Claim.MD Claim Status API

openapi: 3.0.1
info:
  title: Claim.MD Claim Status API
  description: REST API for the Claim.MD medical-claims clearinghouse. The API supports electronic claim submission (837P/837I and other formats), claim status and response retrieval, electronic remittance advice (835 ERA), real-time eligibility (270/271), the payer directory, provider enrollment, appeals, and webhook notifications. All requests are authenticated with an AccountKey and responses can be returned as XML (default) or JSON via the Accept header.
  termsOfService: https://www.claim.md/terms
  contact:
    name: Claim.MD Support
    url: https://www.claim.md/contact
  version: '1.0'
servers:
- url: https://svc.claim.md
  description: Claim.MD production API service
security:
- AccountKey: []
tags:
- name: Claim Status
  description: Claim status responses, modifications, and notes.
paths:
  /services/response/:
    post:
      operationId: getClaimResponses
      tags:
      - Claim Status
      summary: Retrieve claim status responses
      description: Incrementally retrieve claim status responses and acknowledgements. Send ResponseID=0 for the initial request, then pass the highest returned ResponseID to fetch only newer responses. Max 20,000 results per request.
      requestBody:
        required: true
        content:
          application/x-www-form-urlencoded:
            schema:
              type: object
              required:
              - AccountKey
              - ResponseID
              properties:
                AccountKey:
                  type: string
                ResponseID:
                  type: integer
                  description: Last seen ResponseID; use 0 for the initial request.
                ClaimID:
                  type: string
                  description: Optional filter for a specific claim.
      responses:
        '200':
          description: Claim status responses.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ResponseList'
  /services/modify/:
    post:
      operationId: getClaimModifications
      tags:
      - Claim Status
      summary: Retrieve claim modification events
      description: Incrementally retrieve claim field modification history.
      requestBody:
        required: true
        content:
          application/x-www-form-urlencoded:
            schema:
              type: object
              required:
              - AccountKey
              properties:
                AccountKey:
                  type: string
                ModID:
                  type: integer
                  description: Last seen ModID for incremental updates.
                ClaimMD_ID:
                  type: string
                  description: Optional filter for a specific claim.
                Field:
                  type: string
                  description: Optional field-name filter.
      responses:
        '200':
          description: Claim modification events.
  /services/notes/:
    post:
      operationId: getClaimNotes
      tags:
      - Claim Status
      summary: Retrieve claim notes
      description: Incrementally retrieve user notes attached to claims.
      requestBody:
        required: true
        content:
          application/x-www-form-urlencoded:
            schema:
              type: object
              required:
              - AccountKey
              properties:
                AccountKey:
                  type: string
                NoteID:
                  type: integer
                  description: Last seen NoteID for incremental updates.
                ClaimMD_ID:
                  type: string
                  description: Optional filter for a specific claim.
      responses:
        '200':
          description: Claim notes.
  /services/archive/:
    post:
      operationId: archiveClaim
      tags:
      - Claim Status
      summary: Archive a claim
      description: Archive or delete one or more claims by claim identifier.
      requestBody:
        required: true
        content:
          application/x-www-form-urlencoded:
            schema:
              type: object
              required:
              - AccountKey
              - claimid
              properties:
                AccountKey:
                  type: string
                claimid:
                  type: string
                  description: Claim identifier; may be repeated to archive multiple claims.
      responses:
        '200':
          description: Archive status.
components:
  schemas:
    ResponseList:
      type: object
      properties:
        results:
          type: object
          properties:
            response:
              type: array
              items:
                type: object
                properties:
                  ResponseID:
                    type: integer
                  claimid:
                    type: string
                  remote_claimid:
                    type: string
                  status:
                    type: string
                  fieldname:
                    type: string
                  message:
                    type: string
  securitySchemes:
    AccountKey:
      type: apiKey
      in: query
      name: AccountKey
      description: Account authentication key from Settings > Account Settings in the Claim.MD portal. Submitted with each request (as a form field or query parameter).