Payer Finder Request & Response
The Payer Finder API provides two methods for querying payers:
- Queries using the HTTP URL path;
- Queries defined by a question mark (
?
) followed by a structured statement as an extended argument in the path.
NOTE
In general, API queries are not case sensitive. However, the key portions of a key-value pair search parameters are case-sensitive while the value portions are not. The key (a field name)) should be in camel case as while the value can be entered anyway. So, for example,
serviceName=eligibility
orserviceName=ELIGIBILITY
both work whileservicename=eligibility
does not.
In a sandbox environment, if you want to query for payers that start with business name blue
and service name Claims
, send a GET
request to the following endpoint with your authorization header.
/medicalnetwork/payerfinder/v1/payers?businessName=blue&serviceName=Claims
In a sandbox environment, if you want to query for payers that start with business name blue
and service name Claims
, send a GET
request to the following endpoint with your authorization header.
https://sandbox.apigw.changehealthcare.com/medicalnetwork/payerfinder/v1/payers?businessName=blue&serviceName=Claims
{
"start": 0,
"size": 50,
"total": 542,
"payers": [
{
"businessName": "Blue Cross Blue Shield of Testing",
"alias": "Test Alias",
"planType": "Test",
"serviceName": "Claims",
"lineOfBusiness": "Dental",
"serviceDate": "2007-10-19T00:00:00",
"serviceId": "61474",
"clearingHouse": "NPD",
"acceptsSecondary": "N",
"reportLevel": "4-Clm Level A/R",
"serviceModified": "2007-11-01T00:00:00",
"enrollmentStatus": "No Enrollment Required",
"serviceNotes1": "Dental Blue Select Product",
"passThroughFee": "N"
},
{
"businessName": "Blue Cross Blue Shield of Testing 2",
"planType": "Test 2 Alias",
"states": "MS",
"serviceName": "Claims",
"lineOfBusiness": "Hospital",
"serviceDate": "2002-04-12T00:00:00",
"serviceId": "12B82",
"clearingHouse": "NPD",
"acceptsSecondary": "Y",
"reportLevel": "4-Clm Level A/R",
"serviceModified": "2012-03-23T00:00:00",
"enrollmentStatus": "Enrollment Required",
"enrollmentType": "Registration",
"enrollmentMethod": "OKC/POSI Setup",
"passThroughFee": "N"
}
]
}
Sending the following request downloads the entire payer list. From this point, add the attributes and arguments to the URL path to query for more-specific information.
https://apigw.changehealthcare.com/medicalnetwork/payerfinder/v1/payers
```
{
"start": 0,
"size": 50,
"total": 542,
"payers": [
{
"businessName": "Blue Cross Blue Shield of Testing",
"alias": "Test Alias",
"planType": "Test",
"serviceName": "Claims",
"lineOfBusiness": "Dental",
"serviceDate": "2007-10-19T00:00:00",
"serviceId": "61474",
"clearingHouse": "NPD",
"acceptsSecondary": "N",
"reportLevel": "4-Clm Level A/R",
"serviceModified": "2007-11-01T00:00:00",
"enrollmentStatus": "No Enrollment Required",
"serviceNotes1": "Dental Blue Select Product",
"passThroughFee": "N"
},
{
"businessName": "Blue Cross Blue Shield of Testing 2",
"planType": "Test 2 Alias",
"states": "MS",
"serviceName": "Claims",
"lineOfBusiness": "Hospital",
"serviceDate": "2002-04-12T00:00:00",
"serviceId": "12B82",
"clearingHouse": "NPD",
"acceptsSecondary": "Y",
"reportLevel": "4-Clm Level A/R",
"serviceModified": "2012-03-23T00:00:00",
"enrollmentStatus": "Enrollment Required",
"enrollmentType": "Registration",
"enrollmentMethod": "OKC/POSI Setup",
"passThroughFee": "N"
}
]
}
```
Updated 6 months ago