Claim Status Sandbox API Values and Test Responses

We provide a list of service ID values for testing different responses.

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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.

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NOTE

Please do not use real-world values in our sandbox API endpoints! Doing so will generate errors.

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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.

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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 tradingPartnerServiceIdDescription
00001Canned response: "Response not possible" - Error on submitted request data.
000002Canned response is claim status for a dependent: "The claim/line has been denied."
00003Canned response: "Accepted and paid."
00004Canned 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.
00005Canned response: "Denied"
STC01: F2 Finalized/Denial - The claim/line has been denied.
STC02: 27 Policy canceled.
997ACanned response: "997 Request is Accepted."
997ECanned response: "997 Request is Accepted with Errors."
997RCanned response: "997 Request is Rejected with reason" - One or more Segments in Error.
999ACanned response: "999 Request is Accepted."
999ECanned response: "999 Request is Accepted with Errors."
999RCanned response: "999 Request is Rejected with reason" - One or more Segments in Error.
AETNACanned response for two claims/lines: "Finalized/Payment" - The claim/line has been paid and Finalized/Denial. - The claim/line has been denied.
BACKSLASHCOMPSEPCanned response where component separator is a backslash symbol - "".
The ClaimStatus Info is: "Response not possible" - error on submitted request data.
CIGNACanned response: "Data Search Unsuccessful" - The payer is unable to return status on the requested claim(s) based on the submitted search criteria.
FLORIDAMEDICAIDCanned response: "Response not possible - System Status."
GREATERTHANCOMPSEPCanned 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.
HUMANACanned response: "Response not possible" - Error on submitted request data.
INVALIDPAYERANDTPGCanned response: "Response not possible." - Error on submitted request data.
This is when payerId and TPG Credentials both are invalid.
The subscriber/dependent are mock.
INVALIDPAYERVALIDTPGCanned 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.
NEWLINESEGSEPCanned response where, segment separator is a new line "\n".
TA1Canned response: TA1 with error - "Invalid Authorization Information Qualifier value."
UHCCanned response: "The claim or encounter is in the adjudication system."
VALIDPAYERANDTPGCanned 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.
VALIDPAYERINVALIDTPGCanned 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.
defaultCanned response: "Response not possible" - Error on submitted request data.