Claim.MD Claims API

openapi: 3.0.1
info:
  title: Claim.MD Claim Status Claims 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: Claims
  description: Claim file upload and reconciliation.
paths:
  /services/upload/:
    post:
      operationId: uploadClaims
      tags:
      - Claims
      summary: Upload a batch claim file
      description: Upload a file containing 1-2000 claims in 837P, 837I, CSV, JSON, XML, XLS, or XLSX format for scrubbing and routing to payers.
      requestBody:
        required: true
        content:
          multipart/form-data:
            schema:
              type: object
              required:
              - AccountKey
              - File
              properties:
                AccountKey:
                  type: string
                  description: Account authentication key.
                File:
                  type: string
                  format: binary
                  description: Claim batch file.
                Filename:
                  type: string
                  description: Optional original filename.
      responses:
        '200':
          description: Upload accepted with claim and file identifiers.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/UploadResponse'
            application/xml:
              schema:
                $ref: '#/components/schemas/UploadResponse'
  /services/uploadlist/:
    post:
      operationId: listUploads
      tags:
      - Claims
      summary: List uploaded files
      description: List previously uploaded claim files with counts and dollar amounts.
      requestBody:
        required: true
        content:
          application/x-www-form-urlencoded:
            schema:
              type: object
              required:
              - AccountKey
              properties:
                AccountKey:
                  type: string
                Page:
                  type: integer
                  description: Page number for pagination.
                UploadDate:
                  type: string
                  description: Filter by upload date (yyyy-mm-dd).
      responses:
        '200':
          description: A list of uploaded files.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/UploadListResponse'
components:
  schemas:
    UploadResponse:
      type: object
      properties:
        fileid:
          type: string
          description: Identifier assigned to the uploaded file.
        claim:
          type: array
          items:
            type: object
            properties:
              claimid:
                type: string
              accept:
                type: string
              field:
                type: string
              error:
                type: string
    UploadListResponse:
      type: object
      properties:
        file:
          type: array
          items:
            type: object
            properties:
              fileid:
                type: string
              filename:
                type: string
              upload_date:
                type: string
              claim_count:
                type: integer
              total_charge:
                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).