Eligibility and Claims
Determine financial eligibility and coverage for care
Claim Status
claim status 270-271
Eligibility
Real-time healthcare eligibility and benefits verification. Confirm member coverage, copay, deductible, and out-of-pocket balances before service delivery using 270/271 transactions.
Insitutional Claims
The ASC X12N Health Care Claim: Institutional (837i) transaction enables institutional healthcare providers to submit healthcare claims for a service or encounter. A healthcare claim includes patient information, related diagnoses, procedures performed or services provided, and any related charges. This API also translates standard X12 EDI 837i transactions to JSON so that it is more accessible to claim readers and developers.
Professional Claims
The Professional Claims API takes the standard X12 EDI 837P transaction and translates it to JSON so it is more accessible to developers and easily integrated into users’ applications.