RAW-12 Validation Requests & Responses

You can use the Integrated Rules Institutional /advanced/v1/raw-x12-validation endpoint to validate your EDI request:

https://sandbox-apigw.optum.com/medicalnetwork/institutionalclaims/advanced/v1/raw-x12-validation

Your transaction will not be sent to the payer. A sample request appears in EDI format:

```javascript
{"x12": "ISA*00*          *01*CYCTRANS  *ZZ*009998999898   *ZZ*CLAIMSCH       *200723*1401*|*00501*000000001*0*T*:~GS*HC*009998999898*1465*20200723*1401*000000001*X*005010X223A3~ST*837*000000001*005010X223A3~BHT*0019*00*000000001*20200723*1401*CH~NM1*41*2*happy doctors group*****46*009998999898~PER*IC*janetwo doetwo*EM*[email protected]~NM1*40*2*EXTRA HEALTHY INSURANCE*****46*CLAIMSCH~HL*1**20*1~NM1*85*2*HAPPY HOSPITAL CHAIN*****XX*1760854442~N3*123 address1~N4*city1*wa*981010000~REF*EI*123456789~HL*2*1*22*0~SBR*P*18*******CI~NM1*IL*1*doeOne*johnOne****MI*0000000001~N3*123 address1~N4*city1*wa*981010000~DMG*D8*19800101*M~NM1*PR*2*EXTRA HEALTHY INSURANCE*****PI*9496~CLM*12345*3.75***11:A:1**A*Y*Y~DTP*096*TM*1130~DTP*434*RD8*20041209-20041214~DTP*435*DT*200410131242~CL1*1*7*10~NTE*ADD*ADD~HI*BK:99761:::::::Y~HI*BJ:99762~SBR*A*19*******11~OI***Y***Y~NM1*IL*1*DOE*****MI*123456~NM1*PR*2*ABC Insurance Co*****PI*11122333~LX*1~SV2*1**72.50*UN*1~SE*32*000000001~GE*1*000000001~IEA*1*000000001~"}
```

Both JSON and EDI endpoints use the same API request model with the same sets of attributes.

Your responses for this API are returned in JSON format, including any errors that the API engine discovers.

📘

NOTE

When your EDI formatted request is corrected and validated, use your normal claim submission workflow to submit the claim. The Institutional Claims v1 API does not directly support X12 EDI submissions.