The Claims Responses and Reports API provides a direct connection to your mailbox where payers will send their final claims responses and reports. Use this API to access your mailbox for all the files containing complete information about claim payments, claim status updates, and other communications regarding revenue cycles and adjudication from the payer.
Version 2 of this API offers significant improvements to the developer seeking to implement file-fetching and EDI content conversion capabilities to their users' medical transaction console:
- A fully updated OpenAPI 3.0 JSON spec with extensive annotation supporting medical coding and explanation of relationships between JSON attributes and the EDI loops and segment that affect those attributes
- Rewritten JSON specifications for clarity and understandability
serviceLinesto match our other APIs
- Updates to support a new 'transactions' JSON object for the /835 and /277 endpoints. It lists out each 277 or 835 transaction contained within the report, each with all claims and service lines, when multiple transactions are completed by the payer.
This API is complementary to other Claims APIs such as Claims Status, Institutional Claims and Professional Claims. For example, the Change Healthcare Claims Status API provides status summaries of a claim; it doesn't download the actual claim data.
|NOTE: You can use this API with your contracted APIs at no additional cost.|
We recommend using this API along with your main Claims API to give you the complete basic functionality to manage your professional or institutional claims. Typically, you will need a suite of three Change Healthcare APIs to do your most effective Claims work:
- Submit your claims with the Professional Claims or Institutional Claims API
- Efficiently check on outstanding claims status with Claims Status
- Download your finished claims files with the Reports v2 API.
Our Claims Responses and Reports v2 API supports the combination and reception of multiple Professional or Institutional claims in a single 277 or 837 report.
If you only plan to use a few daily transactions, you may be able to use ConnectCenter for your transaction needs. It performs most of the features supported by an API console, but only allows manual entry for all data needed for a transaction. For providers sending hundreds of daily requests, we recommend using APIs because you can automate the submission processes and get a better fit for your business needs.
Developer Portal – the home of Change Healthcare’s API documentation.
ConnectCenter – Change Healthcare’s portal for Medical Network transactions. It contains Change Healthcare’s Payer Lists, the Payer List Enrollments wizard, and other API customer resources.
Updated 7 months ago