Response Contents - Professional Claims
Metadata for troubleshooting
Change Healthcare Medical Network APIs support a significant troubleshooting feature called metadata. For more information, see Metadata for troubleshooting.
NOTE
API users need not enable this capability; it is automatic and has no effect on information in any medical transaction. If you encounter any issues with a transaction and need to work with Change Healthcare technical support, give the values provided in the
metaobject to the Change Healthcare representative.
Claim response information
The primary elements of a medical claims submission response consist of the aforementioned meta object, and a claimReference object. It contains a number of tracking values. You can expect to see results similar to the following:
```json
{
"status": "SUCCESS",
"controlNumber": "000000001",
"tradingPartnerServiceId": "9496",
"claimReference": {
"correlationId": "210322R999898~66684261175841",
"submitterId": "009998",
"customerClaimNumber": "000000001",
"patientControlNumber": "12345",
"timeOfResponse": "2021-03-22T19:34:08.85-05:00",
"claimType": "PRO",
"formatVersion": "5010",
"rhclaimNumber": "2108151508527"
},
"meta": {
"submitterId": "999898",
"senderId": "Xxxx.Xxxxxx",
"billerId": "009998",
"traceId": "900773a9-c0ba-6aa2-0f61-cfcc30a0200f",
"applicationMode": "pro"
},
"editStatus": "SUCCESS",
"payer": {
"payerName": "Unknown",
"payerID": "9496"
},
```
The first response you get back from the clearinghouse does not indicate whether the claim is being paid; it indicates that the clearinghouse has accepted the claim and is getting ready to forward it to the payer.
claimReference is the response's main object.
Key values of claims response
| Key Value | Description |
|---|---|
customerClaimNumber | An additional claim tracking number assigned by the Change Healthcare clearinghouse. |
submitterId | Describes the entity that submitted the claim. Value is in Loop 1000A, element NM109. |
patientControlNumber | Echoes the Patient controlNumber back from the original request. |
timeOfResponse | Date and time of the response from the clearinghouse. |
formatVersion | Describes the X12 EDI version to which the claim confirms. |
claimType | "PRO" for Professional. "INST" for Institutional. |
rhClaimNumber | Unique claim number to track the claim at the Change Healthcare clearinghouse. You can use this value to search for the claim in ConnectCenter and check for updates. |
Updated 3 months ago