Eligibility Sandbox API Values And Test Responses

Change Healthcare provides a testing environment called the Sandbox where you can familiarize yourself with our APIs without signing a contract and no further obligation. Contact a Change Healthcare representative at any time for more information.

NOTE: Your representative will provide you with a set of secure credentials that you use for interacting with Sandbox. If you contract with CHC for API usage, you use a separate Change Healthcare-issued credential pair for your production API work.

For Sandbox API testing, you can edit the request body and send it to the API engine to see what kinds of responses you'll get. The Sandbox provides a set of predefined values that you can apply to see how the API works with claim data. It uses simulated Medical Service ID and Personal Medical Information (PMI). For successful use of Sandbox APIs, you must use these "fake patient" and “fake provider” values for your testing. See the table in the Eligibility Sandbox Test Responses subsection for more information.

Avoid using real-world values in our Sandbox API endpoints! Doing so will produce errors.

We provide a list of Medical Service ID test values to use in Sandbox so you can get a variety of different responses. See the Eligibility Sandbox Test Responses document located in the Attachments tab.

The following JSON fields must use one of the following predefined values in Sandbox:

Field NameValues
memberId"0000000000", "0000000001", "0000000002", "1234567890", "0000000004", "0000000005", "0000000006","0000000007", "123456789"
firstName"johnone", "johntwo", "janeone", "janetwo"
lastName"doeone", "doetwo"
middleName"middleone", "middletwo"
gender"m", "u", "f"
dateOfBirth"18800102", "18800101", "18160421", "19800101", "19800102", "20000101", "20000102"
ssn"000000000", "555443333", "1111111111", "000000001", "891234567", "123456789"
groupNumber"0000000000", "1111111111","1234567891","0000000001", "0000000002", "0000000003", "0000000004", "0000000005"
address1"123 address1", "000 address1"
address2"apt 123", "apt 000", "123", "000"
city"city1", "city2"
state"wa", "tn"
postalCode"981010000", "372030000"
employerId"00000", "12345","00001","00002","000000000", "123456789","123456"
propertyCasualtyClaimNumber"00000", "12345","00001","00002"
patientControlNumber"00000", "12345","00001","00002"
priorAuthorizationNumber"00000", "12345","00001","00002"
referralNumber"00000", "12345","00001","00002"
repricedClaimNumber"00000", "12345","00001","00002"
investigationalDeviceExemptionNumber"00000", "12345","00001","00002"
claimNumber"00000", "12345","00001","00002"
name"johnone doeone", "johntwo doetwo", "janeone doeone", "janetwo doetwo", "submitter contact info"
phoneNumber"0000000000", "123456789", "0000000001", "0000000002"
faxNumber"0000000000", "123456789", "0000000001", "0000000002"
email"[email protected]", "[email protected]"
stateLicenseNumber"0000000", "0000001", "123456"
contractVersionIdentifier"111111", "222222", "123456"
patientControlNumber"00000", "12345","00001","00002"
priorAuthorizationNumber"00000", "12345","00001","00002"
referralNumber"00000", "12345","00001","00002"
claimControlNumber"00000", "12345","00001","00002"
cliaNumber"12D4567890", "00D0000001"
repricedClaimNumber"00000", "12345","00001","00002"
mammographyCertificationNumber"00000", "12345","00001","00002"
medicalRecordNumber"00000", "12345","00001","00002"
demoProjectIdentifier"00000", "12345","00001","00002"
carePlanOversightNumber"00000", "12345","00001","00002"
policyNumber"00000", "12345","00001","00002"
npi"1760854442", "1942788757"
organizationName"happy doctors group", "happy doctors grouppractice","extra healthy insurance", "regional ppo network"
NOTE: All fields must use a predefined value to have a successful response in the Sandbox.

Eligibility Sandbox Test Responses

For Eligibility API testing in the Sandbox, you can edit the request body and send it to the API engine to see what kinds of responses you'll get. You can use the following values as the tradingPartnerServiceId to change the responses you'll receive from your test request bodies:

Test using THIS tradingPartnerServiceIdDescription
00001This is a canned response that returns a single coverage plan. This will work for any payer.
00002This is a canned response that returns a badly formatted 271. This will work for any payer.
00003This is a canned response that returns a good 271 that contains maxed MSG01 field (AN..264) and EB03 repeating data element (99 repeats). This will work for any payer.
00004This is a canned response that returns AAA Not Eligible For Inquiries. This will work for any payer.
00005This is a canned response that contains non-printable characters which we need to make sure we can parse. This will work for any payer.
00006A system error from the Payer.  AAA segment in the 2000A Information Source Loop with AAA01 = Y, AAA03 = 42 and AAA04 = R.
00007This is a canned response that returns a single coverage plan with unused fields. This will work for any payer.
00008This is a canned response that returns a 271 that contains data in deprecated fields. It is used to test our parser's handling of data in these fields. This will work for any payer.
00009This returns a canned 271 response where the patient is a dependent.
000010Hospital Inquiry: A 270 request with provider id, subscriber ID, DOB, First Name, Date of Service and service type as input parameters.
000011Rehabilitation Inquiry:  A 270 request with provider id, subscriber ID, DOB, First Name, Last Name Date of Service and service type as input parameters.
000012Medical Care Inquiry: A 270 request with provider id, subscriber ID, Date of Service and service type as input parameters.
000013Rehabilitation Inquiry: A 270 request with provider id, Subscriber last name, first name, Date of Service and service type as input parameters.
000014Vision (Optometry) Inquiry: A 270 request with provider id, subscriber ID, SSN, DOB, Date of Service and service type as input parameters.
000015Home Health Care Inquiry:  A 270 request with provider id, subscriber ID, DOB, Date of Service and service type as input parameters.
000016Pharmacy Inquiry: A 270 request with provider id, subscriber ID, DOB, First Name, Last Name, Date of Service and service type as input parameters.
000017Medical Care Inquiry: A 270 request with provider id, subscriber ID, Date of Service and service type as input parameters.
000018Emergency Services Inquiry: A 270 request with Information Receiver, Subscriber ID, Subscriber Last Name, Date of Service and Service Type parameters as follows is given as input.
000019Rehabilitation Inquiry: A 270 request with provider id, subscriber SSN, DOB, Date of Service and service type as input parameters.
000020Rehabilitation Inquiry: A 270 request with provider id, subscriber ID, DOB, First Name, Date of Service and service type as input parameters.
000021Rehabilitation Inquiry: A 270 request with provider id, DOB, First Name, Last Name Date of Service and service type as input parameters.
000022Medical Care Inquiry: A 270 request with provider id, subscriber ID, Date of Service and service type as input parameters.
000023Health Benefit Plan Coverage Inquiry: A 270 request with provider id, subscriber ID, Last Name, First Name, Date of Service and service type as input parameters.
000024Health Benefit Plan Coverage Inquiry:  A 270 request with provider id, subscriber ID, First Name, Date of Service and service type as input parameters.
000025Rehabilitation Inquiry: A 270 request with provider id, subscriber ID, Last Name, Date of Service and service type as input parameters.
000026Hospital Inquiry: A 270 request with provider id, subscriber ID, DOB, First Name, service type and diagnosis code as input parameters.
000027Hospital Inquiry: A 270 request with provider id, subscriber ID, DOB, First Name, service type and provider code as input parameters.
000028Hospital Inquiry: A 270 request with provider id, subscriber ID, DOB, First Name, service type and provider information as input parameters.
000029Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Provider ID.
000030Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Patient Information.
000031Health Benefit Plan Coverage Inquiry: A 270 request with Inactive Coverage date as service date.
000032Health Benefit Plan Coverage Inquiry: A 270 request with Duplicate. Subscriber ID.
000033Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Provider ID
000034Rehabilitation Inquiry: A 270 request with Subscriber ID, Dependent first Name and service type code as input parameters.
000035Pharmacy Inquiry: A 270 request with Subscriber ID, Dependent first Name and service type as input parameters.
00036Sample response from Florida Medicaid.
000036Home Health Care Inquiry: A 270 request with Subscriber ID, Dependent DOB and service type as input parameters.
000037Psychiatric Inquiry: A 270 request with Subscriber ID, Dependent First Name and service type as input parameters.
000038Rehabilitation Inquiry: A 270 request with Subscriber ID, Dependent DOB, Dependent Last Name and service type as input parameters.
000039Different Deductible at 30 and other STC.
000040EB 1 with no benefits (Active Coverage) and EB I (Non Covered).
000041Test EB 6 (Inactive) and EB W (Other Source of Data).
000042EB R - other additional payer.
000043EB W response (Other source of Data).
000044High Out of pocket remaining but no deductible in response.
000045Low Deductible High Premium - many different copayments.
000046Low Deductible High Premium with no coinsurance.
000047Low Deductible High Premium.
000048Low Deductible with no copayment.
000049Multiple Services.
000050No Deductible, High Out of Pocket Remaining, only Copay and coinsurance.
000051No Deductible, only copay for 33,98, UC.
000052No Deductible, No copayment.
000053Plan with active coverage but no patient responsibility.
000054Response with AD time period 25.
000055Too many deductibles at service levels.
000056Uniquely formatted EB segment.
000067Sample use case from PAA.
000068Sample use case 2 from PAA.
000069Sample Use case for EB V (Cannot Process).
000070Sample Use case for EB U (Contact Following Entity for Eligibility or Benefit Information).
000074Sample Use case for Connecticut Medicaid.
000081Sample response from WellCare.
000082Sample response from Blue Cross Blue Shield Georgia.
000083Sample response from Humana.
ABHFLSample use case for Aetna Better Health of Florida.
ABHKYSample use case for Aetna Better Health of Kentucky.
ABHLASample use case for Aetna Better Health of Louisiana.
ABHMOSample use case for Aetna Better Health of Missouri.
AETNXSample response from AETNA.
BCCTCSample use case for Blue Cross Blue Shield Connecticut.
BCNJCSample response from BCBS of New Jersey (Horizon).
CIGNAExample of response from CIGNA for dependent.
CNTCRSample use case for Connecticare Inc.
COVONSample response from Coventry.
CTSample use case for Connecticut Medicaid.
DENTALThis is a canned response of benefits from Dental Payer.
HUMSample response from Humana.
ILMSASample use case for Aetna Better Health of Illinois.
ISCAMSample response from Medi-CAL Portal connection.
MEDXSample response from MEDEX.
MMSISample use case for Mayo.
TRICESample response from Tricare.
TXSample response from Texas Medicaid.
UHCSample response from United Healthcare.

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