PayerList Definitions

Suggest Edits

/payerfinder/v1/payers?system=[SYSTEM]&transactionType=[TRANSACTIONTYPE_1] &transactionType=[TRANSACTIONTYPE_2] &transactionType=[TRANSACTIONTYPE_N]

List Name

System

Transaction Type

Endpoint

Exchange Real-Time Eligibility & Claim Status PayerList

EXCH

Eligibility
Claim Status

PayerList
/v1/payers?system=EXCH&transactionType=Eligibility&transactionType=Claim+Status

CSV Export List
/v1/payers/export? system=EXCH&transactionType=Eligibility&transactionType=Claim+Status

Exchange Claims & Remittance PayerList

EXCH

Claims Professional
Claims Institutional
ERA Professional
ERA Institutional

PayerList
/v1/payers?system=EXCH&transactionType=Claims+Professional&transactionType=Claims+Institutional& transactionType=ERA+Professional&transactionType=ERA+Institutional

CSV Export List
/v1/payers/export?system=EXCH&transactionType=Claims+Professional&transactionType=Claims+Institutional

IMN Real-Time Eligibility & Claim Status PayerList

IMN

Eligibility
Claim Status

PayerList
/v1/payers?system=IMN&transactionType=Eligibility&transactionType=Claim+Status

CSV Export List
/v1/payers/export?system=IMN&transactionType=Eligibility&transactionType=Claim+Status

RPA Claims & Remittance PayerList

RPA

Claims Professional
Claims Institutional
ERA Professional
ERA Institutional

PayerList
/v1/payers?system=RPA&transactionType=Claims+Professional&transactionType=Claims+Institutional&transactionType=ERA+Professional&transactionType=ERA+Institutional

CSV Export List
/v1/payers/export?system=RPA&transactionType=Claims+Professional&transactionType=Claims+Institutional&transactionType=ERA+Professional&transactionType=ERA+Institutional

Dental Claims & ERA PayerList

Dental

Dental Claims
Dental ERA

PayerList
/v1/payers?system=DENTAL&transactionType=Dental+Claims&transactionType=Dental+ERA

CSV Export List
/v1/payers/export?system=DENTAL&transactionType=Dental+Claims&transactionType=Dental+ERA

IEDI Claims PayerList for Legacy CHC

OKC

Claims Professional
Claims Institutional

PayerList
/v1/payers?system=OKC&transactionType=Claims+Professional&transactionType=Claims+Institutional

Example
/v1/payers?system=OKC&transactionType=ERA+Professional&planPayerName=blue&wildcard=yes

CSV Export List
/v1/payers/export?system=OKC&transactionType=Claims+Professional&transactionType=Claims+Institutional

IEDI ERA PayerList for Legacy CHC

OKC

ERA Professional
ERA Institutional

PayerList
/v1/payers?system=OKC&transactionType=Claims+Professional&transactionType=Claims+Institutional

CSV Export List
/v1/payers/export?system=OKC&transactionType=Claims+Professional&transactionType=Claims+Institutional

IEDI PayerList

IEDI

[No Transactions identified to return all]

Claims Professional
Claims Institutional
ERA Professional
ERA Institutional
Eligibility
Claim Status
Auth Inquiry
Auth Referral
Dental Claims
Dental ERAs

PayerList
/v1/payers?system=IEDI&transactionType=Claims+Professional&transactionType=Claims+Institutional

ERA CSV Export List
/v1/payers/export?system=IEDI&transactionType=Claims+Professional&transactionType=Claims+Institutional

Export Payers v1/payers/export endpoint exports the PayerList to a CSV file.

📘
NOTE

If you only plan to use a few daily transactions, then you can use our PayerList V1 API user interface (UI) for your Medical Network transaction needs.
It provides most of the features supported by an API console but only allows manual entry for all data needed for a transaction. It contains PayerLists, the PayerList Enrollments wizard, and other API customer resources.

For providers sending hundreds of daily requests, we recommend using our APIs to be able to automate the submission processes and have a better fit for your business needs.

Updated 13 days ago

📘NOTE

📘
NOTE