The submitter uses a Claim Status request to ask about the status of a previously submitted claim. The payer returns the response, as an X12 EDI 277 transaction, which is translated back to JSON by the API gateway.
If the claim is finalized, the response provides the disposition of the claim (for example, paid or denied). For denied or rejected outcomes, the response includes the reasons for the denial or rejection.
Reduces transaction costs and enables faster payments with better accuracy and streamlined, digital processes
Tools you need to navigate the complex ecosystem of member benefit and claim transactions