategoryCode: $ref: '#/components/schemas/HealthCareClaimStatusCategoryCode' healthCareClaimStatusCategoryCodeValue: description: Description of the `healthCareClaimStatusCategoryCode` property. Visit [277CA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-status-category-code) for a complete list. type: string nationalCouncilForPrescriptionDrugProgramsRejectPaymentCodes: description: A National Council for Prescription Drug Programs (NCPDP) reject code. type: string statusCode: $ref: '#/components/schemas/HealthCareClaimStatusCode' description: A code indicating the status. statusCodeValue: description: The description of the `statusCode`. type: string type: object ValidationExceptionResponseContent: description: 'A standard error for input validation failures. Thrown when a member of the input structure falls outside of the modeled or documented constraints.' properties: code: description: A code describing the type of validation failure. type: string message: description: A message describing the causes of the validation failure. There may be more than one. type: string required: - message type: object ConvertReport277ResponseContent: properties: meta: $ref: '#/components/schemas/Meta' transactions: description: The payer's 277 response. items: $ref: '#/components/schemas/ReportsClaimAcknowledgmentResponse' type: array required: - meta type: object InternalFailureExceptionResponseContent: description: The server response when an unexpected error occurred while processing request. properties: code: description: Error classification code type: string message: description: Human-readable error message type: string required: - message type: object ClaimsClaimStatus: properties: billTypeIdentifier: description: The bill type identification. type: string claimServiceBeginDate: description: The starting date of the service. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string claimServiceDate: description: The date of the service. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string claimServiceEndDate: description: The ending date of the service. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string clearinghouseTraceNumber: description: The identifier the clearinghouse assigned to the original claim. type: string informationClaimStatuses: description: Claim status information. items: $ref: '#/components/schemas/InformationClaimStatus' type: array patientAccountNumber: deprecated: true description: The patient control number provided in the original claim. Please use `referencedTransactionTraceNumber` to correlate the payer's response with the original claim. type: string pharmacyPrescriptionNumber: deprecated: true description: Not used. type: string referencedTransactionTraceNumber: description: "The patient control number provided in the original claim. It's the same as:\n - Box 26 (Patient's Account No.) on the CMS-1500 submission form.\n - The `claimInformation.patientControlNumber` in JSON claim submissions.\n\nWe recommend using this value to correlate the payer's response with the original claim. When matching transactions, treat the patient control number as case-insensitive, even if the submitted value included both lower and uppercase characters." type: string tradingPartnerClaimNumber: description: The payer's unique identifier for the claim. type: string voucherIdentifier: deprecated: true description: Not used. type: string type: object AccessDeniedExceptionResponseContent: description: The server response for authorization failure. properties: code: description: Error classification code type: string message: description: Human-readable error message type: string required: - message type: object ClaimLevelEntityIdentifierCode: description: Entity identifier code for claim level in claim status reports enum: - '03' - '36' - '40' - '41' - '71' - '72' - '73' - '77' - '82' - '85' - '87' - 1P - 1Z - DK - DN - DQ - FA - GB - HK - IL - LI - MSC - PR - PRP - QB - QC - QD - SEP - TL - TTP - TU type: string ResourceNotFoundExceptionResponseContent: description: The server response when the specified resource cannot be found after an API request passes authentication and authorization. properties: code: description: Error classification code type: string message: description: Human-readable error message type: string required: - message type: object PayerContactInformation: description: The payer's business contact information. properties: contactMethods: description: Each contact will have a single property set, except for phone with extension. items: $ref: '#/components/schemas/ContactMethods' type: array contactName: description: The name of the contact person or entity. type: string type: object PayerEntityIdentifierCode: description: Entity identifier code for payers in claim status reports enum: - AY - PR type: string ProviderEntityIdentifierCodeValue: description: Human-readable descriptions for provider entity identifier codes enum: - Employer - Receiver - Submitter - Clearinghouse - Payer type: string ProviderEntityIdentifierCode: description: Entity identifier code for providers in claim status reports enum: - '36' - '40' - '41' - AY - PR type: string ServiceLineStatus: properties: entityIdentifierCode: $ref: '#/components/schemas/ServiceEntityIdentifierCode' description: A code indicating the entity that is responsible for the service line. entityIdentifierCodeValue: $ref: '#/components/schemas/ServiceEntityIdentifierCodeValue' description: The description of the `entityIdentifierCode`. healthCareClaimStatusCategoryCode: $ref: '#/components/schemas/HealthCareClaimStatusCategoryCode' healthCareClaimStatusCategoryCodeValue: description: Description of the `healthCareClaimStatusCategoryCode` property. Visit [277CA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-status-category-code) for a complete list. type: string nationalCouncilForPrescriptionDrugProgramsRejectPaymentCodes: deprecated: true description: A National Council for Prescription Drug Programs (NCPDP) reject code. type: string statusCode: $ref: '#/components/schemas/HealthCareClaimStatusCode' description: A code indicating the status. statusCodeValue: description: The description of the `statusCode`. type: string type: object ContactMethods: properties: electronicDataInterChangeAccessNumber: description: The Electronic Data Interchange Access Number. type: string email: description: The email address. type: string fax: description: The fax number. type: string phone: description: The telephone number including the area code (if applicable). Phone numbers are formatted as AAABBBCCCC, where AAA represents the area code, BBB represents the telephone number prefix, and CCCC represents the telephone number. Phone numbers are provided without separators, such as dashes or parentheses. For example, `5551123345` for `555-112-3345`. type: string phoneExtension: description: The telephone extension, if applicable. type: string type: object ServiceClaimStatus: properties: effectiveDate: deprecated: true description: The date the status information is effective. type: string serviceStatuses: description: The status of the service. items: $ref: '#/components/schemas/ServiceLineStatus' type: array type: object ClaimAcknowledgmentDetails: properties: patientClaimStatusDetails: description: 'Patient information and the status of claims related to the patient. You can use the `claims[].claimStatus.referencedTransactionTraceNumber` in this object to correlate the 277CA with the original claim. Some payers batch acknowledgments for multiple claims into a single 277CA. In these cases, the 277CA will contain multiple `patientClaimStatusDetails` objects, each with its own `referencedTransactionTraceNumber` for the corresponding claim.' items: $ref: '#/components/schemas/PatientClaimStatusDetails' type: array providerOFServiceInformationTraceIdentifier: description: An identifier for claims related to this provider. type: string serviceProvider: $ref: '#/components/schemas/ClaimAcknowledgmentDetailsServiceProvider' serviceProviderClaimStatuses: description: Status information for claims related to the provider. items: $ref: '#/components/schemas/ServiceProviderClaimStatus' type: array type: object ClaimAcknowledgmentServiceLinesService: description: Information about the service provided. properties: amountPaid: deprecated: true description: The amount paid for the service, expressed as a decimal. type: string chargeAmount: description: The submitted service charge, expressed as a decimal. type: string procedureCode: description: The identifying code for the product or service. type: string procedureModifiers: description: Identifies special circumstances related to the performance of the service. items: type: string type: array revenueCode: description: The National Uniform Billing Committee Revenue Code. type: string serviceIdQualifierCode: $ref: '#/components/schemas/ClaimAcknowledgmentServiceIdQualifierCode' description: The code identifying the source of the `procedureCode`. serviceIdQualifierCodeValue: $ref: '#/components/schemas/ClaimAcknowledgmentServiceIdQualifierCodeValue' description: The description of the `serviceIdQualifierCode`. submittedUnits: description: The number of units of service that were submitted, expressed as a decimal. type: string type: object PayerEntityIdentifierCodeValue: description: Human-readable descriptions for payer entity identifier codes enum: - Clearinghouse - Payer type: string GatewayTimeoutExceptionResponseContent: description: The server response for a gateway timeout error. properties: code: description: Classification of the exception type. type: string message: description: Human readable exception message. type: string required: - message type: object InformationClaimStatus: properties: adjudicatedFinalizedDate: deprecated: true description: Not used. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string claimPaymentAmount: deprecated: true description: Not used. type: string informationStatuses: items: $ref: '#/components/schemas/ClaimLevelStatus' type: array remittanceDate: deprecated: true description: Not used. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string remittanceTraceNumber: deprecated: true description: Not used. type: string statusInformationEffectiveDate: description: The effective date of the status information. pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$ type: string statusMessage: description: Additional free-form information about the claim status. type: string totalClaimChargeAmount: description: The total amount of charges in the original claim, expressed as a decimal. This may differ from the total charges submitted due to claims processing instructions, such as claim splitting. Note that some HMO encounters supply zero as the amount of original charges. type: string type: object ClaimAcknowledgmentServiceIdQualifierCodeValue: description: Human-readable descriptions for service ID qualifier codes. enum: - American Dental Association Codes - Jurisdiction Specific Procedure and Supply Codes - Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes - Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate Code - Home Infusion EDI Coalition (HIEC) Product/Service Code - National Uniform Billing Committee (NUBC) UB92 Codes - Advanced Billing Concepts (ABC) Codes type: string ClaimLevelEntityIdentifierCodeValue: description: Human-readable descriptions for claim level entity identifier codes enum: - Dependent - Employer - Receiver - Submitter - Attending Physician - Operating Physician - Other Physician - Service Location - Rendering Provider - Billing Provider - Pay-to Provider - Provider - Home Health Care - Ordering Physician - Referring Provider - Supervising Physician - Facility - Other Insured - Subscriber - Insured or Subscriber - Independent Lab - Mammography Screening Center - Payer - Primary Payer - Purchase Service Provider - Patient - Responsible Party - Secondary Payer - Testing Laboratory - Tertiary Payer - Third Party Repricing Organization (TPO) type: string PatientClaimStatusDetailsSubscriber: description: Information about the primary policy holder for the health plan. properties: employerIdentificationNumber: deprecated: true description: The subscriber's employer identification number. This may be used in conjunction with a worker's compensation claim. type: string firstName: description: The first name of the subscriber. Can be up to 35 characters. type: string lastName: description: The last name of the subscriber. Can be up to 60 characters. type: string memberId: description: The subscriber's member ID for their health plan. type: string middleName: description: The middle name or initial of the subscriber. Can be up to 25 characters. type: string organizationName: description: The subscriber's business name. Applicable when an employer submitted a worker's compensation claim, or other situations when an employer is the subscriber. type: string standardUniqueHealthIdentifierForEachIndividualInTheUnitedStates: description: Deprecated; do not use. type: string suffix: description: The suffix of the subscriber, such as Jr or III. Can be up to 10 characters. type: string type: object ClaimAcknowledgmentTransactions: properties: claimStatusDetails: description: More detailed status information. This includes information about the patient, provider, and services rendered. items: $ref: '#/components/schemas/ClaimAcknowledgmentDetails' type: array claimTransactionBatchNumber: description: A tracking number Stedi assigns to the corresponding 837 claim. It's returned as the `claimReference.correlationId` in the response from our claim submission endpoints. You can use this value to correlate the 277CA with the original claim. type: string provider: $ref: '#/components/schemas/ClaimAcknowledgmentTransactionsProvider' providerClaimStatuses: description: Overall status information for the claim. items: $ref: '#/components/schemas/ProviderClaimStatus' type: array type: object ClaimAcknowledgmentPayer: properties: centersForMedicareAndMedicaidServicePlanId: description: The payer's Centers for Medicare and Medicaid Services Plan ID. This is specifically for Health Plan ID (HPID) or Other Entity Identifier (OEID), both of which are no longer mandated for use. type: string claimStatusTransactions: description: Claim status details. items: $ref: '#/components/schemas/ClaimAcknowledgmentTransactions' type: array entityIdentifierCode: $ref: '#/components/schemas/PayerEntityIdentifierCode' description: Code identifying the type of organization. entityIdentifierCodeValue: $ref: '#/components/schemas/PayerEntityIdentifierCodeValue' description: The human-readable description of the entity identifier code. etin: description: The payer's Electronic Transmitter Identification Number. type: string federalTaxpayerIdentificationNumber: description: The payer's Federal Taxpayer Identification Number. pattern: ^\d{9}$ type: string organizationName: description: The payer or intermediary clearinghouse's business name. type: string payerContactInformation: $ref: '#/components/schemas/PayerContactInformation' deprecated: true payerIdentification: description: The payer's unique identifier. type: string type: object ThrottlingExceptionResponseContent: description: The server response when usage plan or account-level throttling limits exceeded. properties: code: description: Error classification code type: string message: description: Human-readable error message type: string required: - message type: object ClaimAcknowledgmentDetailsServiceProvider: description: Information about the service provider. properties: firstName: description: The provider's first name, when the provider is an individual. Can be up to 35 characters. type: string lastName: description: The provider's last name, when the provider is an individual. Can be up to 60 characters. type: string middleName: description: The provider's middle name or initial, when the provider is an individual. Can be up to 25 characters. type: string npi: description: The provider's National Provider Identifier. pattern: ^\d{10}$ type: string organizationName: description: The provider's business name. Can be up to 60 characters. type: string spn: description: The provider's service provider number. type: string suffix: description: The provider's name suffix, when the provider is an individual. Can be up to 10 characters. type: string tin: description: The provider's tax identification number. type: string type: object ClaimAcknowledgmentTransactionsProvider: description: Information about the provider receiving the claim status details. properties: etin: description: The provider's Electronic Transmitter Identification Number. type: string firstName: description: The provider's first name. Can be up to 35 characters. type: string lastName: description: The provider's last name. Can be up to 60 characters. type: string middleName: description: The provider's middle name or initial. Can be up to 25 characters. type: string organizationName: description: The provider's business name. Can be up to 60 characters. type: string type: object ServiceEntityIdentifierCode: description: Entity identifier code for service lines in claim status reports enum: - '03' - '36' - '40' - '41' - '71' - '72' - '73' - '77' - '82' - '85' - '87' - 1P - 1Z - DK - DN - DQ - FA - GB - HK - IL - LI - MSC - PR - PRP - QB - QC - QD - SEP - TL - TTP - TU type: string PatientClaimStatusDetails: description: Patient information and the status of claims related to the patient. You can use the `claims[].claimStatus.referencedTransactionTraceNumber` in this object to correlate the 277CA with the original claim. properties: claims: description: Status information for the claim or service line. items: $ref: '#/components/schemas/ReportsClaims' type: array dependent: $ref: '#/components/schemas/PatientClaimStatusDetailsDependent' deprecated: true description: The patient's information will always be returned in the `subscriber` object, regardless of whether they are a subscriber or dependent. subscriber: $ref: '#/components/schemas/PatientClaimStatusDetailsSubscriber' description: Information about the patient who received services related to the claim. type: object securitySchemes: httpApiKeyAuth: description: A [Stedi API Key](https://www.stedi.com/app/settings/api-keys) for authentication. in: header name: Authorization type: apiKey x-stedi: lifecycle: general_availability product: claims public: true