Professional Claims (837P) Raw X12

Submit an 837P professional claim in raw X12 EDI format

POST /change/medicalnetwork/professionalclaims/v3/raw-x12-submission

This endpoint is ideal if you have an existing system that generates X12 EDI files and you want to send them through Stedi.

1. Call this endpoint with a payload in 837 X12 EDI format.
2. Stedi validates the EDI and sends the claim to the payer.
3. The endpoint returns a response from Stedi in JSON format containing information about the claim you submitted and whether the submission was successful.

Visit Submit professional claims for a full how-to guide.

CMS-1500 Claim Form PDF

When you submit a professional claim, Stedi automatically generates a 1500 claim form PDF. If you plan to send these PDFs to payers or retain them for your records, we strongly recommend reviewing the CMS-1500 claim form PDF documentation to learn how to structure claim submissions for optimal generation, the correct printer settings for generated PDFs, and general best practices.

Authorizations

Authorization · string · required · header

A Stedi API Key for authentication.

Body

application/json

x12 · string · required

Response

application/json

ClaimsRawX12Submission 200 response

claimReference · object

Information about the claim.

claimReference. claimType · string

The type of claim, currently not used.

claimReference. correlationId · string

An identifier Stedi assigns to the claim.

claimReference. customerClaimNumber · string

A tracking number that Stedi assigns to the claim.

claimReference. formatVersion · string

The X12 EDI version Stedi used to generate the claim for the payer. This is always 5010.

claimReference. patientControlNumber · string

The patientControlNumber from the original request, if supplied. This is a unique identifier that you assign to the claim so you can track the claim and correlate it with responses from the payer.

claimReference. payerID · string

The ID of the payer. This is the same as the tradingPartnerServiceId.

claimReference. rhclaimNumber · string

A tracking number Stedi assigns to the claim. This is the same as the correlationId.

claimReference. serviceLines · array<object>

Contains a unique identifier for each service line, listed in the order the service lines were included in the claim. You can use these identifiers to correlate payer responses to specific service lines.

claimReference.serviceLines[]. lineItemControlNumber · string

A unique identifier for the service line, matching the value provided for the claimInformation.serviceLines.providerControlNumber property in the claim submission. If you didn't provide a value for providerControlNumber, this property contains a randomly generated a UUID for the service line.

claimReference. submitterId · string

Stedi's ID for the entity that submitted the claim.

claimReference. timeOfResponse · string

A timestamp for Stedi's response to the claim submission.

controlNumber · string

An identifier for the transaction.

editResponses · array<object>

Currently not used.

editResponses[]. allowOverride · string

editResponses[]. badData · string

editResponses[]. claimCorePath · string

editResponses[]. editActivity · string

editResponses[]. editName · string

editResponses[]. element · string

editResponses[]. errorDescription · string

editResponses[]. fieldIndex · string

editResponses[]. loop · string

editResponses[]. phaseID · string

editResponses[]. qualifierCode · string

editResponses[]. referenceID · string

editResponses[]. segment · string

editStatus · string

Currently not used.

errors · array<object>

A list of errors. Currently not used.

errors[]. code · string

The error code.

errors[]. description · string

The description of the error code.

errors[]. field · string

The field related to the error.

errors[]. followupAction · string

Recommended followup actions to correct the error.

errors[]. location · string

Where the error is located in the original request.

errors[]. value · string

The value for the data causing the error.

failure · object

Currently not used.

failure. code · string

failure. description · string

httpStatusCode · string

A 200 response indicates that Stedi successfully generated the X12 EDI claim format required by the payer. It does not indicate whether the payer has accepted the claim - the payer will respond later with a 277CA containing this information. Learn more about 277CAs. A 400 response indicates one or more problems with the claim data in the request. Examples include missing required fields, invalid values, or incorrect data types. The response includes a message describing the problem.

Possible values

200 OK

400 BAD_REQUEST

meta · object

Metadata from Stedi about the request.

meta. applicationMode · string

Indicates where this request can be found for support.

meta. billerId · string

The biller ID assigned to this request.

meta. senderId · string

The sender ID assigned to this request.

meta. submitterId · string

The submitter ID assigned to this request.

meta. traceId · string

The file execution ID, a unique identifier assigned to the processed file within the Stedi platform.

payer · object

Information about the payer for the submitted claim.

payer. payerID · string

The payer's ID. This is the same as the tradingPartnerServiceId.

payer. payerName · string

The payer's business name, such as Aetna or Cigna.

status · string

The status of the claim submission.

tradingPartnerServiceId · string

An ID for the payer you identified in the original claim. This value may differ from the tradingPartnerServiceId you submitted in the original request because it reflects the payer's internal concept of their ID, not necessarily the ID Stedi uses to route requests to this payer.

warnings · array<object>

A list of warnings.

warnings[]. code · string

A machine-readable code indicating the type of problem.

warnings[]. description · string

A human-readable description of the problem.

cURL

curl --request POST \
  --url "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/raw-x12-submission" \
  --header "Authorization: <api_key>" \
  --header "Content-Type: application/json" \
  --data '{
    "x12": "ISA*00*          *00*          *ZZ*001690149382   *ZZ*STEDITEST      *240630*0847*^*00501*000000001*0*T*>~GS*HC*001690149382*STEDITEST*20240630*084744*000000001*X*005010X222A1~ST*837*0001*005010X222A1~BHT*0019*00*01J1M588QT2TAV2N093GNJ998T*20240630*0847*CH~NM1*41*2*Test Data Health Services, Inc.*****46*123567890~PER*IC*Test Data Health Services, Inc.*TE*5552223333~NM1*40*2*Cigna*****46*60054~HL*1**20*1~PRV*BI*PXC*2084P0800X~NM1*85*2*Therapy Associates*****XX*1999999984~N3*123 Some St*Floor 1~N4*A City*NY*123450000~REF*EI*832675429~PER*IC*Test Data Health Services, Inc.*TE*5553334444~HL*2*1*22*0~SBR*P*18*3335555******CI~NM1*IL*1*Anon*John****MI*U7777788888~N3*2222 Random St~N4*A City*NY*123450000~DMG*D8*20000101*M~NM1*PR*2*Cigna*****PI*60054~CLM*22266555*109.0***02>B>1*Y*A*Y*Y~HI*ABK>F1111~NM1*82*1*Smith*Jane****XX*1999999984~PRV*PE*PXC*111YP2000X~NM1*77*2*Smith Associates*****XX*1999999984~N3*1234 Other St~N4*A City*NY*123450000~LX*1~SV1*HC>90837>95*109.2*UN*1.0***1~DTP*472*D8*20240101~SE*30*0001~GE*1*000000001~IEA*1*000000001~"
  }'

JavaScript

const body = JSON.stringify({
  "x12": "ISA*00*          *00*          *ZZ*001690149382   *ZZ*STEDITEST      *240630*0847*^*00501*000000001*0*T*>~GS*HC*001690149382*STEDITEST*20240630*084744*000000001*X*005010X222A1~ST*837*0001*005010X222A1~BHT*0019*00*01J1M588QT2TAV2N093GNJ998T*20240630*0847*CH~NM1*41*2*Test Data Health Services, Inc.*****46*123567890~PER*IC*Test Data Health Services, Inc.*TE*5552223333~NM1*40*2*Cigna*****46*60054~HL*1**20*1~PRV*BI*PXC*2084P0800X~NM1*85*2*Therapy Associates*****XX*1999999984~N3*123 Some St*Floor 1~N4*A City*NY*123450000~REF*EI*832675429~PER*IC*Test Data Health Services, Inc.*TE*5553334444~HL*2*1*22*0~SBR*P*18*3335555******CI~NM1*IL*1*Anon*John****MI*U7777788888~N3*2222 Random St~N4*A City*NY*123450000~DMG*D8*20000101*M~NM1*PR*2*Cigna*****PI*60054~CLM*22266555*109.0***02>B>1*Y*A*Y*Y~HI*ABK>F1111~NM1*82*1*Smith*Jane****XX*1999999984~PRV*PE*PXC*111YP2000X~NM1*77*2*Smith Associates*****XX*1999999984~N3*1234 Other St~N4*A City*NY*123450000~LX*1~SV1*HC>90837>95*109.2*UN*1.0***1~DTP*472*D8*20240101~SE*30*0001~GE*1*000000001~IEA*1*000000001~"
})

fetch("https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/raw-x12-submission", {
  headers: {
    "Authorization": "<api_key>"
  },
  body
})

Go

package main

import (
  "fmt"
  "net/http"
  "io/ioutil"
  "strings"
)

func main() {
  url := "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/raw-x12-submission"
  body := strings.NewReader(`{
    "x12": "ISA*00*          *00*          *ZZ*001690149382   *ZZ*STEDITEST      *240630*0847*^*00501*000000001*0*T*>~GS*HC*001690149382*STEDITEST*20240630*084744*000000001*X*005010X222A1~ST*837*0001*005010X222A1~BHT*0019*00*01J1M588QT2TAV2N093GNJ998T*20240630*0847*CH~NM1*41*2*Test Data Health Services, Inc.*****46*123567890~PER*IC*Test Data Health Services, Inc.*TE*5552223333~NM1*40*2*Cigna*****46*60054~HL*1**20*1~PRV*BI*PXC*2084P0800X~NM1*85*2*Therapy Associates*****XX*1999999984~N3*123 Some St*Floor 1~N4*A City*NY*123450000~REF*EI*832675429~PER*IC*Test Data Health Services, Inc.*TE*5553334444~HL*2*1*22*0~SBR*P*18*3335555******CI~NM1*IL*1*Anon*John****MI*U7777788888~N3*2222 Random St~N4*A City*NY*123450000~DMG*D8*20000101*M~NM1*PR*2*Cigna*****PI*60054~CLM*22266555*109.0***02>B>1*Y*A*Y*Y~HI*ABK>F1111~NM1*82*1*Smith*Jane****XX*1999999984~PRV*PE*PXC*111YP2000X~NM1*77*2*Smith Associates*****XX*1999999984~N3*1234 Other St~N4*A City*NY*123450000~LX*1~SV1*HC>90837>95*109.2*UN*1.0***1~DTP*472*D8*20240101~SE*30*0001~GE*1*000000001~IEA*1*000000001~"
  }`)
  req, _ := http.NewRequest("POST", url, body)
  req.Header.Add("Authorization", "<api_key>")
  req.Header.Add("Content-Type", "application/json")
  res, _ := http.DefaultClient.Do(req)
  defer res.Body.Close()
  body, _ := ioutil.ReadAll(res.Body)

  fmt.Println(res)
  fmt.Println(string(body))
}

Python

import requests

url = "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/raw-x12-submission"
body = {
  "x12": "ISA*00*          *00*          *ZZ*001690149382   *ZZ*STEDITEST      *240630*0847*^*00501*000000001*0*T*>~GS*HC*001690149382*STEDITEST*20240630*084744*000000001*X*005010X222A1~ST*837*0001*005010X222A1~BHT*0019*00*01J1M588QT2TAV2N093GNJ998T*20240630*0847*CH~NM1*41*2*Test Data Health Services, Inc.*****46*123567890~PER*IC*Test Data Health Services, Inc.*TE*5552223333~NM1*40*2*Cigna*****46*60054~HL*1**20*1~PRV*BI*PXC*2084P0800X~NM1*85*2*Therapy Associates*****XX*1999999984~N3*123 Some St*Floor 1~N4*A City*NY*123450000~REF*EI*832675429~PER*IC*Test Data Health Services, Inc.*TE*5553334444~HL*2*1*22*0~SBR*P*18*3335555******CI~NM1*IL*1*Anon*John****MI*U7777788888~N3*2222 Random St~N4*A City*NY*123450000~DMG*D8*20000101*M~NM1*PR*2*Cigna*****PI*60054~CLM*22266555*109.0***02>B>1*Y*A*Y*Y~HI*ABK>F1111~NM1*82*1*Smith*Jane****XX*1999999984~PRV*PE*PXC*111YP2000X~NM1*77*2*Smith Associates*****XX*1999999984~N3*1234 Other St~N4*A City*NY*123450000~LX*1~SV1*HC>90837>95*109.2*UN*1.0***1~DTP*472*D8*20240101~SE*30*0001~GE*1*000000001~IEA*1*000000001~"
}
response = requests.request("POST", url, json = body, headers = {
  "Authorization": "<api_key>",
  "Content-Type": "application/json"
})

print(response.text)

Java

import java.net.URI;
import java.net.http.HttpClient;
import java.net.http.HttpRequest;
import java.net.http.HttpResponse;
import java.net.http.HttpResponse.BodyHandlers;
import java.time.Duration;
import java.net.http.HttpRequest.BodyPublishers;

var body = BodyPublishers.ofString("""{
  "x12": "ISA*00*          *00*          *ZZ*001690149382   *ZZ*STEDITEST      *240630*0847*^*00501*000000001*0*T*>~GS*HC*001690149382*STEDITEST*20240630*084744*000000001*X*005010X222A1~ST*837*0001*005010X222A1~BHT*0019*00*01J1M588QT2TAV2N093GNJ998T*20240630*0847*CH~NM1*41*2*Test Data Health Services, Inc.*****46*123567890~PER*IC*Test Data Health Services, Inc.*TE*5552223333~NM1*40*2*Cigna*****46*60054~HL*1**20*1~PRV*BI*PXC*2084P0800X~NM1*85*2*Therapy Associates*****XX*1999999984~N3*123 Some St*Floor 1~N4*A City*NY*123450000~REF*EI*832675429~PER*IC*Test Data Health Services, Inc.*TE*5553334444~HL*2*1*22*0~SBR*P*18*3335555******CI~NM1*IL*1*Anon*John****MI*U7777788888~N3*2222 Random St~N4*A City*NY*123450000~DMG*D8*20000101*M~NM1*PR*2*Cigna*****PI*60054~CLM*22266555*109.0***02>B>1*Y*A*Y*Y~HI*ABK>F1111~NM1*82*1*Smith*Jane****XX*1999999984~PRV*PE*PXC*111YP2000X~NM1*77*2*Smith Associates*****XX*1999999984~N3*1234 Other St~N4*A City*NY*123450000~LX*1~SV1*HC>90837>95*109.2*UN*1.0***1~DTP*472*D8*20240101~SE*30*0001~GE*1*000000001~IEA*1*000000001~"
}""");
HttpClient client = HttpClient.newBuilder()
  .connectTimeout(Duration.ofSeconds(10))
  .build();

HttpRequest.Builder requestBuilder = HttpRequest.newBuilder()
  .uri(URI.create("https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/raw-x12-submission"))
  .header("Content-Type", "application/json")
  .header("Authorization", "<api_key>")
  .POST(body)
  .build();

try {
  HttpResponse<String> response = client.send(requestBuilder.build(), BodyHandlers.ofString());
  System.out.println("Status code: " + response.statusCode());
  System.out.println("Response body: " + response.body());
} catch (Exception e) {
  e.printStackTrace();
}

200

{
  "claimReference": {
    "correlationId": "01J1M588QT2TAV2N093GNJ998T",
    "formatVersion": "5010",
    "patientControlNumber": "22266555",
    "payerID": "60054",
    "rhclaimNumber": "01J1M588QT2TAV2N093GNJ998T",
    "serviceLines": [
      {
        "lineItemControlNumber": "111222333"
      }
    ],
    "timeOfResponse": "2024-07-10T22:05:32.203Z"
  },
  "controlNumber": "000000001",
  "httpStatusCode": "200 OK",
  "meta": {
    "traceId": "b727b8e7-1f00-4011-bc6e-e41444d406d8"
  },
  "payer": {
    "payerID": "60054",
    "payerName": "Cigna"
  },
  "status": "SUCCESS",
  "tradingPartnerServiceId": "60054"
}

400

{
  "code": "string",
  "message": "string"
}

403

{
  "code": "string",
  "message": "string"
}

404

{
  "code": "string",
  "message": "string"
}

429

{
  "code": "string",
  "message": "string"
}

500

{
  "code": "string",
  "message": "string"
}

503

{
  "code": "string",
  "message": "string"
}

504

{
  "code": "string",
  "message": "string"
}