This page contains information about new features, enhancements, regulatory updates, and any issues or defects that have been addressed from the previous version of the product.

Release Notes V2

• As part of this release, we are now supporting “Real Claim Inquiry API” where providers can receive real-time updates on submitted claims to make informed decisions regarding reconciliation requests and appeals to help reduce administrative burden. Through a single, centralized API, providers can access claim information in real time, including: 

  - Claim summaries and details 
  - Status at the claim and service level  
  - Available actions for reconciliations and appeals at the service level 
  - Download of associated documents 
  

• Addition of post-purchase test environment

- Once the API purchase status shows “subscribed” in the AI Marketplace account, customers can use their existing sandbox credentials to send live data to a sandbox environment for the API they have purchased. 
- At that point, responses will be based on the live data submitted to the sandbox environment as opposed to mock data preloaded to the sandbox environment. 
-The customer will retain the ability to query mock responses from sandbox environment by using an optional request header called “environment” by placing the value “sandbox’ in the optional header.

NOTE: Do not submit PHI or PII data in the TRY IT functionality below.

Release Notes V1

• As part of this release, we are now supporting “Real Pre-Service Eligibility API” where providers can access eligibility data across multiple payers directly within their existing workflow, including: 

         -Eligibility information including patient demographic information, plan-level cost shares, 
           plan coverage details and insurance details
          -Coordination of benefits including primacy and coverage details for each payer plan  
          -Image of a patient’s insurance ID card 
          -Provider In and Out of Network status
  

• As part of this release, we are now supporting “Real Claim Pre-Check API” where providers can validate claim data directly within existing workflow, including:

          -X12 claim validation (HIPAA)
          -Membership and coverage eligibility for the date of service 
          -Coordination of Benefits (COB) including primacy and coverage details for patient  
          -Prior Authorization (PA) requirements and status   
          -Adherence to payment and medical policies