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
meta
object 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 9 months ago