API & Services Connectionā„¢
API Reference
Request Sandbox AccessMarketplaceCommunityQuick Reference

Check Claim Status

post
https://sandbox-apigw.optum.com/medicalnetwork/claimstatus/v2/
Recent Requests
Log in to see full request history
TimeStatusUser Agent
Retrieving recent requestsā€¦
LoadingLoadingā€¦

šŸ“˜

NOTE

In the Response 200 pop-up below, the X12 segment in the payerIdentification is the same as that of the trandingPartnerServiceId.


ā—ļø

IMPORTANT

Please note that the request requires you to provide all the required field values. These required values are GREYED out, which are pre-populated example values and can be selected to view the canned response. To view the required fields, expand the + symbol (indicated by the variables field below. For more information, please refer to the JSON-to-EDI API Contents section.

Body Params
string
required
length between 9 and 9

Header, Segment: ST02 (no loop), Notes: Transaction Set Control Number

string

Loop: 2100A, Segment: NM1, Element: NM103, Notes: organizational name

string
length between 2 and 80

Loop: 2100A Segment: NM1, Element: NM109, Notes: we send this as MN108 as PI = Payer Identification

providers
array of objects
required
length between 1 and 2147483647

Loop: 2100B, Loop: 2100C

providers*
string
length between 1 and 60

Segment: NM1, Element: NM103, Notes: Providerā€™s organization name. Can use organization or last name.

string
length between 1 and 35

Segment: NM1, Element: NM104, Notes: Maps to providerName

string
length between 1 and 60

Segment: NM1, Element: NM103, Notes: Provider last name. Can use organization or last name.

string
length between 2 and 80

Loop: 2100B, 2100C, Segment: NM1, Element: NM109, Notes: National Provider Identification. Maps to provider NPI. NM108=XX

string
length between 2 and 80

Loop: 2100B, 2100C, Segment: NM1, Element: NM109, Notes: Service Provider Number. Maps to provider SPN. NM108=SV

string
length between 2 and 80

Loop: 2100B, 2100C, Segment: NM1, Element: NM109, Notes: Taxpayerā€™s Identification Number. Maps to provider TIN. NM108=FI

string
length between 2 and 80

Loop: 2100B, Segment: NM1, Element: NM109, Notes: Taxpayerā€™s Identification Number used when ProviderType = BillingProvider

string
length between 2 and 80

Loop: 2100B, Segment: NM1, Element: NM109, Notes: Electronic transmitter identification Number (ETIN) used when ProviderType = BillingProvider

string
enum
required

Segment: NM1, Notes: Code for entity (Billing or Service) Billing Provider: Loop 2100B, NM101=41 (required), Service Provider: Loop 2100C, NM101=1P if not present it is added and assigned tin = BillingProvider taxId

Allowed:
subscriber
object
required

Loop: 2000D

dependent
object

Loop: 2000E

encounter
object

Loop: 2200D or 2200E

serviceLineInformation
object

Loop: 2220D or 2220E

Headers
string
required

Bearer Your-Access-Token
Example: Bearer eyJraWQiOiIxIiwidā€¦

Response

Updated about 2 months ago

Language
LoadingLoadingā€¦
Response
Click Try It! to start a request and see the response here! Or choose an example:
application/json

Updated about 2 months ago