POST
/
change
/
medicalnetwork
/
professionalclaims
/
v3
/
raw-x12-submission
cURL
curl --request POST \
  --url https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/raw-x12-submission \
  --header 'Authorization: <api-key>' \
  --header 'Content-Type: application/json' \
  --data '{
  "x12": "ISA*00*          *00*          *ZZ*001690149382   *ZZ*STEDITEST      *240630*0847*^*00501*000000001*0*T*>~GS*HC*001690149382*STEDITEST*20240630*084744*000000001*X*005010X222A1~ST*837*0001*005010X222A1~BHT*0019*00*01J1M588QT2TAV2N093GNJ998T*20240630*0847*CH~NM1*41*2*Test Data Health Services, Inc.*****46*123567890~PER*IC*Test Data Health Services, Inc.*TE*5552223333~NM1*40*2*Cigna*****46*60054~HL*1**20*1~PRV*BI*PXC*2084P0800X~NM1*85*2*Therapy Associates*****XX*1999999984~N3*123 Some St*Floor 1~N4*A City*NY*123450000~REF*EI*832675429~PER*IC*Test Data Health Services, Inc.*TE*5553334444~HL*2*1*22*0~SBR*P*18*3335555******CI~NM1*IL*1*Anon*John****MI*U7777788888~N3*2222 Random St~N4*A City*NY*123450000~DMG*D8*20000101*M~NM1*PR*2*Cigna*****PI*60054~CLM*22266555*109.0***02>B>1*Y*A*Y*Y~HI*ABK>F1111~NM1*82*1*Smith*Jane****XX*1999999984~PRV*PE*PXC*111YP2000X~NM1*77*2*Smith Associates*****XX*1999999984~N3*1234 Other St~N4*A City*NY*123450000~LX*1~SV1*HC>90837>95*109.2*UN*1.0***1~DTP*472*D8*20240101~SE*30*0001~GE*1*000000001~IEA*1*000000001~"
}'
{
  "status": "SUCCESS",
  "controlNumber": "000000001",
  "tradingPartnerServiceId": "60054",
  "claimReference": {
    "correlationId": "01J1M588QT2TAV2N093GNJ998T",
    "patientControlNumber": "22266555",
    "timeOfResponse": "2024-07-10T22:05:32.203Z",
    "payerID": "60054",
    "formatVersion": "5010",
    "rhclaimNumber": "01J1M588QT2TAV2N093GNJ998T",
    "serviceLines": [
      {
        "lineItemControlNumber": "111222333"
      }
    ]
  },
  "httpStatusCode": "200 OK",
  "meta": {
    "traceId": "b727b8e7-1f00-4011-bc6e-e41444d406d8"
  },
  "payer": {
    "payerName": "Cigna",
    "payerID": "60054"
  }
}
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 837 X12 EDI format.
  2. Stedi validates the EDI and sends the claim 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 professional claims for a full how-to guide.

CMS-1500 Claim Form PDF

When you submit a professional claim, Stedi automatically generates a 1500 claim form PDF. If you plan to send these PDFs to payers or retain them for your records, we strongly recommend reviewing the CMS-1500 claim form PDF documentation to learn how to structure claim submissions for optimal generation, the correct printer settings for generated PDFs, and general best practices.

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 a non-default release of the Professional Claims guide needs to be used.

Body

application/json
x12
string
required

Response

ClaimsRawX12Submission 200 response

status
string

The status of the claim submission.

controlNumber
string

An identifier for the transaction.

tradingPartnerServiceId
string

An ID for the payer you identified in the original claim. 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.

claimReference
object

Information about the claim.

errors
object[]

A list of errors. Currently not used.

warnings
object[]

A list of warnings.

httpStatusCode
enum<string>

A 200 response indicates that Stedi successfully generated the X12 EDI claim format required by the payer. It does not indicate whether the payer has accepted the claim - the payer will respond later with a 277CA containing this information. Learn more about 277CAs. A 400 response indicates one or more problems with the claim data in the request. Examples include missing required fields, invalid values, or incorrect data types. The response includes a message describing the problem.

Available options:
200 OK,
400 BAD_REQUEST
meta
object

Metadata from Stedi about the request.

editStatus
string

Currently not used.

editResponses
object[]

Currently not used.

payer
object

Information about the payer for the submitted claim.

failure
object

Currently not used.