EDI to JSON Translation

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Here is an example of a 1:1 translation from EDI to JSON, starting with getting a display of an EDI-formatted Remittance file: GET

https://sandbox-apigw.optum.com/medicalnetwork/reports/v2/R5000000.XX

{
    "report_content": "ISA~00~          ~00~          ~ZZ~CHC            ~ZZ~658675C9801437 ~200422~2313~|~00501~156233287~0~P~^_GS~HP~CHC~658675C9801437~20200422~23135600~1~X~005010X221A1_ST~835~000000001_BPR~I~2563.13~C~ACH~CCP~01~042000013~DA~152302017834~1351840597~~01~071921891~DA~4638544662~20200423_TRN~1~895322770~1351840597_REF~EV~99992_DTM~405~20200422_N1~PR~NATIONAL GOVERNMENT SERVICES, 
}

This is quite a substantial body of EDI information.

Then, you append the /835 suffix to get the JSON translation of the same remittance file. It consists of a complete breakdown of payment information for all service identifications, payments, payment adjustments, financial information, and Payer and Payee information: GET

https://sandbox-apigw.optum.com/medicalnetwork/reports/v2/R5000000.XX/835

{
    "detailInfo": [
        {
            "assignedNumber": "1",
            "paymentInfo": [
                {
                    "claimPaymentInfo": {
                        "claimFilingIndicatorCode": "MB",
                        "claimFrequencyCode": "1",
                        "claimPaymentAmount": "2563.13",
                        "claimStatusCode": "19",
                        "facilityTypeCode": "11",
                        "patientControlNumber": "00309",
                        "patientResponsibilityAmount": "711.4",
                        "payerClaimControlNumber": "0220087697150",
                        "totalClaimChargeAmount": "9006"
                    },
                    "claimReceivedDate": {
                        "date": "20200327",
                        "dateTimeQualifier": "050"
                    },
                    "crossoverCarrier": {
                        "entityIdentifierCode": "TT",
                        "entityTypeQualifier": "2",
                        "identificationCode": "00268",
                        "identificationCodeQualifier": "PI",
                        "name": "HUMANA, INC."
                    },
                    "outpatientAdjudication": {
                        "claimPaymentRemarkCode1": "MA01",
                        "claimPaymentRemarkCode2": "MA15",
                        "claimPaymentRemarkCode3": "MA18"
                    },
                    "patientName": {
                        "entityIdentifierCode": "QC",
                        "entityTypeQualifier": "1",
                        "firstName": "JANE",
                        "identificationCode": "7SL5RA7XR19",
                        "identificationCodeQualifier": "MI",
                        "name": "DOE"
                    },
                    "renderingProvider": {
                        "entityIdentifierCode": "82",
                        "entityTypeQualifier": "1",
                        "identificationCode": "1234567893",
                        "identificationCodeQualifier": "XX"

...

Updated 3 months ago