Medical Network Institutional Claims v1

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Overview

The ASC X12N Health Care Claim: Institutional (837i) transaction enables healthcare providers to submit healthcare claims for a service or encounter. A healthcare claim includes patient information, related diagnoses, procedures performed or services provided, and any related charges. This API also translates standard X12 EDI 837i transactions to JSON so that it is more accessible to claim readers and developers.

Prior to submitting an institutional claim, the Institutional Claims Validation endpoint allows the submitter to run claims through extensive repositories of rules and logic in order to correct potential errors before to sending to the payer. This allows for significant savings in time and a higher propensity for acceptance on the first submission.