Overview

Introduction

The PayerList API empowers you to programmatically access and integrate accurate, up-to-date payer list data into your systems to eliminate manual processes and enable smarter transaction workflows. The PayerList API helps you select the correct payer list based on the clearinghouse.

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NOTE

• If you only plan to use a few daily transactions, 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 Payer Lists, the PayerList Enrollments wizard, and other API customer resources.
• For providers sending hundreds of daily requests, we recommend using our APIs to automate the submission processes and have a better fit for your business needs.

• The /healthcheck endpoint verifies that the APIs are up and running.
• The /payers endpoint retrieves the payer list across transactions, with filters for payer ID, transaction type, enrollment, and other criteria in a specific clearinghouse.

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NOTE

system is the only required parameter (for example, Exchange real-time and Exchange batch both use system=EXCH but they have different transactionType parameters).

• The /fields endpoint retrieves the available fields for querying the payer data.
• The /export endpoint returns paginated results similar to the GET payers endpoint, but is intended for exporting the data in a CSV format.