Using Test Payers in the Sandbox

📘

NOTE

DO NOT perform load testing or production data testing in the sandbox environment. Please use the sandbox ONLY to view sample API responses to HTTP requests using our predefined values and to familiarize yourself with our APIs.
For load testing and production data testing, we recommend using our APIs in the production environment.

How to Use the Test Payers in the sandbox

You can use your API client to test all of our API response types in the sandbox. You do this using a separate Test Payer ID, that is unique for each response type. All IDs for API response types follow a specific naming pattern:

TEST<EP/PP><StatusCode>
  • EP: Electronic Payer (a payer (insurance company where the claim is going to) that supports electronic attachment submissions)
  • PP: Print/Fax Payer
  • The two-digit StatusCode (01, 02, ...), this is the status code identifying the response type for which the payer is configured, as in: TESTEP02

How to use the test payer accounts for each Attachments API response type?

  1. Submit an attachment using the /attachments/submission/v1/uploads endpoint. Use a Test payer ID for each response type.
  2. After the successful submission, the API returns the traceId in the response header.
  3. Send an API request for the summary/detail/attachments/status/v1/{traceId} endpoint using the traceId from step 2 or to the /attachments/status/v1/metadata endpoint using the transaction dates along with any filtering criteria you want to use.

The Attachments Status API returns a pre-defined sandbox status response that is configured for that payerId.

A Metadata search returns a list of matching transactions with their traceId and corresponding statuses. All trace IDs corresponding to a test payerId will return a test status message. If any trace ID values that do not belong to the payer list appear, the result returns the actual status from the database.

All notifications apply to payers accepting both Solicited and Unsolicited attachments unless noted otherwise.

StatusCode Responses

For the status messages and examples of the respective statusCode, see Status code and status messages.

Transaction Received by Change Healthcare Clearinghouse

TESTEP01 Test PayerId

If you use the sandbox with this test payerId, you will receive the message that the Change Healthcare clearinghouse has successfully received your submitted attachments transaction.

```json
[
    {
        "statusCode": "01",
        "statusMessage": "TRANSACTION_RECEIVED",
        "statusTimeStamp": "2021-08-19T18:27Z",
        "documents": [
            {
                "documentName": "rightarm.jpg",
                "controlNumber": "123456789"
            }
        ]
    }
]
```

Transaction accepted by Change Healthcare clearinghouse

TESTEP02 Test PayerId

If you use the sandbox with this test payerId, you will receive the message that the Change Healthcare clearinghouse has accepted your submitted attachments transaction.

```json
[
    {
        "statusCode": "02",
        "statusMessage": "ACCEPTED_BY_CHC",
        "statusTimeStamp": "2021-05-13 10:33",
        "documents": [
            {
                "documentName": "rightarm.jpg",
                "controlNumber": "51827660-012714"
            }
        ]
    }
]
```

Successful Reception of Attachment by Payer

TESTEP04 Test PayerId

If you use the sandbox with this test payerId, you will receive the notification when the clearinghouse delivers the attachment(s) to the payer. At this point, the Change Healthcare clearinghouse has forwarded the attachment to the payer.

```json
[
    {
        "statusCode": "04",
        "statusMessage": "DELIVERED_TO_PAYER",
        "statusTimeStamp": "2021-08-19T18:43Z",
        "documents": [
            {
                "documentName": "rightarm.jpg",
                "controlNumber": "123456789"
            }
        ]
    }
]
```

Acknowledgement of Attachment Reception by Payer

TESTEP05 Test PayerId

The payer sends acknowledgement of your attachment transmission through the Change Healthcare clearinghouse. It indicates that they received your transaction and will evaluate it for accuracy and usability. This does not indicate payer acceptance of the transaction.

```json
[
    {
        "statusCode": "05",
        "statusMessage": "ACKNOWLEDGED_BY_PAYER",
        "statusTimeStamp": "2021-08-20T13:22Z",
        "documents": [
            {
                "documentName": "rightarm.jpg",
                "controlNumber": "123456789"
            },
            {
                "documentName": "rightarm1.jpg",
                "controlNumber": "123456789"
            }
        ]
    }
]
```

Acceptance of Attachment by Payer

TESTEP06 Test PayerId

If you use the sandbox with this test payerId, you will receive the message indicating a successful attachment transaction.

```json
[
    {
        "statusCode": "06",
        "statusMessage": "ACCEPTED_BY_PAYER",
        "statusTimeStamp": "2021-08-20T13:36Z",
        "documents": [
            {
                "documentName": "rightarm.jpg",
                "controlNumber": "123456789"
            },
            {
                "documentName": "rightarm1.jpg",
                "controlNumber": "123456789"
            }
        ]
    }
]
```

Partial Acceptance of Multiple Attachments

📘

NOTE

The TESTEP10 Test PayerId is designed for the "Partially Accepted" use case. Use at least two attachments in the same sandbox API request to receive an accurate response for this use case.

This response occurs when the payer accepts one or more files while rejecting others in a transaction with multiple files. The rejectionInformation field may or may not be a part of the response in real-life transactions, and its data contents are up to the payer to provide. You can convert the file to the correct format and re-send it in a separate transaction. Ensure all documents conform to file format standards and also avoid sending files that exceed more than a few megabytes each. For example, modern cell phones can produce photos that are in excess of 6 to 8 megabytes; take measures to reduce their size before sending. Some diagnostics files, when sent in PDF format, may also exceed payer file size limits and need to be broken up into several smaller files.

TESTEP10 Test PayerId

```json
[
    {
        "statusCode": "10",
        "statusMessage": "PARTIALLY_ACCEPTED",
        "statusTimeStamp": "2021-08-20T13:25Z",
        "documents": [

  {
                "documentName": "rightarm1.jpg",
                "controlNumber": "123456789",
                "statusCode": "52",
                "statusMessage": "REJECTED_BY_PAYER",
                "statusTimeStamp": "2021-08-20T13:25Z",
            },

{
                "documentName": "rightarm.jpg",
                "controlNumber": "123456789",
                "statusCode": "06",
                "statusMessage": "ACCEPTED_BY_PAYER",
                "statusTimeStamp": "2021-08-20T13:25Z"
            }
        ]
    }
]
```

Rejection of attachment transaction by Change Healthcare clearinghouse

TESTEP51 Test PayerId

In this test case, the Change Healthcare clearinghouse is rejecting the transaction due to errors. The clearinghouse will reject attachments with the wrong format and will not convert any file in an incorrect format; the sender must fix the problem and re-send. See format types supported for more information. If information is missing from the request body, the Change Healthcare clearinghouse also may detect that and reject it for that reason.

```json
    "status": [
        {
            "statusCode": "51",
            "statusMessage": "REJECTED_BY_CHC",
            "statusTimeStamp": "2021-08-19T18:34Z",
            "documents": [
                {
                    "documentName": "rightarm.doc",
                    "controlNumber": "123456789"
                }
            ]
        }
    ]
}
```

The clearinghouse may contribute information for the rejectionInformation field. You may or may not receive helpful information here, so it is important to address any possible issues before sending the transaction to the clearinghouse through the API:

```json
    "rejectionInformation": "File type not supported"
```

Rejection of Attachment by Payer

TESTEP52 Test PayerId

In this test case, the payer rejects the attachment. Notification reaches the Change Healthcare clearinghouse who forwards the results back to the submitter. Payers may reject an attachment due to excessive file sizes. CHAMPUS is a good example. File size is the most frequent issue in this use case.

```json
    "status": [
        {
            "statusCode": "52",
            "statusMessage": "REJECTED_BY_PAYER",
            "statusTimeStamp": "2021-05-13 10:33",
            "documents": [
                {
                    "documentName": "rightarm.jpg",
                    "controlNumber": "51827660-012714"
                }
            ]
        }
    ]
}
```

The payer can optionally contribute information for the rejectionInformation field. You may or may not receive helpful information here, so it is important to address any possible issues before starting the transaction. The rejections do not apply when you are running these calls in the sandbox but they apply when you are running the API in the real world:

```json
    "rejectionInformation": "Attachment type not supported"
```

Rejection of Attachment Due to Request Validation Error

Successful Fax Transmission

TESTPP11 Test PayerId

You will receive a notification from the Change Healthcare clearinghouse once the fax transmission has reached the fax/print facility.

```json
        "status": [
            {
                "statusCode": "11",
                "statusMessage": "Attachment reached print/fax facility",
                "statusTimeStamp": "2021-08-19T18:51Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

Rejected/Failed Fax Transmissions

TESTPP12 Test PayerId

You might receive this message when Optum's contracted print/fax facility finds issues with the documents comprising the fax. It is possible that the request has an incorrect or missing fax number, or other errors that prevent the transmission from being sent. Ensure that all information in the request is accurate. The file attachments also may be too large.

```json
        "status": [
            {
                "statusCode": "12",
                "statusMessage": "Attachment rejected by print/fax facility",
                "statusTimeStamp": "2021-08-19T18:47Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

Successful Fax Transmission

TESTPP13 Test PayerId

You will receive a notification from the Change Healthcare clearinghouse once the fax transmission was completed.

```json
        "status": [
            {
                "statusCode": "13",
                "statusMessage": "Attachment faxed successfully",
                "statusTimeStamp": "2021-08-19T19:23Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

Failures to Fax Transmission

TESTPP14 Test PayerId

Attachments may fail to fax; you will receive a notification for each attempt until it goes through. when the fax/print facility receives your transaction contents, they will make three fax call attempts per day until successful transmission. Make sure to add the payerFaxNumber in your JSON request body before sending the request to the clearinghouse. The fax/print facility will not be able to handle sending the contents unless that information is your request and is correct. Ensure all other JSON request fields are correct in the request body before sending to clearinghouse.

```json
        "status": [
            {
                "statusCode": "14",
                "statusMessage": "Attachment failed to fax",
                "statusTimeStamp": "2021-08-19T19:21Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

Failed Mail Attachments

TESTPP15 Test PayerId

In rare instances, an attachment may not be mailed successfully. This is usually due to the payerAddress not being present in the JSON request to the clearinghouse, along with the correct tradingPartnerServiceId. The payerAddress is a JSON object with several mandatory fields in the request before attempting a mail-in submission. Please verify that all information is correct before sending. Not doing so can result in extensive delays for attachments and for claims processing.

```json
       "status": [
            {
                "statusCode": "15",
                "statusMessage": "Attachment failed to mail",
                "statusTimeStamp": "2021-08-19T19:24Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

Mailed Attachments

TESTPP16 Test PayerId

Optum's print/fax contractor also handles mailing of attachments to payers who accept only mailed hardcopies. This message indicates that the print/fax facility deems the attachments acceptable and the payerAddress information is correct; the attachments have been printed and mailed.

```json
        "status": [
            {
                "statusCode": "16",
                "statusMessage": "Attachment mailed to the payer",
                "statusTimeStamp": "2021-08-19T19:25Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

Tracking Information for Sent Transactions

TESTPP17 Test PayerId

You will receive tracking information when the API engine forwards your transaction. In both the following use cases, the transaction has reached the Change Healthcare clearinghouse.

```json
        "status": [
            {
                "statusCode": "17",
                "statusMessage": "Tracking #: 789123456",
                "statusTimeStamp": "2021-08-19T19:27Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]
```

TESTPP18 Test PayerId

```json
        "status": [
            {
                "statusCode": "18",
                "statusMessage": "Tracking #: 26101357, Status : SANTA CLARITA CA Phase 2b - Destination SCF Processing, Date : 01/22/2021",
                "statusTimeStamp": "2021-08-19T19:27Z",
                "documents": [
                    {
                        "documentName": "rightarm.jpg",
                        "controlNumber": "123456789"
                    }
                ]
            }
        ]
    }
]

```

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