Submit paper claims

Some payers require claims to be submitted on paper rather than electronically. Instead of mailing these claims yourself, you can send the claim information to Stedi using an electronic submission workflow with the receiver ID set to PAPER. Stedi then handles printing and mailing the claim to the designated payer on your behalf.

Supported claim types

You can submit the following claim types for printing and mailing:

Claim Type	Submission Methods
Professional (CMS-1500 form)	API: Professional Claims JSON \| Professional Claims Raw X12 SFTP: 837P X12 EDI UI: 1500 form
Institutional (UB-04 form)	API: Institutional Claims JSON \| Institutional Claims Raw X12 SFTP: 837I X12 EDI

Limitations

Paper claims currently have the following limitations:

No dental claims: 837D dental claims (ADA form) aren't supported for paper submission.
No paper attachments: You can't submit paper attachments today by setting the receiver ID to PAPER.
No real-time claim status: Real-time claim status checks aren't supported for paper claims.
Limited acknowledgments: You'll receive 277CA claim acknowledgments indicating when Stedi has forwarded the claim for printing. Additional status updates (such as when the claim is printed, mailed, or returned as undeliverable) aren't currently available.
ERAs typically unavailable: Payers that require paper claim submission usually don't support Electronic Remittance Advice (ERAs). Instead, they typically mail an Explanation of Benefits (EOB) back to the provider.

Transaction enrollment

Transaction enrollment isn't required for paper claim submission - it's only required for electronic transactions.

You may still need to complete transaction enrollment for Electronic Remittance Advice (ERAs) if the payer supports them. However, payers that require paper claim submission usually don't support ERAs:

HIPAA covered entity health plans are required to send ERAs electronically.
Other health plans may use different formats and communication channels for both claim submissions and remittances.

Paper receiver ID

Stedi uses a special payer ID to route claim submissions for printing and mailing: PAPER (Print and Mail - All Payers). You'll submit this as the receiver ID in the claim submission.

For paper claims, it's the receiver ID that determines whether a claim is printed and mailed or sent electronically:

Name	Location	Description
Receiver ID	JSON: `receiver.receiverId` X12 EDI: `Loop 1000B` (Receiver Name) `NM109` CMS-1500 UI: Send section	Controls the delivery method.
Payer ID	JSON: `tradingPartnerServiceId` X12 EDI: `Loop 2010BB` (Payer Name) `NM109` CMS-1500 UI: Stedi payer dropdown	Identifies the destination payer.

When the receiver ID is set to PAPER (or By mail is selected in the CMS-1500 form), Stedi bypasses the traditional electronic submission flow and uses the mail-to payer name and mailing address to print and mail a paper claim to the payer.

You'll still set the payer ID to the destination payer's ID or alias, if available in the Stedi Payer Network. However, you can also set the payer ID to PAPER when you need to send paper claims to payers outside of the electronic network.

For example, you can set the receiver ID to PAPER while keeping the payer ID as CIGNA. This tells Stedi to print and mail the claim to Cigna.

JSON - API submission

You can send paper claims through the following JSON endpoints:

Construct your claim request as you normally would. Then, add the following information.

Property	Description
`receiver.organizationName`	The actual payer name, such as Cigna.
`receiver.receiverId`	Set to `PAPER`. This is what tells Stedi to bypass the typical electronic submission flow and instead route this claim to be printed and mailed.
`tradingPartnerName`	The mail-to payer name. This is what should be listed on the physical envelope. This information may be different from `receiver.organizationName`.
`tradingPartnerServiceId`	Set this to the destination payer's ID or alias, if available in the Stedi Payer Network. If you're sending claims to payers outside the Payer Network, set this to `PAPER`.
`payerAddress.address1`	The first line of the street address. This typically contains the building number and street name.
`payerAddress.address2`	The second line of the street address. This is optional, and typically contains the apartment or suite number, if relevant.
`payerAddress.city`	The city name.
`payerAddress.state`	The state or province code. Only required when the city is in the United States and Canada.
`payerAddress.postalCode`	The postal zone or zip code. Exclude punctuation and spaces.

After you submit the claim, Stedi will use the paper payer ID and the mailing address you provided to route the claim for printing and mailing.

Example: Professional paper claim

The following example sends a professional paper claim to Cigna.

curl --request POST \
  --url "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/submission" \
  --header "Authorization: <api_key>" \
  --header "Content-Type: application/json" \
  --data '{
  "receiver": {
    "receiverId": "PAPER",
    "organizationName": "CIGNA"
  },
  "tradingPartnerName": "CIGNA Workers Compensation Claims",
  "tradingPartnerServiceId": "62308",
  "payerAddress": {
    "address1": "123 Example Street",
    "address2": "STE 100",
    "city": "Mountain View",
    "state": "CA",
    "postalCode": "940433706"
  }
  ... // remaining claim data
}'

Example: Payer not in Stedi's network

The following example sets the tradingPartnerServiceId to PAPER because this payer is outside the Stedi Payer Network.

curl --request POST \
  --url "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/professionalclaims/v3/submission" \
  --header "Authorization: <api_key>" \
  --header "Content-Type: application/json" \
  --data '{
  "receiver": {
    "receiverId": "PAPER",
    "organizationName": "ACME Employer LLC"
  },
  "tradingPartnerName": "ACME Employer LLC",
  "tradingPartnerServiceId": "PAPER",
  "payerAddress": {
    "address1": "987 Example Street",
    "address2": "STE 200",
    "city": "Philadelphia",
    "state": "PA",
    "postalCode": "19192"
  },
  ... // remaining claim data
}'

X12 EDI - API and SFTP submission

You can send X12 EDI claims through the following methods:

API endpoints: Professional Claims Raw X12 | Institutional Claims Raw X12
SFTP: SFTP connection guide

Construct an X12 EDI claim as you normally would. Then, add the following information.

Location Elements

Location	Elements
`Loop 1000B` (Receiver Name)	Set the following paper-specific elements: `NM103`: The actual payer name, such as Cigna. `NM109`: Set to `PAPER`. This is what tells Stedi to bypass the typical electronic submission flow and instead route this claim to be printed and mailed.
`Loop 2010BB` (Payer Name)	Set the following paper-specific elements: `NM103`: The mail-to payer name. This is what should be listed on the physical envelope. This information may be different from `1000B NM103`. `NM109`: Set this to the destination payer's ID or alias, if available in the Stedi Payer Network. If you're sending claims to payers outside the Payer Network, set this to `PAPER`. `N301`: The first line of the street address. This typically contains the building number and street name. `N302`: The second line of the street address. This is optional, and typically contains the apartment or suite number, if relevant. `N401`: The city name. `N402`: The state or province code. Only required when the city is in the United States and Canada. `N403`: The postal zone or zip code. Exclude punctuation and spaces.

Loop 1000B (Receiver Name)

Set the following paper-specific elements:

NM103: The actual payer name, such as Cigna.
NM109: Set to PAPER. This is what tells Stedi to bypass the typical electronic submission flow and instead route this claim to be printed and mailed.

Loop 2010BB (Payer Name)

Set the following paper-specific elements:

NM103: The mail-to payer name. This is what should be listed on the physical envelope. This information may be different from 1000B NM103.
NM109: Set this to the destination payer's ID or alias, if available in the Stedi Payer Network. If you're sending claims to payers outside the Payer Network, set this to PAPER.
N301: The first line of the street address. This typically contains the building number and street name.
N302: The second line of the street address. This is optional, and typically contains the apartment or suite number, if relevant.
N401: The city name.
N402: The state or province code. Only required when the city is in the United States and Canada.
N403: The postal zone or zip code. Exclude punctuation and spaces.

After you submit the claim, Stedi will use the paper payer ID and the mailing address you provided to route the claim for printing and mailing.

Example: Professional paper claim

The following example uses:

The payer payer ID PAPER in Loop 1000B (Receiver Name) NM109.
Cigna's payer ID from the Stedi Payer Network in Loop 2010BB (Payer Name) NM109.

ISA...~
GS...~
ST*837*0001*005010X222A1~
...

NM1*40*2*CIGNA*****46*PAPER~                             // Paper payer ID
NM1*PR*2*CIGNA Workers Compensation Claims*****PI*62308~ // Name and payer ID
N3*123 Example Street*STE 100~                           // Mailing address
N4*Mountain View*CA*940433706~

...
SE...~
GE...~
IEA...~

Example: Payer not in Stedi's network

The following example uses:

The payer payer ID PAPER in Loop 1000B (Receiver Name) NM109.
The paper payer ID PAPER in Loop 2010BB (Payer Name) NM109. This allows you to submit paper claims to payers outside of the Stedi Payer Network.

ISA...~
GS...~
ST*837*0001*005010X222A1~
...

NM1*40*2*ACME Employer LLC*****46*PAPER~ // Paper payer ID
NM1*PR*2*ACME Employer LLC*****PI*PAPER~ // Name and paper payer ID
N3*987 Example Street*STE 200~           // Mailing address
N4*Philadelphia*PA*19192~

...
SE...~
GE...~
IEA...~

UI submission (CMS-1500 form)

You can submit professional paper claims through the CMS-1500 form UI in the Stedi portal. Within the form, configure these paper-specific settings:

CMS-1500 paper claim fields

In the Send section, select By mail. This expands the UI to show additional fields for the mail-to payer name and payer address.
In the Stedi payer dropdown:
- If the payer exists in Stedi's Payer Network, select it from the dropdown.
- If the payer is not in the network, check I'm sending to a payer not found in Stedi's network. Stedi automatically populates the dropdown with the Print and Mail - All Payers option.
In the Postage address section:
- Update the Mail-to payer name if necessary. This becomes the addressee on the physical envelope.
- Fill in the Payer address fields with the complete mailing address where the claim should be sent.

After you submit the claim, Stedi will use the paper payer ID and the mailing address you provided to route the claim for printing and mailing.

Paper claim responses

When you submit a paper claim, you receive different types of responses than you would for electronic claims. This section explains what acknowledgments and remittances to expect.

277CA claim acknowledgments

After you submit a paper claim, Stedi immediately confirms receipt:

API: Stedi returns an HTTP response with claim submission details.
SFTP: Stedi generates a 999 Functional Acknowledgment confirming receipt of the EDI file.
UI: The portal displays a confirmation message with the submitted claim details.

Then, Stedi returns a 277CA claim acknowledgment with category code A1 (Acknowledgment/Receipt) and status code 19 (Acknowledged) to indicate that we received the claim and forwarded it to our print-and-mail vendor. This is not confirmation that the claim has been printed or mailed.

{
  "providerStatuses": [
    {
      "healthCareClaimStatusCategoryCode": "A1",
      "healthCareClaimStatusCategoryCodeValue": "Acknowledgement/Receipt - The claim/encounter has been received. This does not mean that the claim has been accepted for adjudication.",
      "statusCode": "19",
      "statusCodeValue": "Acknowledged.",
      "entityIdentifierCode": "40",
      "entityIdentifierCodeValue": "Receiver"
    }
  ],
  "statusInformationEffectiveDate": "20260101",
  "totalSubmittedChargeAmount": "100.50"
}

STC*A1:19:40*20260101*WQ*100.50~

You won't receive electronic 277CAs from the payer the way you would for an electronic claim submission. Instead, payers may send printed acknowledgments through the mail.

Real-time claim status checks aren't supported for paper claim submissions. If you haven't received an Explanation of Benefits (EOB) in your expected timeframe, you'll need to contact the payer directly for details.

Explanation of Benefits (EOB)

Payers that require paper claim submission usually don't support Electronic Remittance Advice (ERAs). Instead, they mail an Explanation of Benefits (EOB) back to the provider.

This means you shouldn't expect to receive 835 ERAs through Stedi for paper claims. You'll receive paper EOBs by mail from the payer.

Claim attachments

Paper claims with attachments aren't supported today. You can't submit claim attachments with paper claims by setting the receiver ID to PAPER.

Submit paper claims

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