Professional Claims

commercialv3

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.

Send live requests to the sandbox environment. Requests are proxied through the portal server.

Headers

Body Parameters

controlNumber*string

Header, Segment: ST02 (no loop), Notes: Transaction Set Control Number

tradingPartnerServiceIdstring

Loop: 2010BB Segment: NM1, Element: NM109, Notes: we send this as MN108 as PI = Payer Identification

usageIndicatorstring

Interchange Usage Indicator ISA15; T-Test Data, P-Production Data

tradingPartnerNamestring

Loop 2010BB NM103

curl -X POST \
  'https://sandbox-apigw.optum.com/medicalnetwork/professionalclaims/v3/validation'
  -H 'Accept: application/json'
Send a request to see the response here.