Claims processing

Submit healthcare claims, check claim status, and receive electronic remittances using developer-friendly APIs

99213 - Outpatient visit

$109.20

3 units

Payer: Cigna
Provider: Smiths Associates

Jane S Doe
U1234567890

May 14th

Services rendered

May 16th

Claim created

May 22nd

Claim accepted

May 22nd

Paid

99213 - Outpatient visit

$109.20

3 units

Payer: Cigna
Provider: Smiths Associates

Jane S Doe
U1234567890

May 14th

Services rendered

May 16th

Claim created

May 22nd

Claim accepted

May 22nd

Paid

99213 - Outpatient visit

$109.20

3 units

Payer: Cigna
Provider: Smiths Associates

Jane S Doe
U1234567890

May 14th

Services rendered

May 16th

Claim created

May 22nd

Claim accepted

May 22nd

Paid

99213 - Outpatient visit

$109.20

3 units

Payer: Cigna
Provider: Smiths Associates

Jane S Doe
U1234567890

May 14th

Services rendered

May 16th

Claim created

May 22nd

Claim accepted

May 22nd

Paid

Automate claim submission

Reduce administrative work and avoid unnecessary delays. Our APIs have built-in validation and repair—commonly referred to as “edits”—for fewer payer rejections.

Track outstanding claims

Keep patients and providers informed with real-time claim status updates.

Streamline issue resolution

Quickly identify and address underpayments, denials, and disputes.

Ingest ERAs

Automatically ingest electronic remittances to keep your financial ledger up to date and get paid faster.

How it works

Integrate with a modern, developer-friendly API

Claim submission

Submit claims to thousands of payers through our Professional Claims API. Stedi creates a HIPAA-compliant transaction and delivers it to the payer or peer clearinghouse.

Claim submitted

97530 - Therapeutic exercises

submitClaim.js

fetch(
"https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/submission",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "6400",
    submitter: {
      organizationName: "Doctors LLC",
      contactInformation: 
        { 
          name: "Doctors LLC", 
          phoneNumber: "5552221212" 
        },
    },
    receiver: 
      {
        organizationName: "Cigna"
      },
    subscriber: {},
    providers: [],
    claimInformation: {
      serviceLines: [{}]
    },
  }
).then((response) => response.json());

Claim declined

36415 - Routine venipuncture

getClaimStatus.js

fetch(
"https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/claimstatus/v2",
  {
    controlNumber: "000000001",
    tradingPartnerServiceId: "UHC",
    encounter: {
      beginningDateOfService: "20240322",
      endDateOfService: "20240322",
      trackingNumber: "1234AAA",
    },
    providers:[
      { 
        providerType: "BillingProvider",
        organizationName: "Doctors LLC", 
        npi: "1234567890",
      }
    ],
    subscriber: {
      memberId: "0000000000",
      firstName: "Jane",
      lastName: "Doe",
      dateOfBirth: "19891002",
    },
    
  }
).then((response) => response.json());

Real-time claim status

Check any claim’s status in seconds with our Claim Status API. Receive status responses in easily digestible JSON.

Claim payments (ERAs)

Receive ERAs automatically through Stedi webhooks or periodically poll for new transactions.

Payment sent

835 - Electronic remittance advice

electronicRemittanceAdvice.json

{	
  "transactions": [
	{
	  "controlNumber": "1003",
	  "productionDate": "20240324",
	  "receiverIdentifier": "55555500",
	  "financialInformation": {
	    "transactionHandlingCode": "I",
	    "totalActualProviderPaymentAmount": "109.2",
	    "creditOrDebitFlagCode": "C",
	    "paymentMethodCode": "ACH",
	    "paymentFormatCode": "CCP",
	    "payerIdentifier": "1111666666",
	    "checkIssueOrEFTEffectiveDate": "20240327",
           "senderAccountDetails": {},
	    "receiverAccountDetails": {}
	  },
	  "payer": {},
	  "payee": {},
	  "detailInfo": [],
      }
   ],
   "meta": {}
}

“We submitted claims three days after signing, and the support is excellent in quality and timeliness of response. For example, Stedi's team—including their CEO—regularly resolves our engineers’ issues within minutes. This used to take months or just never happen at all with our previous vendor.”

— Craig Micon

Head of Product at Pair Team

— Craig Micon

Head of Product at Pair Team

— Craig Micon

Head of Product at Pair Team

Connect to thousands of payers

Our growing set of payers provide broad, reliable connectivity.

Browse our network

View payer status dashboard

COMING SOON

Automatic failover

Stedi dynamically routes traffic to the most reliable connection, eliminating single points of failure, providing redundant connections.