Test ERAs now support professional claims without an NPI

Stedi's test claims workflow now returns a test Electronic Remittance Advice (ERA) for professional claims without the billing provider’s National Provider Identifier (NPI).

The test claims workflow lets you submit a test claim to the Stedi Test Payer and get a test ERA in response. You can use the workflow to do end-to-end validation and build integration tests.

Atypical providers – providers without an NPI – sometimes submit professional claims using a commercial number or location number.

Previously, the test claims workflow required the billing provider’s NPI in the submitted claim to generate and return a test ERA. Now, the test ERA uses the billing provider's tax ID instead.

Submitting the test claim

To generate a test ERA without the billing provider’s NPI, include the billing provider’s tax ID and a state license number when submitting the test professional claim to the Stedi Test Payer.

Field837P Claims Submission JSON API fieldX12 element
Tax IDbilling.employerIdREF02 of Loop 2010AA (Billing Provider Name), where REF01 = ”EI” (Employer's Identification Number)
State license numberbilling.stateLicenseNumberREF02 of Loop 2010AA (Billing Provider Name), where REF01 = ”0B” (State License Number)

Receiving the test ERA

The test ERA identifies the payee by tax ID and returns the state license number from the original claim.

Field835 ERA Report API fieldX12 element
Tax IDpayee.federalTaxPayersIdentificationNumberN104 of Loop 1000B (Payee Identification), where N103 = ”FI” (Federal Tax ID)
State license numbertransactions[].payee.stateLicenseNumberREF02 of Loop 1000B (Payee Identification), where REF01 = ”0B” (State License Number)

For example, an ERA retrieved using the 835 ERA Report endpoint:

{
  "transactions": [
    {
      "payee": {
        "name": "Test Provider",
        "taxId": "123456789", // Billing provider's tax ID
        "stateLicenseNumber": "LIC987654", // Billing provider's state license, if submitted
        ...
      },
      ...
    }
  ]
}

For more information, see our Test claims workflow docs.

PreviousClaim edit: Invalid diagnosis-related group code format

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