Medical Network Professional Claims v3

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Overview

The Professional Claims API takes the standard established in the X12 EDI 837P transaction and translates this standard to JSON so it is more accessible to developers and easily integrated into users’ applications.

The ASC X12N Health Care Claim: Professional (837P) transaction allows 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. Use the Validation API to check and validate your upcoming submission. Your transaction will not be sent to the payer. The validation does not examine the actual contents of your claim; it checks for the correct well-formed syntax of the submission, and elements such as correctly summing service line charges and verifying codes.