Stedi’s Claim Submission API now returns raw X12 277CA claim acknowledgments

Stedi’s Claim Submission API responses now include an X12 277CA claim acknowledgment from Stedi in the x12 field. The x12 field is returned by the JSON and X12 endpoints across professional, institutional, and dental claims. It’s returned for both accepted and rejected claims.

For example, a JSON Professional Claim Submission API response for a rejected claim:

{
  "status": "ERROR",
  "errors": [
    {
      "code": "33",
      "description": "The billing provider tax id (TIN), 1234567893, is invalid. The TIN must be ...",
      "followupAction": "Please Correct and Resubmit"
    }
  ],
  "x12": "ISA*00*          *00*          *ZZ*STEDITEST      *ZZ*284631039151 ...,
  "httpStatusCode": "400 BAD_REQUEST",
  ...
}

You can use the x12 field to debug errors from claim rejections or store Stedi’s claim acknowledgments for tracking. Previously, Claim Submission API responses only included errors as JSON in the errors array.

What’s a claim acknowledgment?

A 277CA claim acknowledgment tells you whether a claim has been accepted or rejected for processing.

Stedi returns a claim acknowledgment after initial validation. Payers also return one or more acknowledgments later in the claim lifecycle.

The x12 field contains Stedi’s initial acknowledgment, generated after validating the claim against our database of edits. These edits – the industry’s term for an automated validation rule – mirror the same edits payers apply later in the process.

Stedi’s edits help catch validation errors early and reduce downstream payer rejections, which can delay payment for providers.

Rejections

If Stedi rejects a claim, the API response’s x12 field includes a descriptive claim status category code, claim status code, and error message in the STC (Status Information) segments of Loop 2200B, 2200B, 2200C, 2200D, or 2220D.

For example:

STC*A7>128>85*[DATE]*U*[AMOUNT]********The billing provider tax id (TIN), 1234567893, is invalid. The TIN must be a string of exactly 9 numbers with no separators. Correct and resubmit

You can use this information to correct and resubmit the claim.

Accepted claims

If Stedi accepts a claim, the API response’s x12 field includes the following values in the STC segments of Loop 2200B, 2200C, 2200D, or 2220D:

• Claim status category code is A0 (Acknowledgement/Forwarded)

• Claim status code is 17 (Claim/encounter has been forwarded by third party entity to entity)

• Entity identifier code) is AY (Clearinghouse)

For example:

STC*A0>17>AY*[DATE]*WQ*[AMOUNT]

Other claim acknowledgements

Stedi’s initial acceptance of a claim doesn’t guarantee payer acceptance. Rejections may occur during downstream validation, including later rejections by Stedi or an intermediary clearinghouse.

Each acceptance or rejection returns a separate claim acknowledgment transaction. You can use a webhook to listen for these additional claim acknowledgments, poll for them using our Poll Transactions API, or monitor them manually in the Stedi portal.