Claim Status
claim status 270-271
/medicalnetwork/claimstatus/v2/raw-x12rawX12
Check Claim Status x12
Header Parameters
| Name | Type | Description |
|---|---|---|
| Authorization* | string | Bearer Your-Access-Token<br/>Example: <b>Bearer eyJraWQiOiIxIiwid…</b> |
Request Body*
application/json
Responses
Response
Provided by the submitter in the 270 Request. Transaction Set Control Number.
ID used by Clearing House for the trading partner.
Loop: 2100A
Segment: NM1, Element: NM103, Notes: Payers’s organization name.
Segment: NM1, Element: NM109, Notes: Payers’s identification number established through trading partner agreement. NM108=PI
Segment: NM1, Element: NM109, Notes: Use when reporting Health Plan ID (HPID) or Other Entity Identifier (OEID). NM108=XV
Segment: PER
Segment: PER, Element: PER02, Notes: Payer’s name.
Segment: PER, Element: PER04, PER06 or PER08, Notes: Payer's electronic data interchange access number. PER03=PER05=PER07=ED
Segment: PER, Element: PER04, PER06 or PER08, Notes: Payer's email. PER03=PER05=PER07=EM
Segment: PER, Element: PER04, PER06 or PER08, Notes: Payer's facsimile number. PER03=PER05=PER07=FX
Segment: PER, Element: PER04, PER06 or PER08, Notes: Payer's telephone number. PER03=PER05=PER07=TE
Segment: PER, Element: PER04, PER06 or PER08, Notes: Payer's telephone extension. PER05=PER07=EX
Loop: 2100B and 2100C
Loop: 2000D
Loop: 2100D, Segment: NM1, Element: NM109, Notes: The subscriber's insurance member ID. Maps to subscriberId.
Loop: 2100D, Segment: NM1, Element: NM104, Notes: The subscriber's first name as specified on their policy
Loop: 2100D, Segment: NM1, Element: NM103, Notes: The subscriber's last name as specified on their policy.
Loop: 2000D, 2000E, Segment: DMG, Element: DMG03, Notes: The subscriber's gender as specified on their policy.
Enum: MFU
Loop: 2000D, Segment: DMG, Element: DMG02, Notes: The birth date as specified on the policy for the subscriber. Maps to BirthDate
Loop: 2200D, Segment: REF, Element: REF01, Notes: The group number associated with the subscriber.
Loop: 2000E
Loop: 2100E, Segment: NM1, Element: NM104, Notes: The dependent's first name as specified on their policy.
Loop: 2100E, Segment: NM1, Element: NM103, Notes: The dependent's last name as specified on their policy.
Loop: 2000E, Segment: DMG, Element: DMG03, Notes: dependent's gender as specified on their policy.
Enum: MFU
Loop: 2000E, Segment: DMG, Element: DMG02, Notes: The birth date as specified on the policy for the dependent.
Loop: 2200E, Segment: REF, Element: REF02 when REF01=6P, Notes: The group number associated with the subscriber and dependent. Maps to dependent groupNumber.
Loop: 2200D and 2200E
Segment: ISA, Element: ISA13, Notes: Interchange control number
Code for the error.
Description of the error code. Value provided in payer id should be a valid Optum assigned ERA payer Id.
The number assigned by the originator to identify the transaction within the originator's business application system
The number assigned by the originator to identify the transaction within the originator's business application system
Loop: 2200D, Segment: STC, Element: STC01, Health care claim status, Used to convey status of the entire claim or specific service line.
The 999 acknowledgment code
The 999 syntax error code
Basic x12 edi response (for x12 endpoint)
Meta data about the request
submitterId assigned to this request
senderId assigned to this request
billerId assigned to this request
Unique Id assigned to each request by Optum
Used by Optum to identify where this request can be found for support
Example Request
curl -X POST \ 'https://sandbox-apigw.optum.com/medicalnetwork/claimstatus/v2/raw-x12'