835 ERA Report
Retrieve an 835 Electronic Remittance Advice (ERA) in JSON format
/change/medicalnetwork/reports/v2/{transactionId}/835The 835 Electronic Remittance Advice (ERA) contains details about payments for specific services and explanations for any adjustments or denials. This endpoint retrieves processed 835 ERA transactions from Stedi.
- Call this endpoint with the
transactionIdof the 835 ERA you want to retrieve. You can retrieve the transaction ID through webhooks or through Stedi's API. Learn more - The endpoint returns the 835 ERA in JSON format.
Note that the payer won't send 835 ERAs for rejected claims. If a claim is rejected in a 277CA claim acknowledgment, there's no adjudication or payment information to report.
Visit Correlate 835 ERA to learn how to match 835 ERAs to the original claim.
Claim status
You can't reliably determine a claim's status based on the amount paid in an 835 ERA. There are many instances in which a claim is accepted and the total amount paid is 0 dollars. For example, in Value-Based Care (VBC) scenarios, line item rates are usually 0 dollars, and providers are paid a flat rate per month or for a complete bundle of services.
Use the Real-Time Claim Status API to check the claim's status instead.
A Stedi API Key for authentication.
Path Parameters
A unique identifier for the processed 835 transaction within Stedi. This ID is included in the transaction processed event, which you can receive automatically through Stedi webhooks. You can also retrieve it through the Poll Transactions endpoint or from the transaction's details page within the Stedi portal.
Response
ConvertReport835 200 response
Metadata that helps Stedi track and debug the response.
Show attributes
Whether this is a test or production ERA.
An identifier for the most recent sender of the ERA. This is usually not the original sender, so this value is unlikely to be a payer ID. When Stedi processes and delivers ERAs through the clearinghouse, this value is always STEDI.
Not currently used.
The Stedi transaction identifier.
The payer's 835 response.
Array item
The control number the payer provided in the claim payment response. This is used to identify the transaction.
Detailed information about claims in this payment advice.
Array item
A unique ID assigned to identify this set of claim information within the response.
Information relevant to the claim and claim payment, including the subscriber, providers, and service lines. Note that the amount paid may not match the claim amount, even when the claim was not denied. This can happen for several reasons, including adjustments and corrected balances due from other claims.
Array item
Adjustments applied to this claim.
Array item
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
The code identifying the category of adjustment reason codes. Visit ERA code lists for a complete list and usage notes.
COOAPIPRThe description of the claimAdjustmentGroupCode.
Contact information for claim-related communications.
Array item
Array item
The email address.
The fax number.
The telephone number including the area code (if applicable). Phone numbers are formatted as AAABBBCCCC, where AAA represents the area code, BBB represents the telephone number prefix, and CCCC represents the telephone number. Phone numbers are provided without separators, such as dashes or parentheses. For example, 5551123345 for 555-112-3345.
The telephone extension, if applicable.
The name of the contact person or entity.
Basic claim payment information including amounts and status.
Show attributes
A code identifying the type of claim. For example DS - Disability. Visit ERA code lists for a complete list and usage notes.
1213141516A code identifying the frequency of the claim. It matches what the payer received in the original claim. Visit Bill Type Frequency Codes for a complete list and definitions.
The total amount of the claim payment, expressed as a decimal. This value can be positive, zero, or negative.
The status of the claim. For example, 1 - Processed as Primary. Visit ERA code lists for a complete list and usage notes.
123419Code indicating a patient's diagnosis group based on their medical symptoms.
The adjudicated diagnosis-related group (DRG) weight.
The adjudicated discharge fraction.
A code identifying where services were or may be performed. This is the Place of Service Codes for Professional or Dental Services.
The patient control number provided in the original claim. You can use this value to correlate the payer's response with the original claim.
The amount the patient is responsible for paying. This can include the deductible, non-covered services, co-pay, and co-insurance. This is not used for reversals.
The payer's internal control number for the claim.
The total amount of submitted charges for this claim, expressed as a decimal. This can be positive, zero, or negative. For example, this may contain a negative charge for a reversal claim.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The date the claim was received by the payer.
^\d{4}-(0[1-9]|1[0-2])-(0[1-9]|[12]\d|3[01])$The claim period end date in ISO 8601 format (YYYY-MM-DD). This format is intentionally inconsistent with other date properties to maintain backwards compatibility.
^\d{4}-(0[1-9]|1[0-2])-(0[1-9]|[12]\d|3[01])$The claim period start date in ISO 8601 format (YYYY-MM-DD). This format is intentionally inconsistent with other date properties to maintain backwards compatibility.
If the response doesn’t include a claimStatementPeriodEnd, you should assume the end date is the same as the start date.
Supplemental information about the claim.
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The total covered charges. This is the sum of the original submitted provider charges that are considered for payment under the health plan. This excludes charges considered not covered, but includes reductions to payments of covered services, such as patient deductibles.
This is the Prompt Pay Discount Amount.
Federal Medicare or Medicaid Payment Mandate - Category 1.
Federal Medicare or Medicaid Payment Mandate - Category 2.
Federal Medicare or Medicaid Payment Mandate - Category 3.
Federal Medicare or Medicaid Payment Mandate - Category 4.
Federal Medicare or Medicaid Payment Mandate - Category 5.
The interest amount.
The negative ledger balance. Only used by Medicare Part A and Medicare Part B.
The amount the patient has already paid.
The per day limit.
The total taxes.
The total claim amount before taxes.
Supplemental quantity information about the claim.
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The actual amount of co-insurance designated by the health plan.
The number of days covered.
Federal Medicare or Medicaid Payment Mandate - Category 1.
Federal Medicare or Medicaid Payment Mandate - Category 2.
Federal Medicare or Medicaid Payment Mandate - Category 3.
Federal Medicare or Medicaid Payment Mandate - Category 4.
Federal Medicare or Medicaid Payment Mandate - Category 5.
The actual lifetime reserve days.
The estimated lifetime reserve days.
The non-covered estimated amount.
The number of non-replaced blood units.
The number of outlier days.
The prescription.
The number of visits.
Corrected patient or insured name information.
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The insured's first name.
The insured's changed unique identification number.
The insured's last name.
The insured's middle name or initial of the insured.
The business name of the insured when they are not an individual.
The insured's name suffix, such as Jr. or III.
Corrected priority payer information.
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The provider's Blue Cross Blue Shield Association Plan Code.
Used to report the provider's Health Plan ID (HPID) or Other Entity Identifier (OEID).
The provider's National Association of Insurance Commissioners (NAIC) number.
The provider's business name (when the provider is not an individual) or the provider's last name (when the provider is an individual).
The provider's Payer Identification number.
The provider's Pharmacy Processor Number.
^\d{9}$The provider's Federal Tax Identification Number.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The expiration date of the patient's coverage.
Crossover carrier information.
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The provider's Blue Cross Blue Shield Association Plan Code.
Used to report the provider's Health Plan ID (HPID) or Other Entity Identifier (OEID).
The provider's National Association of Insurance Commissioners (NAIC) number.
The provider's business name (when the provider is not an individual) or the provider's last name (when the provider is an individual).
The provider's Payer Identification number.
The provider's Pharmacy Processor Number.
The provider's Federal Tax Identification Number.
Inpatient adjudication information.
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The Diagnosis Related Group (DRG) amount.
The Disproportionate Share amount.
The indirect teaching amount.
The Medicare Secondary Payer (MSP) pass-through amount.
The total Prospective Payment System (PPS) capital amount.
The Prospective Payment System (PPS) Capital Outlier amount.
The number of cost report days.
The number of days or visits covered by the health plan.
The number of psychiatric days for the patient's lifetime.
The professional component amount billed but not payable.
The old capital amount.
The Prospective Payment System (PPS) capital, disproportionate share, hospital Diagnosis Related Group (DRG) amount.
The capital exception amount.
The Prospective Payment System (PPS) capital, federal specific portion, Diagnosis Related Group (DRG) amount.
The Prospective Payment System (PPS) capital, hospital specific portion, Diagnosis Related Group (DRG), amount.
The Prospective Payment System (PPS) capital indirect medical education claim amount.
The federal specific Diagnosis Related Group (DRG) amount.
The hospital specific Diagnosis Related Group (DRG) Amount.
The Prospective Payment System (PPS) Operating Outlier amount, expressed as a decimal.
Other claim-related identification numbers.
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The adjusted repriced claim reference number.
An authorization number assigned by the adjudication process that was not provided prior to the services.
The class of contract code.
A list of class of contract codes when multiple codes are applicable.
The employee identification number.
The other insured group number.
The group or policy number for the health plan.
The insurance policy number.
The medical record identification number.
The health plan member identification number.
The reference number for the original claim. This is included for correction claims.
The predetermination of benefits identification number.
The prior authorization number.
The repriced claim reference number.
^\d{9}$The social security number (SSN).
Other subscriber information.
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The subscriber's first name.
The subscriber's last name.
The subscriber's member ID for their health plan.
The subscriber's middle name or initial.
The subscriber's business name, if the subscriber is not an individual.
Deprecated
The subscriber's name suffix, such as Jr. or III.
The subscriber's Federal Taxpayer's Identification Number. Only used when the subscriber is a business entity and not an individual.
Outpatient adjudication information.
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The End Stage Renal Disease (ESRD) payment amount.
The claim Health Care Financing Administration Common Procedural Coding System (HCPCS) payable amount, expressed as a decimal.
The professional component amount billed but not payable.
The reimbursement rate, expressed as a decimal.
Patient name information.
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The patient's first name.
The patient's Health Insurance Claim (HIC) Number.
The patient's last name.
The patient's Medicaid Recipient Identification Number.
The patient's member ID number for their health plan.
The patient's middle name or initial.
The patient's Social Security Number (SSN).
Deprecated.
The patient's name suffix, such as Jr or III.
Information about the provider who rendered services.
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The rendering provider's Blue Cross Provider Number.
The rendering provider's Blue Shield Provider Number.
The rendering provider's first name.
The rendering provider's last name.
The rendering provider's Medicare Provider Number.
The rendering provider's middle name or initial.
The rendering provider's National Provider Identifier (NPI).
The rendering provider's business name.
The rendering provider's Provider Commercial Number.
The rendering provider's State License Number.
The rendering provider's name suffix, such as Jr. or III.
The rendering provider's Federal Taxpayer Identification Number.
Deprecated; replaced by NPI in 2007.
Rendering provider identification information.
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The rendering provider's Blue Cross Provider Number.
The rendering provider's Blue Shield Provider Number.
The rendering provider's CHAMPUS Identification Number.
The rendering provider's Facility ID Number.
The rendering provider's Location Number.
The rendering provider's Medicaid Provider Number.
The rendering provider's Medicare Provider Number.
The rendering provider's National Council for Prescription Drug Program Pharmacy Number.
The rendering provider's Provider Commercial Number.
Deprecated; replaced by NPI in 2007.
The rendering provider's State License Number.
Service lines included in this claim.
Array item
Healthcare check remark codes for this service.
Array item
Code identifying the specific industry code list containing the remarkCode. Can be HE - Claim Payment Remark Codes or RX - National Council for Prescription Drug Programs Reject/Payment Codes.
The description of the codeListQualifierCode. Can be Claim Payment Remark Codes or National Council for Prescription Drug Programs Reject/Payment Codes.
The human readable description of the remark code.
The code identifying the specific remark.
This property can either be a Remittance Advice Remark Code (RARC) (codeListQualifierCode set to HE) or a National Council for Prescription Drug Programs Reject/Payment Code (codeListQualifierCode set to RX).
Healthcare policy identification for this service.
Array item
The identifying number for the policy form.
The providerControlNumber submitted in the original claim to identify the service line.
Information about the provider who rendered this service.
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The rendering provider's Blue Cross Provider Number.
The rendering provider's Blue Shield Provider Number.
The rendering provider's CHAMPUS Identification Number.
The rendering provider's Facility ID Number.
The rendering provider's Federal Taxpayer Identification Number.
The rendering provider's Medicaid Provider Number.
The rendering provider's Medicare Provider Number.
The rendering provider's National Council for Prescription Drug Programs Pharmacy Number.
^\d{10}$The rendering provider's National Provider Identifier (NPI).
The Provider Commercial Number.
Deprecated; replaced by NPI in 2007.
^\d{9}$The rendering provider's Social Security Number (SSN).
The rendering provider's State License Number.
Adjustments applied to this service line.
Array item
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The amount of the adjustment. A negative amount increases the claim payment and a positive amount decreases the claim payment.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
The units of service being adjusted. A positive value decreases the covered days and a negative number increases the covered days.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A description identifying the detailed reason the adjustment was made.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
A code identifying the detailed reason the adjustment was made. Visit Claim Adjustment Reason Codes in the X12 documentation for a complete list.
The code identifying the category of adjustment reason codes. Visit ERA code lists for a complete list and usage notes.
COOAPIPRThe description of the claimAdjustmentGroupCode.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The date the service was rendered. Used for single-day services.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The date the service ended. Used for multi-day services.
Service identification details.
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The service line's Ambulatory Patient Group (APG) Number.
The service line's Ambulatory Payment Classification Number.
The service line's Attachment Code.
The service line's Authorization Number.
The payer's identification for the provider location.
The service line's Predetermination of Benefits Identification Number.
The service line's Prior Authorization Number.
The service line's Rate code number, a percentage that reflects the Ambulatory Surgical Center (ASC) rate for Medicare. This is either 0, 50, 100, or 150.
Payment information for this service line.
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The adjudicated procedure code - an identifying number for a product or service.
A list of up to four modifiers that identify special circumstances related to the product or service.
The submitted service charge, expressed as a decimal.
The amount paid for the service, expressed as a decimal.
This amount is calculated as follows:
servicePaymentInformation.lineItemProviderPaymentAmount = servicePaymentInformation.lineItemChargeAmount - (sum(serviceAdjustments[].adjustmentAmount1) + sum(serviceAdjustments[].adjustmentAmount2) + sum(serviceAdjustments[].adjustmentAmount3) + sum(serviceAdjustments[].adjustmentAmount4) + sum(serviceAdjustments[].adjustmentAmount5) + sum(serviceAdjustments[].adjustmentAmount6))
All properties in the formula are within a single transactions.detailInfo.paymentInfo.serviceLines array entry. Note that serviceAdjustments is an object array that could contain up to 99 entries, each with up to 6 adjustment amounts in separate properties. This allows for up to 594 total adjustments.
Adjustments can be either positive or negative. When the adjustment amounts are positive, the payment decreases. When the adjustment amounts are negative, the payment amount increases, and will be larger than the lineItemChargeAmount.
The National Uniform Billing Committee Revenue Code.
The original number of units of service submitted, expressed as a decimal.
The code identifying the source of the adjudicatedProcedureCode.
HCADERIVN4The description of the productOrServiceIDQualifier.
The submitted adjudicated procedure code - an identifying number for a product or service.
A list of up to four modifiers that identify special circumstances related to the product or service.
A free-form description to further clarify the procedure code and any modifiers.
The code identifying the source of the submittedAdjudicatedProcedureCode.
HCADERIVN4The description of the submittedProductOrServiceIDQualifier.
The number of units of service that were paid, expressed as a decimal. If not present, the value is assumed to be one.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The date the service began. Used for multi-day services.
Supplemental amount information for this service.
Show attributes
The payer payment plus any assigned patient responsibility.
This is the late filing reduction amount.
Federal Medicare or Medicaid Payment Mandate - Category 1.
Federal Medicare or Medicaid Payment Mandate - Category 2.
Federal Medicare or Medicaid Payment Mandate - Category 3.
Federal Medicare or Medicaid Payment Mandate - Category 4.
Federal Medicare or Medicaid Payment Mandate - Category 5.
The tax amount.
The total amount for the service charge before taxes.
Supplemental quantity information for this service.
Show attributes
Federal Medicare or Medicaid Payment Mandate - Category 1.
Federal Medicare or Medicaid Payment Mandate - Category 2.
Federal Medicare or Medicaid Payment Mandate - Category 3.
Federal Medicare or Medicaid Payment Mandate - Category 4.
Federal Medicare or Medicaid Payment Mandate - Category 5.
Subscriber information for the insurance policy.
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The subscriber's first name.
The subscriber's last name.
The subscriber's member ID for their health plan.
The subscriber's middle name or initial.
The subscriber's business name, if the subscriber is not an individual.
Deprecated
The subscriber's name suffix, such as Jr. or III.
The subscriber's Federal Taxpayer's Identification Number. Only used when the subscriber is a business entity and not an individual.
Summary information about the provider.
Show attributes
A code identifying the type of facility where services were performed. This is the Place of Service Codes for Professional or Dental Services.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The last day of the provider's fiscal year.
The provider number.
The total of the charges reported for all claims, expressed as a decimal.
The total number of claims.
The total of the charges reported for all HCPCS codes that are payable, expressed as a decimal.
The total of the charges reported for all Health Care Financing Administration Common Procedural Coding System (HCPCS) codes, expressed as a decimal.
The total Medicare Secondary Payer (MSP) patient liability met, expressed as a decimal.
The total Medicare Secondary Payer (MSP) primary payer amount, expressed as a decimal.
The total of non-laboratory charges, expressed as a decimal.
The total periodic interim payment (PIP) adjustment amount, expressed as a decimal.
The total periodic interim payment (PIP) number of claims, expressed as a decimal.
The total patient reimbursement amount, expressed as a decimal.
The total of the professional component charges, expressed as a decimal.
Supplemental summary information about the provider.
Show attributes
The average length of stay for diagnosis related group (DRG) claims.
The average diagnosis-related group (DRG) weight.
The total capital amount. This includes: capital federal-specfic amount, hospital federal-specfic amount, hold harmless amount, Indirect Medical Education amount, Disproportionate Share Hospital amount, and the exception amount. It does not include any capital outlier amount.
The total cost outlier amount.
The total number of cost report days.
The total number of covered days.
The total of the charges reported for all diagnosis-related group (DRG) codes.
The total day outlier amount.
The total number of discharges.
The total disproportionate share amount.
The total federal specific amount.
The total hospital specific amount.
The total indirect medical education amount.
The total Medicare Secondary Payer (MSP) pass-through amount, calculated for a non-Medicare payer.
The total number of non-covered days.
The total number of outlier days.
The total prospective payment system (PPS) capital, federal-specific portion, diagnosis-related group (DRG) amount.
The total prospective payment system (PPS) capital, hospital-specific portion, diagnosis-related group (DRG) amount.
The total prospective payment system (PPS) disproportionate share, hospital diagnosis-related group (DRG) amount.
Financial information about the payment including amounts and account details.
Show attributes
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The date the payer considers the transaction to be settled. If the payment is made by automated clearinghouse (ACH), this is the date the funds are available to the provider. If the payment is made by check, this is the date the check is issued. If the payment is made by Federal Reserve Funds/wire transfer, this is the date that the payer anticipates the money to move.
A code indicating whether the payment is a credit or debit. Can be set to C - Credit or D - Debit. Visit ERA code lists for usage notes.
CDA code that further identifies the payer by division or region.
A unique identifier for the payer, mutually established between the financial institution and the payer.
A code identifying the payment format. Can be set to CCP - Cash Concentration/Disbursement plus Addenda (CCD+) (ACH) or CTX - Corporate Trade Exchange (CTX) (ACH).
CCPCTXA code indicating the payment method. For example, ACH - Automated Clearing House or CHK - Check. Visit ERA code lists for a complete list and usage notes.
ACHBOPCHKFWTNONAccount details for the payment receiver.
Show attributes
The provider's account number.
The code identifying the type of account. Can be either DA - Demand Deposit or SA - Savings.
DASAThe code identifying the type of identification number of the Depository Financial Institution (DFI). Can be either 01 - ABA Transit Routing Number Including Check Digits (9 digits) or 04 - Canadian Bank Branch Institution Number.
0104The identification number specified in receiverDfiIdNumberQualifier.
Account details for the payment sender.
Show attributes
The account number for the company originating the payment.
The code identifying the type of account the payment is being made from. Can be DA - Demand Deposit.
DASAThe identifier specified by the senderDfiIdNumberQualifier.
The code identifying the type of identification number of the Depository Financial Institution (DFI). Can be either 01 - ABA Transit Routing Number Including Check Digits (9 digits) or 04 - Canadian Bank Branch Institution Number.
0104The total amount of the payment to the provider, expressed as a decimal.
A code indicating the actions taken by both the sender and the receiver. For example, D - Make Payment Only. Visit ERA code lists for a complete list and usage notes.
CDHIPThe standard ISO code for the country whose currency is being used for payments. If this is not present, the currency is US dollars.
Information about the payee receiving the payment.
Show attributes
The payee's address information.
Show attributes
The first line of the address.
The second line of the address.
The city where the address is located.
The standard code for the country from Part 1 of ISO 3166.
The standard code for the country subdivision from Part 2 of ISO 3166.
The postal code for the address, excluding punctuation and blanks.
The standard code for the state or province. For example PA for Pennsylvania.
Formerly used to report the payee's Centers for Medicare and Medicaid Services (CMS) Plan ID. This used to report the Health Plan ID (HPID) or Other Entity Identifier (OEID). The Centers for Medicare and Medicaid Services (CMS) no longer uses HPID, so this property will not be populated.
The payee's Federal Taxpayer's Identification Number (when the payee is a business) or the payee's social security number (when the payee is an individual provider).
The payee's name. This can be the name of an individual or an organization.
The payee's National Council for Prescription Drugs Pharmacy Number.
The payee's National Provider Identifier (NPI).
Other information necessary to identify the payee.
Method for delivering remittance advice to the payee.
Show attributes
The email address.
Information for file transfer deliveries, such as SFTP, FTP, or FTPS.
The name of the third party processor, if required, that would be the first recipient of the remittance.
The web address of the online portal for secure hosted or other electronic delivery. The URL is typically provided without the scheme and separator. For example, stedi.com.
The payee's State License Number.
The payee's Federal Tax Identification Number (TIN).
Information about the payer making the payment.
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The payer's address information.
Show attributes
The first line of the address.
The second line of the address.
The city where the address is located.
The standard code for the country from Part 1 of ISO 3166.
The standard code for the country subdivision from Part 2 of ISO 3166.
The postal code for the address, excluding punctuation and blanks.
The standard code for the state or province. For example PA for Pennsylvania.
A person or office.
Show attributes
Array item
The email address.
The fax number.
The telephone number including the area code (if applicable). Phone numbers are formatted as AAABBBCCCC, where AAA represents the area code, BBB represents the telephone number prefix, and CCCC represents the telephone number. Phone numbers are provided without separators, such as dashes or parentheses. For example, 5551123345 for 555-112-3345.
The telephone extension, if applicable.
The name of the contact person or entity.
Formerly used to report the payer's Health Plan ID (HPID) or Other Entity Identifier (OEID). The Centers for Medicare and Medicaid Services (CMS) no longer uses HPID, so this property will not be populated.
The payer's health industry number.
The payer's business name, such as Cigna or Aetna.
The payer's National Association of Insurance Commissioners (NAIC) code.
An identifier for the payer. For Medicare carriers or intermediaries, this is the Medicare carrier or intermediary ID number. For Blue Cross and Blue Shield Plans, this is the Blue Cross Blue Shield association plan code.
Providers rarely use this identifier in practice.
The payer's web address. The URL is typically provided without the scheme and separator. For example, stedi.com.
An identifier for the payer. This is used when the original transaction sender is not the payer or has an identifier other than those already provided.
A person or office.
Array item
Available contact methods for technical support.
Array item
The contact email address.
The contact fax number.
The contact telephone number including the area code. Phone numbers are formatted as AAABBBCCCC, where AAA represents the area code, BBB represents the telephone number prefix, and CCCC represents the telephone number. Phone numbers are provided without separators, such as dashes or parentheses. For example, 5551123345 for 555-112-3345.
The contact telephone extension, if applicable.
A web address to contact the person or entity. The URL is typically provided without the scheme and separator. For example, stedi.com.
The name of the contact person or entity.
Payment and remittance reassociation details for transaction tracking.
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This value uniquely identifies the transaction. This is either the check number, the EFT reference number, or a unique remittance advice identification number (for non-payment ERAs).
A unique identifier for the payer. This is a 1 followed by the payer's Employer Identification Number (EIN) or Taxpayer Identification Number (TIN).
A value that identifies a further subdivision within the payer's organization.
Code that identifies which transaction is being referenced. This can be set to 1 - Current Transaction Trace Numbers.
1^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The end date for the adjudication production cycle for claims included in this ERA.
Provider-level adjustment information for debit or credit transactions such as: accelerated payments, cost report settlements for a fiscal year, and timeliness report penalties unrelated to a specific claim or service. These adjustments can either decrease the payment (a positive number) or increase the payment (a negative number).
Array item
List of adjustments applied to the provider.
Array item
A code identifying the reason for the adjustment. Visit Provider Adjustment Reason Codes for a complete list and descriptions.
The description of the adjustmentReasonCode.
The amount of the adjustment, per the adjustment reason provided. A negative amount increases the claim payment and a positive amount decreases the claim payment.
An identifier used to assist the receiver in identifying, tracking, or reconciling the adjustment.
^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$The last day of the provider's fiscal year.
This is the provider's NPI.
The business identification information for the entity initially receiving the transaction. This is typically included when the receiver of the transaction is not the payee, such as a clearinghouse or billing service.
The version number of the adjudication system that generated the claim payments.
curl --request GET \ --url "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/reports/v2/{transactionId}/835" \ --header "Authorization: <api_key>"fetch("https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/reports/v2/{transactionId}/835", { headers: { "Authorization": "<api_key>" }})package mainimport ( "fmt" "net/http" "io/ioutil")func main() { url := "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/reports/v2/{transactionId}/835" req, _ := http.NewRequest("GET", url, nil) req.Header.Add("Authorization", "<api_key>") res, _ := http.DefaultClient.Do(req) defer res.Body.Close() body, _ := ioutil.ReadAll(res.Body) fmt.Println(res) fmt.Println(string(body))}import requestsurl = "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/reports/v2/{transactionId}/835"response = requests.request("GET", url, headers = { "Authorization": "<api_key>"})print(response.text)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;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/reports/v2/{transactionId}/835")) .header("Authorization", "<api_key>") .GET() .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();}{
"meta": {
"applicationMode": "production",
"senderId": "BSW",
"transactionId": "7647d644-9348-4596-a3b4-6830b8b48cc8"
},
"transactions": [
{
"controlNumber": "112233",
"detailInfo": [
{
"assignedNumber": "1",
"paymentInfo": [
{
"claimPaymentInfo": {
"claimFilingIndicatorCode": "12",
"claimFrequencyCode": "1",
"claimPaymentAmount": "500",
"claimStatusCode": "1",
"facilityTypeCode": "11",
"patientControlNumber": "1112223333",
"patientResponsibilityAmount": "300",
"payerClaimControlNumber": "94060555410000",
"totalClaimChargeAmount": "800"
},
"claimSupplementalInformation": {
"coverageAmount": "800"
},
"patientName": {
"firstName": "JOHN",
"lastName": "DOE",
"memberId": "1234567891"
},
"serviceLines": [
{
"lineItemControlNumber": "111222333",
"serviceAdjustments": [
{
"adjustmentAmount1": "300",
"adjustmentReason1": "Deductible Amount",
"adjustmentReasonCode1": "1",
"claimAdjustmentGroupCode": "PR",
"claimAdjustmentGroupCodeValue": "Patient Responsibility"
}
],
"serviceDate": "20190301",
"servicePaymentInformation": {
"adjudicatedProcedureCode": "99211",
"lineItemChargeAmount": "800",
"lineItemProviderPaymentAmount": "500",
"productOrServiceIDQualifier": "HC",
"productOrServiceIDQualifierValue": "Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes"
},
"serviceSupplementalAmounts": {
"allowedActual": "800"
}
}
]
},
{
"claimPaymentInfo": {
"claimFilingIndicatorCode": "12",
"claimFrequencyCode": "1",
"claimPaymentAmount": "600",
"claimStatusCode": "1",
"facilityTypeCode": "11",
"patientControlNumber": "22255566677",
"patientResponsibilityAmount": "600",
"payerClaimControlNumber": "9407779923000",
"totalClaimChargeAmount": "1200"
},
"claimSupplementalInformation": {
"coverageAmount": "1200"
},
"patientName": {
"firstName": "JANE",
"lastName": "DOE",
"memberId": "1234567891"
},
"serviceLines": [
{
"serviceAdjustments": [
{
"adjustmentAmount1": "600",
"adjustmentReason1": "Deductible Amount",
"adjustmentReasonCode1": "1",
"claimAdjustmentGroupCode": "PR",
"claimAdjustmentGroupCodeValue": "Patient Responsibility"
}
],
"serviceDate": "20190310",
"servicePaymentInformation": {
"adjudicatedProcedureCode": "93555",
"lineItemChargeAmount": "1200",
"lineItemProviderPaymentAmount": "600",
"productOrServiceIDQualifier": "HC",
"productOrServiceIDQualifierValue": "Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes"
},
"serviceSupplementalAmounts": {
"allowedActual": "1200"
}
}
]
}
]
}
],
"financialInformation": {
"checkIssueOrEFTEffectiveDate": "20190316",
"creditOrDebitFlagCode": "C",
"payerIdentifier": "000000000",
"paymentFormatCode": "CCP",
"paymentMethodCode": "ACH",
"receiverAccountDetails": {
"receiverAccountNumber": "144444",
"receiverAccountNumberQualifier": "DA",
"receiverDfiIdNumberQualifier": "01",
"receiverDfiIdentificationNumber": "111333555"
},
"senderAccountDetails": {
"senderAccountNumber": "11111111",
"senderAccountNumberQualifier": "DA",
"senderDFIIdentifier": "888999777",
"senderDfiIdNumberQualifier": "01"
},
"totalActualProviderPaymentAmount": "1100",
"transactionHandlingCode": "I"
},
"payee": {
"federalTaxPayersIdentificationNumber": "777667755",
"name": "ACME MEDICAL CENTER",
"npi": "1999999984"
},
"payer": {
"address": {
"address1": "10 SOUTH AVENUET",
"city": "NEW YORK",
"postalCode": "55111",
"state": "SD"
},
"name": "RUSHMORE LIFE",
"technicalContactInformation": [
{
"contactMethods": [
{
"phone": "8005550000"
}
],
"contactName": "JOHN DOE"
}
]
},
"paymentAndRemitReassociationDetails": {
"checkOrEFTTraceNumber": "71700666555",
"originatingCompanyIdentifier": "1935665544",
"traceTypeCode": "1"
},
"productionDate": "20190314"
}
]
}{
"code": "string",
"message": "string"
}{
"code": "string",
"message": "string"
}{
"code": "string",
"message": "string"
}{
"code": "string",
"message": "string"
}{
"code": "string",
"message": "string"
}{
"code": "string",
"message": "string"
}{
"code": "string",
"message": "string"
}