Glossary
ACN
Attachment Control Number.
AD
Admitting.
ANSI
American National Standards Institute.
API
Change Healthcare APIs for the next generation
of healthcare applications!
- Medical Network Eligibility V3 API: Provides complete patient profile and benefits information to support for delivering healthcare with more efficient and accurate reimbursement.
- Care Cost Estimator API: Out-Of-Pocket Estimation API service used for both Estimation and Accumulation of Benefits.
- Vaccination Data Intake Service API: Gives immunization providers and authorized users a simple way to add data to the Vaccination Record Service and issue certified vaccination credentials.
The Vaccination Data Intake API is a companion to the Vaccination Credential Sharing API and Vaccination Credential Verification API for secure sharing and verification of the vaccination record. - Vaccination Credential Sharing and Verification APIs: Are Vaccination Credential Initiative, and allow authorized client applications to request and verify immunization credentials in the form of 'Smart Health Cards' from the Change Healthcare Vaccination Record solution.
- Professional Claims API and the Institutional Claims API:
- Allow healthcare providers and institutions to submit healthcare claims for a service or encounter.
- Claims Status API: Used by the submitter of a medical claim to determine the status of any previously submitted Institutional or Professional claim.
BI
Billing
Bundled Cost
A bundled cost is the price that a provider charges for a given service.
CCE
Care Cost Estimator.
CCN
Claim Control Number.
CI
Commercial Insurance.
CMS
Centers for Medicare and Medicaid.
CPID
Claim Payer Identification (for claims process only).
Change Healthcare Payer List (also internally known as Legacy Change, Emdeon, or Ark)
For our Submitters who are given a 9-digit submitter ID, and typically do not utilize APIs to submit their transactions. If you have a 6-digit submitter ID, you will want to use the below mentioned ConnectCenter payer ID.
ClaimInformation
A key block of medical coding information that defines the actual procedures and services rendered for the medical encounter. It contains other JSON blocks including the serviceLines objects that contain the professionalService line item charges and diagnosis information.
ClaimReference
Contains important values, such as the payerId, customerClaimNumber, the claimType, and other values that mostly will be managed programmatically.
CLIA
Clinical Laboratory Improvement Amendment.
COB
Coordination of Benefits.
ConnectCenter (aka Legacy Relay Health (LRH) Payer List
A portal for our customers who are utilizing our Clearance or Assurance solutions. When you log into ConnectCenter it does show all payer lists so that may be what you are looking for. If you are using our APIs for Claims and Eligibility you will want to use the ConnectCenter payer list.
ControlNumber
A single arbitrary value that the requestor defines in the initial Eligibility API transaction request, perhaps by a random number generator. All parties to the Eligibility transaction refer to this number to ensure accurate responses and completion of the exchange.
ControlNumbers must be defined as a nine-digit unsigned numeric value.
CSA
Customer service announcements.
DCN
Document Control Number.
Dependent
Dependent of the policy holder (information about the insurance policy holder's dependent who received the medical services.
DMERC
Durable Medical Equipment Regional Carrier Certificate.
DRG
Diagnosis Related Group.
DMG
Demographic information.
DOB
Date-of-Birth.
DOS
Date-of-Service: date of provider service to the subscriber.
EDI
Electronic data interchange.
ERA
Electronic Remittance Advice.
EOB
Explanation of Benefits.
ESRD
End Stage Renal Disease.
ETIN
Electronic Transmitter Identification Number.
HCI
Health Care Information.
G
HCPCS
Healthcare Common Procedure Coding System: defines reference codes for items and services provided in the delivery of healthcare.
HIPAA
Health Insurance Portability and Accountability Act.
Healthcheck
The `/healthcheck` endpoint verifies that the operating status of the Change Healthcare APIs is optimal and the APIs are running and accessible.
- status: "OK" for successful health check
ICN
Internal Control Number.
InNetworkIndicator Values
N (Out of Network), U(Unknown), W (Not Applicable), Y (In Network).
K
L
M
NAIC
National Association of Insurance Commissioners.
NCCI
National Correct Coding Initiative.
NPI
National Provider ID number for the submitting provider.
NUBC
National Uniform Billing Committee.
Pagination
Works with the query parameters size and page. Its maximum size is 1000. Page numbering starts at page 0.
ParCode
An access code required to view any additional information about payers, such as the parStatus in the Payer Finder user interface (UI) and API. Contact support for an access code.
ParStatus
An indication of whether or not a provider agrees to participate in the Medicare program and agrees to always accept the Medicare assignment for services rendered to Medicare beneficiaries.
Payer
Insurance company where the claim is going to.
Payer ID
Unique ID number that is assigned to an insurance company for the purpose of transmitting provider claims electronically. It can be found on the back of the insurance card.
PHI
Personal health information.
PMI
Personal medical information.
Providers
The providers involved with the medical claim.
QMB
Qualified medicare beneficiary.
Realtime Payer ID
Used by Eligibility or Claims status.
ReassociationKey
A tracking number associated with the eligibility transaction so that we can look up the transaction being sent.
Receiver
Payer.
Required
The Required field indicates mandatory information.
REST API
Revenue Performance Advisor (known internally as RPA or Capario) Payer List
Another product that has a specific payer list for users of that product. Change Healthcare Attachment is a payer list for customers who are sending attachments through Change Healthcare.
Rural FQHC
Rural Health Clinics and Federally Qualified Health Centers.
SBC
Summary of benefits and coverage.
serviceLines and serviceDate
serviceLines is an array of one or more medical services, procedures, or products for the encounter each of which, is specified as a serviceDate record in the array.
serviceTypeCode
Here is a complete list of service codes. Service Type Code-30 is most commonly used and provides general benefit information in the response. Depending on your need for specific eligibility information, the service type code might change.
Situational
Specific information may be you can included or omitted depending on the individual encounter.
Subscriber
Medical insurance policy holder; includes the patient's insurance member ID and insurance policyNumber.
SDK
A Software Dev Kit lets developers test applications before deploying on the production server.
Submitter
Provider submitting the claim; identification of the provider, including information, such as the organizationName.
Submitter ID
The submitter is your account number with Change Healthcare used to identify transactions routing to and from specific customers. A submitter ID is assigned to any entity submitting healthcare transactions to a payer.
Token
A hashed alphanumeric representation of sensitive data, such as a authorization token.
TraceID
The `traceId` is a unique 128-bit UUID value (as an example, `3ba21288-3f65-11eb-a512-6ab12069ade5`) that Change Healthcare returns to the submitter as an acknowledgement when they receive every new attachments transaction. A traceId can also be retrieved by calling the metadata endpoint.
TradingPartnersServiceID
This is the Payer ID (a number you will find on your insurance card). This is required to request benefit information from an insurance carrier. This will vary based on the payer you want to connect to. Here is a list of test Trading Partner Service ID.
UMO
Utilization Management Organization.
VCI
Vaccination Credential Initiative, a cross-industry consortium that includes Change Healthcare.
For an alphabetical list of topics, see Quick Reference
Updated 2 months ago
Attachment Control Number.
AD
Admitting.
ANSI
American National Standards Institute.
API
Change Healthcare APIs for the next generation
of healthcare applications!
- Medical Network Eligibility V3 API: Provides complete patient profile and benefits information to support for delivering healthcare with more efficient and accurate reimbursement.
- Care Cost Estimator API: Out-Of-Pocket Estimation API service used for both Estimation and Accumulation of Benefits.
- Vaccination Data Intake Service API: Gives immunization providers and authorized users a simple way to add data to the Vaccination Record Service and issue certified vaccination credentials.
The Vaccination Data Intake API is a companion to the Vaccination Credential Sharing API and Vaccination Credential Verification API for secure sharing and verification of the vaccination record. - Vaccination Credential Sharing and Verification APIs: Are Vaccination Credential Initiative, and allow authorized client applications to request and verify immunization credentials in the form of 'Smart Health Cards' from the Change Healthcare Vaccination Record solution.
- Professional Claims API and the Institutional Claims API:
- Allow healthcare providers and institutions to submit healthcare claims for a service or encounter.
- Claims Status API: Used by the submitter of a medical claim to determine the status of any previously submitted Institutional or Professional claim.
BI
Billing
Bundled Cost
A bundled cost is the price that a provider charges for a given service.
CCE
Care Cost Estimator.
CCN
Claim Control Number.
CI
Commercial Insurance.
CMS
Centers for Medicare and Medicaid.
CPID
Claim Payer Identification (for claims process only).
Change Healthcare Payer List (also internally known as Legacy Change, Emdeon, or Ark)
For our Submitters who are given a 9-digit submitter ID, and typically do not utilize APIs to submit their transactions. If you have a 6-digit submitter ID, you will want to use the below mentioned ConnectCenter payer ID.
ClaimInformation
A key block of medical coding information that defines the actual procedures and services rendered for the medical encounter. It contains other JSON blocks including the serviceLines objects that contain the professionalService line item charges and diagnosis information.
ClaimReference
Contains important values, such as the payerId, customerClaimNumber, the claimType, and other values that mostly will be managed programmatically.
CLIA
Clinical Laboratory Improvement Amendment.
COB
Coordination of Benefits.
ConnectCenter (aka Legacy Relay Health (LRH) Payer List
A portal for our customers who are utilizing our Clearance or Assurance solutions. When you log into ConnectCenter it does show all payer lists so that may be what you are looking for. If you are using our APIs for Claims and Eligibility you will want to use the ConnectCenter payer list.
ControlNumber
A single arbitrary value that the requestor defines in the initial Eligibility API transaction request, perhaps by a random number generator. All parties to the Eligibility transaction refer to this number to ensure accurate responses and completion of the exchange.
ControlNumbers must be defined as a nine-digit unsigned numeric value.
CSA
Customer service announcements.
DCN
Document Control Number.
Dependent
Dependent of the policy holder (information about the insurance policy holder's dependent who received the medical services.
DMERC
Durable Medical Equipment Regional Carrier Certificate.
DRG
Diagnosis Related Group.
DMG
Demographic information.
DOB
Date-of-Birth.
DOS
Date-of-Service: date of provider service to the subscriber.
EDI
Electronic data interchange.
ERA
Electronic Remittance Advice.
EOB
Explanation of Benefits.
ESRD
End Stage Renal Disease.
ETIN
Electronic Transmitter Identification Number.
HCI
Health Care Information.
G
HCPCS
Healthcare Common Procedure Coding System: defines reference codes for items and services provided in the delivery of healthcare.
HIPAA
Health Insurance Portability and Accountability Act.
Healthcheck
The `/healthcheck` endpoint verifies that the operating status of the Change Healthcare APIs is optimal and the APIs are running and accessible.
- status: "OK" for successful health check
ICN
Internal Control Number.
InNetworkIndicator Values
N (Out of Network), U(Unknown), W (Not Applicable), Y (In Network).
K
L
M
NAIC
National Association of Insurance Commissioners.
NCCI
National Correct Coding Initiative.
NPI
National Provider ID number for the submitting provider.
NUBC
National Uniform Billing Committee.
Pagination
Works with the query parameters size and page. Its maximum size is 1000. Page numbering starts at page 0.
ParCode
An access code required to view any additional information about payers, such as the parStatus in the Payer Finder user interface (UI) and API. Contact support for an access code.
ParStatus
An indication of whether or not a provider agrees to participate in the Medicare program and agrees to always accept the Medicare assignment for services rendered to Medicare beneficiaries.
Payer
Insurance company where the claim is going to.
Payer ID
Unique ID number that is assigned to an insurance company for the purpose of transmitting provider claims electronically. It can be found on the back of the insurance card.
PHI
Personal health information.
PMI
Personal medical information.
Providers
The providers involved with the medical claim.
QMB
Qualified medicare beneficiary.
Realtime Payer ID
Used by Eligibility or Claims status.
ReassociationKey
A tracking number associated with the eligibility transaction so that we can look up the transaction being sent.
Receiver
Payer.
Required
The Required field indicates mandatory information.
REST API
Revenue Performance Advisor (known internally as RPA or Capario) Payer List
Another product that has a specific payer list for users of that product. Change Healthcare Attachment is a payer list for customers who are sending attachments through Change Healthcare.
Rural FQHC
Rural Health Clinics and Federally Qualified Health Centers.
SBC
Summary of benefits and coverage.
serviceLines and serviceDate
serviceLines is an array of one or more medical services, procedures, or products for the encounter each of which, is specified as a serviceDate record in the array.
serviceTypeCode
Here is a complete list of service codes. Service Type Code-30 is most commonly used and provides general benefit information in the response. Depending on your need for specific eligibility information, the service type code might change.
Situational
Specific information may be you can included or omitted depending on the individual encounter.
Subscriber
Medical insurance policy holder; includes the patient's insurance member ID and insurance policyNumber.
SDK
A Software Dev Kit lets developers test applications before deploying on the production server.
Submitter
Provider submitting the claim; identification of the provider, including information, such as the organizationName.
Submitter ID
The submitter is your account number with Change Healthcare used to identify transactions routing to and from specific customers. A submitter ID is assigned to any entity submitting healthcare transactions to a payer.
Token
A hashed alphanumeric representation of sensitive data, such as a authorization token.
TraceID
The `traceId` is a unique 128-bit UUID value (as an example, `3ba21288-3f65-11eb-a512-6ab12069ade5`) that Change Healthcare returns to the submitter as an acknowledgement when they receive every new attachments transaction. A traceId can also be retrieved by calling the metadata endpoint.
TradingPartnersServiceID
This is the Payer ID (a number you will find on your insurance card). This is required to request benefit information from an insurance carrier. This will vary based on the payer you want to connect to. Here is a list of test Trading Partner Service ID.
UMO
Utilization Management Organization.
VCI
Vaccination Credential Initiative, a cross-industry consortium that includes Change Healthcare.
For an alphabetical list of topics, see Quick Reference
Updated 2 months ago
Admitting.
ANSI
American National Standards Institute.
API
Change Healthcare APIs for the next generation
of healthcare applications!
- Medical Network Eligibility V3 API: Provides complete patient profile and benefits information to support for delivering healthcare with more efficient and accurate reimbursement.
- Care Cost Estimator API: Out-Of-Pocket Estimation API service used for both Estimation and Accumulation of Benefits.
- Vaccination Data Intake Service API: Gives immunization providers and authorized users a simple way to add data to the Vaccination Record Service and issue certified vaccination credentials.
The Vaccination Data Intake API is a companion to the Vaccination Credential Sharing API and Vaccination Credential Verification API for secure sharing and verification of the vaccination record. - Vaccination Credential Sharing and Verification APIs: Are Vaccination Credential Initiative, and allow authorized client applications to request and verify immunization credentials in the form of 'Smart Health Cards' from the Change Healthcare Vaccination Record solution.
- Professional Claims API and the Institutional Claims API:
- Allow healthcare providers and institutions to submit healthcare claims for a service or encounter.
- Claims Status API: Used by the submitter of a medical claim to determine the status of any previously submitted Institutional or Professional claim.
BI
Billing
Bundled Cost
A bundled cost is the price that a provider charges for a given service.
CCE
Care Cost Estimator.
CCN
Claim Control Number.
CI
Commercial Insurance.
CMS
Centers for Medicare and Medicaid.
CPID
Claim Payer Identification (for claims process only).
Change Healthcare Payer List (also internally known as Legacy Change, Emdeon, or Ark)
For our Submitters who are given a 9-digit submitter ID, and typically do not utilize APIs to submit their transactions. If you have a 6-digit submitter ID, you will want to use the below mentioned ConnectCenter payer ID.
ClaimInformation
A key block of medical coding information that defines the actual procedures and services rendered for the medical encounter. It contains other JSON blocks including the serviceLines objects that contain the professionalService line item charges and diagnosis information.
ClaimReference
Contains important values, such as the payerId, customerClaimNumber, the claimType, and other values that mostly will be managed programmatically.
CLIA
Clinical Laboratory Improvement Amendment.
COB
Coordination of Benefits.
ConnectCenter (aka Legacy Relay Health (LRH) Payer List
A portal for our customers who are utilizing our Clearance or Assurance solutions. When you log into ConnectCenter it does show all payer lists so that may be what you are looking for. If you are using our APIs for Claims and Eligibility you will want to use the ConnectCenter payer list.
ControlNumber
A single arbitrary value that the requestor defines in the initial Eligibility API transaction request, perhaps by a random number generator. All parties to the Eligibility transaction refer to this number to ensure accurate responses and completion of the exchange.
ControlNumbers must be defined as a nine-digit unsigned numeric value.
CSA
Customer service announcements.
DCN
Document Control Number.
Dependent
Dependent of the policy holder (information about the insurance policy holder's dependent who received the medical services.
DMERC
Durable Medical Equipment Regional Carrier Certificate.
DRG
Diagnosis Related Group.
DMG
Demographic information.
DOB
Date-of-Birth.
DOS
Date-of-Service: date of provider service to the subscriber.
EDI
Electronic data interchange.
ERA
Electronic Remittance Advice.
EOB
Explanation of Benefits.
ESRD
End Stage Renal Disease.
ETIN
Electronic Transmitter Identification Number.
HCI
Health Care Information.
G
HCPCS
Healthcare Common Procedure Coding System: defines reference codes for items and services provided in the delivery of healthcare.
HIPAA
Health Insurance Portability and Accountability Act.
Healthcheck
The `/healthcheck` endpoint verifies that the operating status of the Change Healthcare APIs is optimal and the APIs are running and accessible.
- status: "OK" for successful health check
ICN
Internal Control Number.
InNetworkIndicator Values
N (Out of Network), U(Unknown), W (Not Applicable), Y (In Network).
K
L
M
NAIC
National Association of Insurance Commissioners.
NCCI
National Correct Coding Initiative.
NPI
National Provider ID number for the submitting provider.
NUBC
National Uniform Billing Committee.
Pagination
Works with the query parameters size and page. Its maximum size is 1000. Page numbering starts at page 0.
ParCode
An access code required to view any additional information about payers, such as the parStatus in the Payer Finder user interface (UI) and API. Contact support for an access code.
ParStatus
An indication of whether or not a provider agrees to participate in the Medicare program and agrees to always accept the Medicare assignment for services rendered to Medicare beneficiaries.
Payer
Insurance company where the claim is going to.
Payer ID
Unique ID number that is assigned to an insurance company for the purpose of transmitting provider claims electronically. It can be found on the back of the insurance card.
PHI
Personal health information.
PMI
Personal medical information.
Providers
The providers involved with the medical claim.
QMB
Qualified medicare beneficiary.
Realtime Payer ID
Used by Eligibility or Claims status.
ReassociationKey
A tracking number associated with the eligibility transaction so that we can look up the transaction being sent.
Receiver
Payer.
Required
The Required field indicates mandatory information.
REST API
Revenue Performance Advisor (known internally as RPA or Capario) Payer List
Another product that has a specific payer list for users of that product. Change Healthcare Attachment is a payer list for customers who are sending attachments through Change Healthcare.
Rural FQHC
Rural Health Clinics and Federally Qualified Health Centers.
SBC
Summary of benefits and coverage.
serviceLines and serviceDate
serviceLines is an array of one or more medical services, procedures, or products for the encounter each of which, is specified as a serviceDate record in the array.
serviceTypeCode
Here is a complete list of service codes. Service Type Code-30 is most commonly used and provides general benefit information in the response. Depending on your need for specific eligibility information, the service type code might change.
Situational
Specific information may be you can included or omitted depending on the individual encounter.
Subscriber
Medical insurance policy holder; includes the patient's insurance member ID and insurance policyNumber.
SDK
A Software Dev Kit lets developers test applications before deploying on the production server.
Submitter
Provider submitting the claim; identification of the provider, including information, such as the organizationName.
Submitter ID
The submitter is your account number with Change Healthcare used to identify transactions routing to and from specific customers. A submitter ID is assigned to any entity submitting healthcare transactions to a payer.
Token
A hashed alphanumeric representation of sensitive data, such as a authorization token.
TraceID
The `traceId` is a unique 128-bit UUID value (as an example, `3ba21288-3f65-11eb-a512-6ab12069ade5`) that Change Healthcare returns to the submitter as an acknowledgement when they receive every new attachments transaction. A traceId can also be retrieved by calling the metadata endpoint.
TradingPartnersServiceID
This is the Payer ID (a number you will find on your insurance card). This is required to request benefit information from an insurance carrier. This will vary based on the payer you want to connect to. Here is a list of test Trading Partner Service ID.
UMO
Utilization Management Organization.
VCI
Vaccination Credential Initiative, a cross-industry consortium that includes Change Healthcare.
For an alphabetical list of topics, see Quick Reference
Updated 2 months ago
American National Standards Institute.
API
Change Healthcare APIs for the next generation
of healthcare applications!
- Medical Network Eligibility V3 API: Provides complete patient profile and benefits information to support for delivering healthcare with more efficient and accurate reimbursement.
- Care Cost Estimator API: Out-Of-Pocket Estimation API service used for both Estimation and Accumulation of Benefits.
- Vaccination Data Intake Service API: Gives immunization providers and authorized users a simple way to add data to the Vaccination Record Service and issue certified vaccination credentials.
The Vaccination Data Intake API is a companion to the Vaccination Credential Sharing API and Vaccination Credential Verification API for secure sharing and verification of the vaccination record. - Vaccination Credential Sharing and Verification APIs: Are Vaccination Credential Initiative, and allow authorized client applications to request and verify immunization credentials in the form of 'Smart Health Cards' from the Change Healthcare Vaccination Record solution.
- Professional Claims API and the Institutional Claims API:
- Allow healthcare providers and institutions to submit healthcare claims for a service or encounter.
- Claims Status API: Used by the submitter of a medical claim to determine the status of any previously submitted Institutional or Professional claim.
BI
Billing
Bundled Cost
A bundled cost is the price that a provider charges for a given service.
CCE
Care Cost Estimator.
CCN
Claim Control Number.
CI
Commercial Insurance.
CMS
Centers for Medicare and Medicaid.
CPID
Claim Payer Identification (for claims process only).
Change Healthcare Payer List (also internally known as Legacy Change, Emdeon, or Ark)
For our Submitters who are given a 9-digit submitter ID, and typically do not utilize APIs to submit their transactions. If you have a 6-digit submitter ID, you will want to use the below mentioned ConnectCenter payer ID.
ClaimInformation
A key block of medical coding information that defines the actual procedures and services rendered for the medical encounter. It contains other JSON blocks including the serviceLines objects that contain the professionalService line item charges and diagnosis information.
ClaimReference
Contains important values, such as the payerId, customerClaimNumber, the claimType, and other values that mostly will be managed programmatically.
CLIA
Clinical Laboratory Improvement Amendment.
COB
Coordination of Benefits.
ConnectCenter (aka Legacy Relay Health (LRH) Payer List
A portal for our customers who are utilizing our Clearance or Assurance solutions. When you log into ConnectCenter it does show all payer lists so that may be what you are looking for. If you are using our APIs for Claims and Eligibility you will want to use the ConnectCenter payer list.
ControlNumber
A single arbitrary value that the requestor defines in the initial Eligibility API transaction request, perhaps by a random number generator. All parties to the Eligibility transaction refer to this number to ensure accurate responses and completion of the exchange.
ControlNumbers must be defined as a nine-digit unsigned numeric value.
CSA
Customer service announcements.
DCN
Document Control Number.
Dependent
Dependent of the policy holder (information about the insurance policy holder's dependent who received the medical services.
DMERC
Durable Medical Equipment Regional Carrier Certificate.
DRG
Diagnosis Related Group.
DMG
Demographic information.
DOB
Date-of-Birth.
DOS
Date-of-Service: date of provider service to the subscriber.
EDI
Electronic data interchange.
ERA
Electronic Remittance Advice.
EOB
Explanation of Benefits.
ESRD
End Stage Renal Disease.
ETIN
Electronic Transmitter Identification Number.
HCI
Health Care Information.
G
HCPCS
Healthcare Common Procedure Coding System: defines reference codes for items and services provided in the delivery of healthcare.
HIPAA
Health Insurance Portability and Accountability Act.
Healthcheck
The `/healthcheck` endpoint verifies that the operating status of the Change Healthcare APIs is optimal and the APIs are running and accessible.
- status: "OK" for successful health check
ICN
Internal Control Number.
InNetworkIndicator Values
N (Out of Network), U(Unknown), W (Not Applicable), Y (In Network).
K
L
M
NAIC
National Association of Insurance Commissioners.
NCCI
National Correct Coding Initiative.
NPI
National Provider ID number for the submitting provider.
NUBC
National Uniform Billing Committee.
Pagination
Works with the query parameters size and page. Its maximum size is 1000. Page numbering starts at page 0.
ParCode
An access code required to view any additional information about payers, such as the parStatus in the Payer Finder user interface (UI) and API. Contact support for an access code.
ParStatus
An indication of whether or not a provider agrees to participate in the Medicare program and agrees to always accept the Medicare assignment for services rendered to Medicare beneficiaries.
Payer
Insurance company where the claim is going to.
Payer ID
Unique ID number that is assigned to an insurance company for the purpose of transmitting provider claims electronically. It can be found on the back of the insurance card.
PHI
Personal health information.
PMI
Personal medical information.
Providers
The providers involved with the medical claim.
QMB
Qualified medicare beneficiary.
Realtime Payer ID
Used by Eligibility or Claims status.
ReassociationKey
A tracking number associated with the eligibility transaction so that we can look up the transaction being sent.
Receiver
Payer.
Required
The Required field indicates mandatory information.
REST API
Revenue Performance Advisor (known internally as RPA or Capario) Payer List
Another product that has a specific payer list for users of that product. Change Healthcare Attachment is a payer list for customers who are sending attachments through Change Healthcare.
Rural FQHC
Rural Health Clinics and Federally Qualified Health Centers.
SBC
Summary of benefits and coverage.
serviceLines and serviceDate
serviceLines is an array of one or more medical services, procedures, or products for the encounter each of which, is specified as a serviceDate record in the array.
serviceTypeCode
Here is a complete list of service codes. Service Type Code-30 is most commonly used and provides general benefit information in the response. Depending on your need for specific eligibility information, the service type code might change.
Situational
Specific information may be you can included or omitted depending on the individual encounter.
Subscriber
Medical insurance policy holder; includes the patient's insurance member ID and insurance policyNumber.
SDK
A Software Dev Kit lets developers test applications before deploying on the production server.
Submitter
Provider submitting the claim; identification of the provider, including information, such as the organizationName.
Submitter ID
The submitter is your account number with Change Healthcare used to identify transactions routing to and from specific customers. A submitter ID is assigned to any entity submitting healthcare transactions to a payer.
Token
A hashed alphanumeric representation of sensitive data, such as a authorization token.
TraceID
The `traceId` is a unique 128-bit UUID value (as an example, `3ba21288-3f65-11eb-a512-6ab12069ade5`) that Change Healthcare returns to the submitter as an acknowledgement when they receive every new attachments transaction. A traceId can also be retrieved by calling the metadata endpoint.
TradingPartnersServiceID
This is the Payer ID (a number you will find on your insurance card). This is required to request benefit information from an insurance carrier. This will vary based on the payer you want to connect to. Here is a list of test Trading Partner Service ID.
UMO
Utilization Management Organization.
VCI
Vaccination Credential Initiative, a cross-industry consortium that includes Change Healthcare.
For an alphabetical list of topics, see Quick Reference
Updated 2 months ago
Change Healthcare APIs for the next generation of healthcare applications!
- Medical Network Eligibility V3 API: Provides complete patient profile and benefits information to support for delivering healthcare with more efficient and accurate reimbursement.
- Care Cost Estimator API: Out-Of-Pocket Estimation API service used for both Estimation and Accumulation of Benefits.
- Vaccination Data Intake Service API: Gives immunization providers and authorized users a simple way to add data to the Vaccination Record Service and issue certified vaccination credentials.
The Vaccination Data Intake API is a companion to the Vaccination Credential Sharing API and Vaccination Credential Verification API for secure sharing and verification of the vaccination record. - Vaccination Credential Sharing and Verification APIs: Are Vaccination Credential Initiative, and allow authorized client applications to request and verify immunization credentials in the form of 'Smart Health Cards' from the Change Healthcare Vaccination Record solution.
- Professional Claims API and the Institutional Claims API:
- Allow healthcare providers and institutions to submit healthcare claims for a service or encounter.
- Claims Status API: Used by the submitter of a medical claim to determine the status of any previously submitted Institutional or Professional claim.
BI
Billing
Bundled Cost
A bundled cost is the price that a provider charges for a given service.
CCE
Care Cost Estimator.
CCN
Claim Control Number.
CI
Commercial Insurance.
CMS
Centers for Medicare and Medicaid.
CPID
Claim Payer Identification (for claims process only).
Change Healthcare Payer List (also internally known as Legacy Change, Emdeon, or Ark)
For our Submitters who are given a 9-digit submitter ID, and typically do not utilize APIs to submit their transactions. If you have a 6-digit submitter ID, you will want to use the below mentioned ConnectCenter payer ID.
ClaimInformation
A key block of medical coding information that defines the actual procedures and services rendered for the medical encounter. It contains other JSON blocks including the serviceLines objects that contain the professionalService line item charges and diagnosis information.
ClaimReference
Contains important values, such as the payerId, customerClaimNumber, the claimType, and other values that mostly will be managed programmatically.
CLIA
Clinical Laboratory Improvement Amendment.
COB
Coordination of Benefits.
ConnectCenter (aka Legacy Relay Health (LRH) Payer List
A portal for our customers who are utilizing our Clearance or Assurance solutions. When you log into ConnectCenter it does show all payer lists so that may be what you are looking for. If you are using our APIs for Claims and Eligibility you will want to use the ConnectCenter payer list.
ControlNumber
A single arbitrary value that the requestor defines in the initial Eligibility API transaction request, perhaps by a random number generator. All parties to the Eligibility transaction refer to this number to ensure accurate responses and completion of the exchange. ControlNumbers must be defined as a nine-digit unsigned numeric value.
CSA
Customer service announcements.
DCN
Document Control Number.
Dependent
Dependent of the policy holder (information about the insurance policy holder's dependent who received the medical services.
DMERC
Durable Medical Equipment Regional Carrier Certificate.
DRG
Diagnosis Related Group.
DMG
Demographic information.
DOB
Date-of-Birth.
DOS
Date-of-Service: date of provider service to the subscriber.
EDI
Electronic data interchange.
ERA
Electronic Remittance Advice.
EOB
Explanation of Benefits.
ESRD
End Stage Renal Disease.
ETIN
Electronic Transmitter Identification Number.
HCI
Health Care Information.
G
HCPCS
Healthcare Common Procedure Coding System: defines reference codes for items and services provided in the delivery of healthcare.
HIPAA
Health Insurance Portability and Accountability Act.
Healthcheck
The `/healthcheck` endpoint verifies that the operating status of the Change Healthcare APIs is optimal and the APIs are running and accessible.
- status: "OK" for successful health check
ICN
Internal Control Number.
InNetworkIndicator Values
N (Out of Network), U(Unknown), W (Not Applicable), Y (In Network).
K
L
M
NAIC
National Association of Insurance Commissioners.
NCCI
National Correct Coding Initiative.
NPI
National Provider ID number for the submitting provider.
NUBC
National Uniform Billing Committee.
Pagination
Works with the query parameters size and page. Its maximum size is 1000. Page numbering starts at page 0.
ParCode
An access code required to view any additional information about payers, such as the parStatus in the Payer Finder user interface (UI) and API. Contact support for an access code.
ParStatus
An indication of whether or not a provider agrees to participate in the Medicare program and agrees to always accept the Medicare assignment for services rendered to Medicare beneficiaries.
Payer
Insurance company where the claim is going to.
Payer ID
Unique ID number that is assigned to an insurance company for the purpose of transmitting provider claims electronically. It can be found on the back of the insurance card.
PHI
Personal health information.
PMI
Personal medical information.
Providers
The providers involved with the medical claim.
QMB
Qualified medicare beneficiary.
Realtime Payer ID
Used by Eligibility or Claims status.
ReassociationKey
A tracking number associated with the eligibility transaction so that we can look up the transaction being sent.
Receiver
Payer.
Required
The Required field indicates mandatory information.
REST API
Revenue Performance Advisor (known internally as RPA or Capario) Payer List
Another product that has a specific payer list for users of that product. Change Healthcare Attachment is a payer list for customers who are sending attachments through Change Healthcare.
Rural FQHC
Rural Health Clinics and Federally Qualified Health Centers.
SBC
Summary of benefits and coverage.
serviceLines and serviceDate
serviceLines is an array of one or more medical services, procedures, or products for the encounter each of which, is specified as a serviceDate record in the array.
serviceTypeCode
Here is a complete list of service codes. Service Type Code-30 is most commonly used and provides general benefit information in the response. Depending on your need for specific eligibility information, the service type code might change.
Situational
Specific information may be you can included or omitted depending on the individual encounter.
Subscriber
Medical insurance policy holder; includes the patient's insurance member ID and insurance policyNumber.
SDK
A Software Dev Kit lets developers test applications before deploying on the production server.
Submitter
Provider submitting the claim; identification of the provider, including information, such as the organizationName.
Submitter ID
The submitter is your account number with Change Healthcare used to identify transactions routing to and from specific customers. A submitter ID is assigned to any entity submitting healthcare transactions to a payer.
Token
A hashed alphanumeric representation of sensitive data, such as a authorization token.
TraceID
The `traceId` is a unique 128-bit UUID value (as an example, `3ba21288-3f65-11eb-a512-6ab12069ade5`) that Change Healthcare returns to the submitter as an acknowledgement when they receive every new attachments transaction. A traceId can also be retrieved by calling the metadata endpoint.
TradingPartnersServiceID
This is the Payer ID (a number you will find on your insurance card). This is required to request benefit information from an insurance carrier. This will vary based on the payer you want to connect to. Here is a list of test Trading Partner Service ID.
UMO
Utilization Management Organization.
VCI
Vaccination Credential Initiative, a cross-industry consortium that includes Change Healthcare.
For an alphabetical list of topics, see Quick Reference
Updated 2 months ago