Test claim workflows

You can submit test professional, dental, and institutional claims through the APIs, SFTP, or Stedi portal. Stedi processes test transactions, applies all validation, and returns test responses without sending any data to the payer. If you're new to Stedi, submitting test claims is a great way to learn how claims processing at Stedi works.

Stedi offers two test claim workflows for production accounts. Sandbox accounts can't submit test claims.

• Test payer-specific edits: Submit test claims to any payer and receive test 277CA claim acknowledgments from Stedi.
• Generate a test ERA: Submit test claims to the Stedi Test Payer and receive both test 277CA and test 835 ERA responses from Stedi.

Don't submit Protected Health Information (PHI) or Personally Identifiable Information (PII) in test claims.

Get test credentials

You need test credentials to send test claims and receive test responses.

API - Test API key

When submitting test claims through Stedi APIs, create a test API key:

1. Log into your Stedi account.
2. Click API keys in the side navigation.
3. Click + Generate new API Key.
4. Enter descriptive name for the API key.
5. Choose Test as the Mode.
6. Click Generate.
7. Copy your key and store it in a secure location. Stedi won't show it again.

Learn more about API authentication.

SFTP - Test user

When submitting test claims through Stedi SFTP, create a test user:

1. Go to the SFTP setup page in your account settings.
2. Click + Add test user.
3. Enter a description like "Test claims - Stedi Test Payer" and click Create.
4. Copy your credentials and store them in a secure location. Stedi won't show them again.

Use your user credentials to connect to Stedi's SFTP server at transfer.us.stedi.com using Port 22. Visit SFTP setup for more details.

UI - Test mode

Toggle Test mode to ON at the top of the side navigation. When test mode is on, you can:

• Submit test claims through the CMS-1500 form.
• Review test claim submissions and processing activity from the claims view.
• Review test ERAs from the 835 ERAs view.

Workflow 1: Test payer-specific edits

You can submit test claims to any payer. For each test claim, Stedi applies our entire catalog of edits and repairs (including any payer-specific edits) and returns a 277CA claim acknowledgment indicating whether it passed our validation.

This test claims workflow helps you validate claim data for specific payers and practice handling and interpreting 277CA responses. It's only available for production accounts.

Submit test claims and attachments

You can submit test 837 claims and unsolicited 275 claim attachments through Stedi APIs, SFTP, or the Stedi portal. Stedi processes these transactions and applies all validation without sending them to the payer.

Submission Method	Designate as Test
JSON APIs: Professional Claim JSON, 837P JSON (Legacy), 837I JSON, 837D JSON, 275 Claim Attachments	Use a test API key. Stedi infers the mode - test or production - from the API key type. For 837 JSON APIs, the usageIndicator is optional. If present, it must be T, otherwise Stedi rejects the request with an HTTP 403 error.
Raw X12 APIs: 837P Raw X12, 837I Raw X12, 837D Raw X12, 275 Claim Attachments	Use a test API key. Set ISA15 to T (Test Data). If omitted, Stedi returns an HTTP 400 error with a TA1 rejection.
SFTP: Docs	Use an SFTP test user. Set ISA08 to STEDITEST. Set ISA15 to T (Test Data).
Portal: CMS-1500 form	Toggle Test mode to ON in the side navigation. Go to the claims view and click Submit claim. Select CMS-1500 form. Fill out and submit. You can add claim attachments in Box 19b or service-line attachments in Box 24 to test that workflow. Stedi automatically routes to the test clearinghouse.

Patient Control Number

We recommend setting a unique Patient Control Number (PCN) for each test claim in:

• JSON: claimInformation.patientControlNumber
• X12 EDI: Loop 2300 CLM01 (Patient Control Number)
• CMS-1500 claim form UI: Set Box 26 (Patient account number)

This lets you and Stedi correlate each test claim with the associated test responses. To get started, simple numeric values like 11122333 are fine, as long as they're unique. For best results in production, implement our PCN best practices.

Examples

Test responses

Stedi emits the following test responses when you send test claims to any payer.

999s (SFTP)

For SFTP submissions, Stedi emits 999 Implementation Acknowledgments if we reject any transaction in your submission (including partial rejections). We emit 999s for both claim and claim attachment submissions.

We strongly recommend monitoring the from-stedi directory for these error 999s that indicate rejections. Visit Monitor for 999 rejections for details.

277CAs

For all submission methods, Stedi returns a test 277CA claim acknowledgment indicating whether it passed our validation.

Visit Retrieve test responses for instructions about how to review and interpret the 277CA response.

Workflow 2: Generate a test ERA

When you submit test claims to the Stedi Test Payer, Stedi returns a test 277CA claim acknowledgment and a test 835 Electronic Remittance Advice (ERA) based on the original claim. Only test claims you send to the Stedi Test Payer generate a test 835 ERA.

This test claims workflow lets you evaluate your claims processing integration from end to end. It's only available for production accounts.

Enroll with the Stedi Test Payer

You must enroll your provider with the Stedi Test Payer for 835 Claim payment (transactions.claimPayment).

You must complete the enrollment in production - you can't submit enrollments with a test API key or in test mode. Once the enrollment is complete, switch to test credentials to submit test claims and retrieve test responses.

Submit an enrollment request through one of the following options:

• Stedi portal: Toggle Test mode to OFF at the top of the side navigation. Follow the UI submission instructions to create a provider record and then an enrollment request for the Stedi Test Payer.
• API: Create a production API key. Call Create Provider and then Create Enrollment to enroll that provider with the Stedi Test Payer.

If you need to test ERAs for providers without an NPI:

• Enroll with a dummy NPI value, such as 1999999984. Stedi validates NPIs using the Luhn algorithm, so your dummy NPI must pass this check.
• Use a random, unique tax ID when enrolling to avoid collisions with real tax IDs in other Stedi accounts.
• Submit test claims with a state license number and the tax ID from your enrollment.

Once submitted, Stedi automatically sets the enrollment request to LIVE status within one minute. You can start submitting test claims to the Stedi Test Payer immediately.

Submit test claims and attachments

You can submit test 837 claims and unsolicited 275 claim attachments to the Stedi Test Payer. Include the billing provider identifiers you enrolled with the Stedi Test Payer. You can submit:

• Providers with an NPI: NPI and tax ID
• Providers without an NPI: tax ID and state license number

Submission Method	Submit test claim
JSON APIs: Professional Claim JSON, 837P JSON (Legacy), 837I JSON, 837D JSON, 275 Claim Attachments	Use a test API key. Stedi infers the mode - test or production - from the API key type. Set payer id to STEDI. For 837 JSON APIs, set tradingPartnerServiceId to STEDI and the usageIndicator is optional. If present, it must be T, otherwise Stedi rejects the request with an HTTP 403 error.
Raw X12 APIs: 837P Raw X12, 837I Raw X12, 837D Raw X12, 275 Claim Attachments	Use a test API key. Set ISA15 to T (Test Data). If omitted, Stedi returns an HTTP 400 error with a TA1 rejection. Set Loop 2010BB (Payer Name) NM109 to STEDI.
SFTP: Docs	Use an SFTP test user. Set ISA15 to T (Test Data) and ISA08 to STEDITEST. Set Loop 2010BB (Payer Name) NM109 to STEDI.
Portal: CMS-1500 form	Toggle Test mode to ON in the side navigation. Go to the claims view and click Submit claim. Select CMS-1500 form. Select the Stedi Test Payer. Fill out and submit. You can add claim attachments in Box 19b or service-line attachments in Box 24 to test that workflow. Stedi automatically routes to the test clearinghouse.

Patient Control Number

We recommend setting a unique Patient Control Number (PCN) for each test claim in:

• JSON: claimInformation.patientControlNumber
• X12 EDI: Loop 2300 CLM01 (Patient Control Number)
• CMS-1500 claim form UI: Set Box 26 (Patient account number)

This lets you and Stedi correlate each test claim with the associated test responses. To get started, simple numeric values like 11122333 are fine, as long as they're unique. For best results in production, implement our PCN best practices.

Examples

Test responses

Stedi emits the following test responses when you submit test claims to the Stedi Test Payer.

999s (SFTP)

For SFTP submissions, Stedi also emits 999 Implementation Acknowledgments when we reject any transaction in your submission (including partial rejections). We emit 999s for both claim and claim attachment submissions.

We strongly recommend monitoring the from-stedi directory for these error 999s that indicate rejections. Visit Monitor for 999 rejections for details.

277CAs and 835 ERA

For all submission methods, Stedi returns the following responses within minutes:

• A test 277CA claim acknowledgment indicating whether Stedi successfully processed the claim. Visit Interpret test 277CAs for details.
• A test 835 Electronic Remittance Advice (ERA) containing information from the original claim, including the same:
  • Provider information
  • Patient information
  • Service line details
  • Charges

Test 835 ERAs identify the payee using the billing provider's tax ID from the claim submission. The ERA also includes whichever provider identifier you submitted in the 837 claim (NPI or state license number).

Test 835 ERAs always show all service lines as paid, with the same charge amounts you submitted in the test claim. Note that when you submit production claims, payers may send ERAs with different outcomes, including partially paid, denied, split, or bundled claims.

If Stedi rejects the claim in the 277CA, you won't receive a test 835 ERA.

View test claims

You can view test claims from the claims view in the Stedi portal. Toggle Test mode to ON in the side navigation to review test claims and their associated responses.

Retrieve test responses

The simplest way to review test claim responses is through the Stedi portal. Regardless of submission method (API, SFTP, or UI), Stedi displays test claims and associated responses on the claims view.

You can also retrieve claim responses through Stedi's APIs or SFTP.

Stedi portal

Toggle Test mode to ON in the side navigation.

To review test 277CAs:

1. Go to the claims view.
2. Click a test claim to view a timeline of its processing activity.
3. Click an Acknowledgment (277CA) to review its details.

Stedi displays key information about the 277CA, including the billing provider's information and status codes.

To review test ERAs:

1. Click 835 ERAs in the side navigation to go to the 835 ERAs view. Stedi displays a list of all test ERAs in your account.
2. Click an ERA to review its details.

The Claim payment information table contains one row per claim payment information record. There's one row for each claim included in the test ERA. Click a row to view the claim payment information details specific to your test claim submission.

APIs

To retrieve test responses:

1. Either listen for webhooks or poll for transactions.

2. Call Stedi's 277CA Report and 835 ERA Report endpoints with a test API key.

   If you try to retrieve test transactions with a production key, Stedi returns an HTTP 404 error.

Visit Get, correlate, and interpret 277CAs and ERAs for complete instructions.

SFTP

Stedi drops claim responses in your server's from-stedi directory. Visit SFTP submission for details.

999 settings

By default, you only receive 999s when Stedi rejects one or more transactions in a functional group. You can opt in to receive 999s for fully accepted functional groups as well. To change this:

1. Go to the SFTP setup page.
2. Choose All 999s in the 999 settings section.

Match test responses to claim

When retrieving test responses through Stedi's APIs or SFTP, you can use the Patient Control Number (PCN) to match both 277CA and 835 ERA responses with the original test claim.

For 277CAs, the PCN is available in the following locations:

• JSON: transactions[].payers[].claimStatusTransactions[].claimStatusDetails[].patientClaimStatusDetails[].claims[].claimStatus.patientAccountNumber
• X12 EDI: Loop 2200D TRN02 (Patient Control Number)

For 835 ERAs, the PCN is available in the following locations:

• JSON: transactions[].detailInfo[].paymentInfo[].claimPaymentInfo.patientControlNumber
• X12 EDI: Loop 2100 CLP01 (Patient Control Number)

Interpret test 277CAs

When a test claim passes Stedi's validation, Stedi returns a 277CA with the following codes. These are the same codes you receive when Stedi forwards production claims to the payer.

In serviceProviderClaimStatuses, which is Loop 2200C (Provider of Service Information):

• Claim Status Category Code: A1 - Acknowledgment/Receipt
• Claim Status Code: 19 - Entity acknowledges receipt of claim/encounter.

In claimStatus, which is Loop 2200C (Claim Status Tracking Number):

• Claim Status Category Code: A1 - Acknowledgment/Receipt
• Claim Status Code: 16 - Claim/encounter has been forwarded to entity.

When Stedi rejects your test claim, these locations contain error codes to help you diagnose and fix the issues with your claim data. Visit Interpret 277CA claim status for more details and sample 277CA rejection codes.