Claim Status Sandbox API Values and Test Responses
We provide a list of service ID values for testing different responses.
NOTE
DO NOT perform load testing or production data testing in the sandbox environment. Please use the sandbox ONLY to view sample API responses to HTTP requests using our predefined fields and values and to familiarize yourself with our APIs.
For load testing and production data resting, we recommend subscribing to our APIs.
Contact an Optum representative at any time for more information.
For testing the APIs in the sandbox environment, you can edit the request body and send it to the API engine to see different responses.
NOTE
Please do not use real-world values in our sandbox API endpoints! Doing so will generate errors.
NOTE
All fields must use predefined values to have successful responses in the sandbox.
Sandbox Test Responses
For API testing in sandbox, edit the request body and send it to the API engine to view different responses. You can use the following values as the tradingPartnerServiceId (is the Payer ID; this will vary based on the payer you want to connect to) to change the responses you will receive from your test request body.
IMPORTANT
The sandbox returns canned responses based on the received data. There is no validation check or confirmation of specifically required information. These checks occur only in the production environment. You should manually review the companion guides offered by the specific payers to confirm what is required.
| Test using THIS tradingPartnerServiceId | Description |
|---|---|
| 00001 | Canned response: "Response not possible" - Error on submitted request data. |
| 000002 | Canned response is claim status for a dependent: "The claim/line has been denied." |
| 00003 | Canned response: "Accepted and paid." |
| 00004 | Canned response: "Rejected" STC01: A7 Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. STC02: 34 Subscriber and policyholder name not found. |
| 00005 | Canned response: "Denied" STC01: F2 Finalized/Denial - The claim/line has been denied. STC02: 27 Policy canceled. |
| 997A | Canned response: "997 Request is Accepted." |
| 997E | Canned response: "997 Request is Accepted with Errors." |
| 997R | Canned response: "997 Request is Rejected with reason" - One or more Segments in Error. |
| 999A | Canned response: "999 Request is Accepted." |
| 999E | Canned response: "999 Request is Accepted with Errors." |
| 999R | Canned response: "999 Request is Rejected with reason" - One or more Segments in Error. |
| AETNA | Canned response for two claims/lines: "Finalized/Payment" - The claim/line has been paid and Finalized/Denial. - The claim/line has been denied. |
| BACKSLASHCOMPSEP | Canned response where component separator is a backslash symbol - "". The ClaimStatus Info is: "Response not possible" - error on submitted request data. |
| CIGNA | Canned response: "Data Search Unsuccessful" - The payer is unable to return status on the requested claim(s) based on the submitted search criteria. |
| FLORIDAMEDICAID | Canned response: "Response not possible - System Status." |
| GREATERTHANCOMPSEP | Canned response where, component separator is a greater than symbol '>'. The Claim Status info is: "Acknowledgement/Acceptance into adjudication system." - The claim/encounter has been accepted into the adjudication system. |
| HUMANA | Canned response: "Response not possible" - Error on submitted request data. |
| INVALIDPAYERANDTPG | Canned response: "Response not possible." - Error on submitted request data. This is when payerId and TPG Credentials both are invalid. The subscriber/dependent are mock. |
| INVALIDPAYERVALIDTPG | Canned response: "Response not possible." - Error on submitted request data. This is when payerId is invalid and TPG Credentials are valid. The subscriber/dependent are mock. |
| NEWLINESEGSEP | Canned response where, segment separator is a new line "\n". |
| TA1 | Canned response: TA1 with error - "Invalid Authorization Information Qualifier value." |
| UHC | Canned response: "The claim or encounter is in the adjudication system." |
| VALIDPAYERANDTPG | Canned response: "Data Search Unsuccessful" - The payer is unable to return status on the requested claim(s) based on the submitted search criteria. This is when payerId and TPG Credentials both are valid. The subscriber/dependent however are not found by the payer. |
| VALIDPAYERINVALIDTPG | Canned response: "Response not possible" - Error on submitted request data. This is when payerId is valid and TPG Credentials are invalid. The subscriber/dependent are mock. |
| default | Canned response: "Response not possible" - Error on submitted request data. |
Updated about 8 hours ago