Stedi Claim acknowledgments API

components:
  schemas:
    AccessDeniedExceptionResponseContent:
      description: The server response for authorization failure.
      properties:
        code:
          description: Error classification code
          type: string
        message:
          description: Human-readable error message
          type: string
      required:
      - message
      type: object
    ClaimAcknowledgmentDetails:
      properties:
        patientClaimStatusDetails:
          description: 'Patient information and the status of claims related to the patient. You can use the `claims[].claimStatus.referencedTransactionTraceNumber`
            in this object to correlate the 277CA with the original claim.


            Some payers batch acknowledgments for multiple claims into a single 277CA. In these cases, the 277CA
            will contain multiple `patientClaimStatusDetails` objects, each with its own `referencedTransactionTraceNumber`
            for the corresponding claim.'
          items:
            $ref: '#/components/schemas/PatientClaimStatusDetails'
          type: array
        providerOFServiceInformationTraceIdentifier:
          description: An identifier for claims related to this provider.
          type: string
        serviceProvider:
          $ref: '#/components/schemas/ClaimAcknowledgmentDetailsServiceProvider'
        serviceProviderClaimStatuses:
          description: Status information for claims related to the provider.
          items:
            $ref: '#/components/schemas/ServiceProviderClaimStatus'
          type: array
      type: object
    ClaimAcknowledgmentDetailsServiceProvider:
      description: Information about the service provider.
      properties:
        firstName:
          description: The provider's first name, when the provider is an individual. Can be up to 35 characters.
          type: string
        lastName:
          description: The provider's last name, when the provider is an individual. Can be up to 60 characters.
          type: string
        middleName:
          description: The provider's middle name or initial, when the provider is an individual. Can be up to 25
            characters.
          type: string
        npi:
          description: The provider's National Provider Identifier.
          pattern: ^\d{10}$
          type: string
        organizationName:
          description: The provider's business name. Can be up to 60 characters.
          type: string
        spn:
          description: The provider's service provider number.
          type: string
        suffix:
          description: The provider's name suffix, when the provider is an individual. Can be up to 10 characters.
          type: string
        tin:
          description: The provider's tax identification number.
          type: string
      type: object
    ClaimAcknowledgmentPayer:
      properties:
        centersForMedicareAndMedicaidServicePlanId:
          description: The payer's Centers for Medicare and Medicaid Services Plan ID. This is specifically for
            Health Plan ID (HPID) or Other Entity Identifier (OEID), both of which are no longer mandated for use.
          type: string
        claimStatusTransactions:
          description: Claim status details.
          items:
            $ref: '#/components/schemas/ClaimAcknowledgmentTransactions'
          type: array
        entityIdentifierCode:
          $ref: '#/components/schemas/PayerEntityIdentifierCode'
          description: Code identifying the type of organization.
        entityIdentifierCodeValue:
          $ref: '#/components/schemas/PayerEntityIdentifierCodeValue'
          description: The human-readable description of the entity identifier code.
        etin:
          description: The payer's Electronic Transmitter Identification Number.
          type: string
        federalTaxpayerIdentificationNumber:
          description: The payer's Federal Taxpayer Identification Number.
          pattern: ^\d{9}$
          type: string
        organizationName:
          description: The payer or intermediary clearinghouse's business name.
          type: string
        payerContactInformation:
          $ref: '#/components/schemas/PayerContactInformation'
          deprecated: true
        payerIdentification:
          description: The payer's unique identifier.
          type: string
      type: object
    ClaimAcknowledgmentServiceIdQualifierCode:
      description: Code identifying the source of the procedure code in claim status reports.
      enum:
      - AD
      - ER
      - HC
      - HP
      - IV
      - NU
      - WK
      type: string
    ClaimAcknowledgmentServiceIdQualifierCodeValue:
      description: Human-readable descriptions for service ID qualifier codes.
      enum:
      - American Dental Association Codes
      - Jurisdiction Specific Procedure and Supply Codes
      - Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes
      - Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate Code
      - Home Infusion EDI Coalition (HIEC) Product/Service Code
      - National Uniform Billing Committee (NUBC) UB92 Codes
      - Advanced Billing Concepts (ABC) Codes
      type: string
    ClaimAcknowledgmentServiceLines:
      properties:
        beginServiceLineDate:
          description: The starting date of the service.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        endServiceLineDate:
          description: The ending date of the service.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        lineItemControlNumber:
          description: A unique identifier for the service line that matches the `providerControlNumber` submitted
            in the original claim. You can use this value to correlate the payer's response with specific service
            lines from the original claim.
          type: string
        service:
          $ref: '#/components/schemas/ClaimAcknowledgmentServiceLinesService'
        serviceClaimStatuses:
          description: The status of the specific service line.
          items:
            $ref: '#/components/schemas/ServiceClaimStatus'
          type: array
        serviceLineDate:
          description: The date of the service.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
      type: object
    ClaimAcknowledgmentServiceLinesService:
      description: Information about the service provided.
      properties:
        amountPaid:
          deprecated: true
          description: The amount paid for the service, expressed as a decimal.
          type: string
        chargeAmount:
          description: The submitted service charge, expressed as a decimal.
          type: string
        procedureCode:
          description: The identifying code for the product or service.
          type: string
        procedureModifiers:
          description: Identifies special circumstances related to the performance of the service.
          items:
            type: string
          type: array
        revenueCode:
          description: The National Uniform Billing Committee Revenue Code.
          type: string
        serviceIdQualifierCode:
          $ref: '#/components/schemas/ClaimAcknowledgmentServiceIdQualifierCode'
          description: The code identifying the source of the `procedureCode`.
        serviceIdQualifierCodeValue:
          $ref: '#/components/schemas/ClaimAcknowledgmentServiceIdQualifierCodeValue'
          description: The description of the `serviceIdQualifierCode`.
        submittedUnits:
          description: The number of units of service that were submitted, expressed as a decimal.
          type: string
      type: object
    ClaimAcknowledgmentTransactions:
      properties:
        claimStatusDetails:
          description: More detailed status information. This includes information about the patient, provider,
            and services rendered.
          items:
            $ref: '#/components/schemas/ClaimAcknowledgmentDetails'
          type: array
        claimTransactionBatchNumber:
          description: A tracking number Stedi assigns to the corresponding 837 claim. It's returned as the `claimReference.correlationId`
            in the response from our claim submission endpoints. You can use this value to correlate the 277CA with
            the original claim.
          type: string
        provider:
          $ref: '#/components/schemas/ClaimAcknowledgmentTransactionsProvider'
        providerClaimStatuses:
          description: Overall status information for the claim.
          items:
            $ref: '#/components/schemas/ProviderClaimStatus'
          type: array
      type: object
    ClaimAcknowledgmentTransactionsProvider:
      description: Information about the provider receiving the claim status details.
      properties:
        etin:
          description: The provider's Electronic Transmitter Identification Number.
          type: string
        firstName:
          description: The provider's first name. Can be up to 35 characters.
          type: string
        lastName:
          description: The provider's last name. Can be up to 60 characters.
          type: string
        middleName:
          description: The provider's middle name or initial. Can be up to 25 characters.
          type: string
        organizationName:
          description: The provider's business name. Can be up to 60 characters.
          type: string
      type: object
    ClaimLevelEntityIdentifierCode:
      description: Entity identifier code for claim level in claim status reports
      enum:
      - '03'
      - '36'
      - '40'
      - '41'
      - '71'
      - '72'
      - '73'
      - '77'
      - '82'
      - '85'
      - '87'
      - 1P
      - 1Z
      - DK
      - DN
      - DQ
      - FA
      - GB
      - HK
      - IL
      - LI
      - MSC
      - PR
      - PRP
      - QB
      - QC
      - QD
      - SEP
      - TL
      - TTP
      - TU
      type: string
    ClaimLevelEntityIdentifierCodeValue:
      description: Human-readable descriptions for claim level entity identifier codes
      enum:
      - Dependent
      - Employer
      - Receiver
      - Submitter
      - Attending Physician
      - Operating Physician
      - Other Physician
      - Service Location
      - Rendering Provider
      - Billing Provider
      - Pay-to Provider
      - Provider
      - Home Health Care
      - Ordering Physician
      - Referring Provider
      - Supervising Physician
      - Facility
      - Other Insured
      - Subscriber
      - Insured or Subscriber
      - Independent Lab
      - Mammography Screening Center
      - Payer
      - Primary Payer
      - Purchase Service Provider
      - Patient
      - Responsible Party
      - Secondary Payer
      - Testing Laboratory
      - Tertiary Payer
      - Third Party Repricing Organization (TPO)
      type: string
    ClaimLevelStatus:
      properties:
        entityIdentifierCode:
          $ref: '#/components/schemas/ClaimLevelEntityIdentifierCode'
          description: A code indicating the entity that is responsible for the claim.
        entityIdentifierCodeValue:
          $ref: '#/components/schemas/ClaimLevelEntityIdentifierCodeValue'
          description: The description of the `entityIdentifierCode`.
        healthCareClaimStatusCategoryCode:
          $ref: '#/components/schemas/HealthCareClaimStatusCategoryCode'
        healthCareClaimStatusCategoryCodeValue:
          description: Description of the `healthCareClaimStatusCategoryCode` property. Visit [277CA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-status-category-code)
            for a complete list.
          type: string
        nationalCouncilForPrescriptionDrugProgramsRejectPaymentCodes:
          description: A National Council for Prescription Drug Programs (NCPDP) reject code.
          type: string
        statusCode:
          $ref: '#/components/schemas/HealthCareClaimStatusCode'
          description: A code indicating the status.
        statusCodeValue:
          description: The description of the `statusCode`.
          type: string
      type: object
    ClaimsClaimStatus:
      properties:
        billTypeIdentifier:
          description: The bill type identification.
          type: string
        claimServiceBeginDate:
          description: The starting date of the service.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        claimServiceDate:
          description: The date of the service.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        claimServiceEndDate:
          description: The ending date of the service.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        clearinghouseTraceNumber:
          description: The identifier the clearinghouse assigned to the original claim.
          type: string
        informationClaimStatuses:
          description: Claim status information.
          items:
            $ref: '#/components/schemas/InformationClaimStatus'
          type: array
        patientAccountNumber:
          deprecated: true
          description: The patient control number provided in the original claim. Please use `referencedTransactionTraceNumber`
            to correlate the payer's response with the original claim.
          type: string
        pharmacyPrescriptionNumber:
          deprecated: true
          description: Not used.
          type: string
        referencedTransactionTraceNumber:
          description: "The patient control number provided in the original claim. It's the same as:\n   - Box 26\
            \ (Patient's Account No.) on the CMS-1500 submission form.\n  - The `claimInformation.patientControlNumber`\
            \ in JSON claim submissions.\n\nWe recommend using this value to correlate the payer's response with\
            \ the original claim. When matching transactions, treat the patient control number as case-insensitive,\
            \ even if the submitted value included both lower and uppercase characters."
          type: string
        tradingPartnerClaimNumber:
          description: The payer's unique identifier for the claim.
          type: string
        voucherIdentifier:
          deprecated: true
          description: Not used.
          type: string
      type: object
    ContactMethods:
      properties:
        electronicDataInterChangeAccessNumber:
          description: The Electronic Data Interchange Access Number.
          type: string
        email:
          description: The email address.
          type: string
        fax:
          description: The fax number.
          type: string
        phone:
          description: The telephone number including the area code (if applicable). Phone numbers are formatted
            as AAABBBCCCC, where AAA represents the area code, BBB represents the telephone number prefix, and CCCC
            represents the telephone number. Phone numbers are provided without separators, such as dashes or parentheses.
            For example, `5551123345` for `555-112-3345`.
          type: string
        phoneExtension:
          description: The telephone extension, if applicable.
          type: string
      type: object
    ConvertReport277ResponseContent:
      properties:
        meta:
          $ref: '#/components/schemas/Meta'
        transactions:
          description: The payer's 277 response.
          items:
            $ref: '#/components/schemas/ReportsClaimAcknowledgmentResponse'
          type: array
      required:
      - meta
      type: object
    GatewayTimeoutExceptionResponseContent:
      description: The server response for a gateway timeout error.
      properties:
        code:
          description: Classification of the exception type.
          type: string
        message:
          description: Human readable exception message.
          type: string
      required:
      - message
      type: object
    HealthCareClaimStatusCategoryCode:
      description: Code indicating the status category of the `statusCode` property. Visit [277CA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-status-category-code)
        for a complete list.
      enum:
      - A0
      - A1
      - A2
      - A3
      - A4
      - A5
      - A6
      - A7
      - A8
      - DR01
      - DR02
      - DR03
      - DR04
      - DR05
      - DR06
      - DR07
      - DR08
      - P0
      - P1
      - P2
      - P3
      - P4
      - P5
      - F0
      - F1
      - F2
      - F3
      - F3F
      - F3N
      - F4
      - R0
      - R1
      - R3
      - R4
      - R5
      - R6
      - R7
      - R8
      - R9
      - R10
      - R11
      - R12
      - R13
      - R14
      - R15
      - R16
      - R17
      - E0
      - E1
      - E2
      - E3
      - E4
      - D0
      type: string
    HealthCareClaimStatusCode:
      enum:
      - '0'
      - '1'
      - '2'
      - '3'
      - '6'
      - '12'
      - '15'
      - '16'
      - '17'
      - '18'
      - '19'
      - '20'
      - '21'
      - '23'
      - '24'
      - '25'
      - '26'
      - '27'
      - '29'
      - '30'
      - '31'
      - '32'
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      - '35'
      - '37'
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      - '42'
      - '44'
      - '45'
      - '46'
      - '47'
      - '49'
      - '50'
      - '51'
      - '52'
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      - '54'
      - '55'
      - '56'
      - '57'
      - '59'
      - '60'
      - '61'
      - '64'
      - '65'
      - '66'
      - '72'
      - '73'
      - '78'
      - '81'
      - '83'
      - '84'
      - '85'
      - '86'
      - '88'
      - '89'
      - '90'
      - '91'
      - '92'
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      - '524'
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      - '526'
      - '527'
      - '528'
      - '529'
      - '530'
      - '531'
      - '532'
      - '533'
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      - '535'
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      - '537'
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      - '540'
      - '541'
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      - '566'
      - '567'
      - '568'
      - '569'
      - '571'
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      - '617'
      - '618'
      - '619'
      - '620'
      - '621'
      - '622'
      - '623'
      - '624'
      - '625'
      - '626'
      - '627'
      - '628'
      - '629'
      - '630'
      - '631'
      - '632'
      - '633'
      - '634'
      - '635'
      - '636'
      - '637'
      - '638'
      - '639'
      - '640'
      - '642'
      - '643'
      - '644'
      - '645'
      - '646'
      - '647'
      - '648'
      - '649'
      - '650'
      - '651'
      - '652'
      - '653'
      - '654'
      - '655'
      - '656'
      - '657'
      - '658'
      - '659'
      - '660'
      - '661'
      - '662'
      - '663'
      - '664'
      - '665'
      - '666'
      - '667'
      - '668'
      - '669'
      - '670'
      - '671'
      - '672'
      - '673'
      - '674'
      - '675'
      - '676'
      - '677'
      - '678'
      - '679'
      - '680'
      - '681'
      - '682'
      - '683'
      - '684'
      - '685'
      - '686'
      - '687'
      - '688'
      - '689'
      - '690'
      - '691'
      - '692'
      - '693'
      - '694'
      - '695'
      - '696'
      - '697'
      - '698'
      - '699'
      - '700'
      - '701'
      - '702'
      - '703'
      - '704'
      - '705'
      - '706'
      - '707'
      - '708'
      - '709'
      - '710'
      - '711'
      - '712'
      - '713'
      - '714'
      - '715'
      - '716'
      - '717'
      - '718'
      - '719'
      - '720'
      - '721'
      - '722'
      - '723'
      - '724'
      - '725'
      - '726'
      - '727'
      - '728'
      - '729'
      - '730'
      - '731'
      - '732'
      - '733'
      - '734'
      - '735'
      - '736'
      - '737'
      - '738'
      - '739'
      - '740'
      - '741'
      - '742'
      - '743'
      - '744'
      - '745'
      - '746'
      - '747'
      - '748'
      - '749'
      - '750'
      - '751'
      - '752'
      - '753'
      - '754'
      - '755'
      - '756'
      - '757'
      - '758'
      - '759'
      - '760'
      - '761'
      - '762'
      - '763'
      - '764'
      - '765'
      - '766'
      - '767'
      - '768'
      - '769'
      - '770'
      - '771'
      - '772'
      - '773'
      - '774'
      - '775'
      - '776'
      - '777'
      - '778'
      - '779'
      - '780'
      - '781'
      - '782'
      - '783'
      - '784'
      - '785'
      - '786'
      - '787'
      - '788'
      - '789'
      - '790'
      - '791'
      - '792'
      - '793'
      - '794'
      - '795'
      - '796'
      - '798'
      - '799'
      - '800'
      - '801'
      - '802'
      - '803'
      type: string
    InformationClaimStatus:
      properties:
        adjudicatedFinalizedDate:
          deprecated: true
          description: Not used.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        claimPaymentAmount:
          deprecated: true
          description: Not used.
          type: string
        informationStatuses:
          items:
            $ref: '#/components/schemas/ClaimLevelStatus'
          type: array
        remittanceDate:
          deprecated: true
          description: Not used.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        remittanceTraceNumber:
          deprecated: true
          description: Not used.
          type: string
        statusInformationEffectiveDate:
          description: The effective date of the status information.
          pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
          type: string
        statusMessage:
          description: Additional free-form information about the claim status.
          type: string
        totalClaimChargeAmount:
          description: The total amount of charges in the original claim, expressed as a decimal. This may differ
            from the total charges submitted due to claims processing instructions, such as claim splitting. Note
            that some HMO encounters supply zero as the amount of original charges.
          type: string
      type: object
    InternalFailureExceptionResponseContent:
      description: The server response when an unexpected error occurred while processing request.
      properties:
        code:
          description: Error classification code
          type: string
        message:
          description: Human-readable error message
          type: string
      required:
      - message
      type: object
    Meta:
      description: Metadata that helps Stedi track and debug the response.
      properties:
        applicationMode:
          description: Whether this is a test or production ERA.
          type: string
        senderId:
          description: An identifier for the most recent sender of the ERA. This is usually not the original sender,
            so this value is unlikely to be a payer ID. When Stedi processes and delivers ERAs through the clearinghouse,
            this value is always `STEDI`.
          type: string
        traceId:
          description: Not currently used.
          type: string
        transactionId:
          description: The Stedi transaction identifier.
          maxLength: 36
          minLength: 36
          pattern: ^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$
          type: string
      type: object
    PatientClaimStatusDetails:
      description: Patient information and the status of claims related to the patient. You can use the `claims[].claimStatus.referencedTransactionTraceNumber`
        in this object to correlate the 277CA with the original claim.
      properties:
        claims:
          description: Status information for the claim or service line.
          items:
            $ref: '#/components/schemas/ReportsClaims'
          type: array
        dependent:
          $ref: '#/components/schemas/PatientClaimStatusDetailsDependent'
          deprecated: true
          description: The patient's information will always be returned in the `subscriber` object, regardless
            of whether they are a subscriber or dependent.
        subscriber:
          $ref: '#/components/schemas/PatientClaimStatusDetailsSubscriber'
          description: Information about the patient who received services related to the claim.
      type: object
    PatientClaimStatusDetailsDependent:
      description: Information about a dependent who received services related to the claim.
      properties:
        firstName:
          deprecated: true
          description: The first name of the dependent. Can be up to 35 characters.
          type: string
        lastName:
          deprecated: true
          description: The last name of the dependent. Can be up to 60 characters.
          type: string
        middleName:
          deprecated: true
          description: The middle name or initial of the dependent. Can be up to 25 characters.
          type: string
        suffix:
          deprecated: true
          description: The suffix of the dependent, such as Jr or III. Can be up to 10 characters.
          type: string
      type: object
    PatientClaimStatusDetailsSubscriber:
      description: Information about the primary policy holder for the health plan.
      properties:
        employerIdentificationNumber:
          deprecated: true
          description: The subscriber's employer identification number. This may be used in conjunction with a worker's
            compensation claim.
          type: string
        firstName:
          description: The first name of the subscriber. Can be up to 35 characters.
          type: string
        lastName:
          description: The last name of the subscriber. Can be up to 60 characters.
          type: string
        memberId:
          description: The subscriber's member ID for their health plan.
          type: string
        middleName:
          description: The middle name or initial of the subscriber. Can be up to 25 characters.
          type: string
        organizationName:
          description: The subscriber's business name. Applicable when an employer submitted a worker's compensation
            claim, or other situations when an employer is the subscriber.
          type: string
        standardUniqueHealthIdentifierForEachIndividualInTheUnitedStates:
          description: Deprecated; do not use.
          type: string
        suffix:
          description: The suffix of the subscriber, such as Jr or III. Can be up to 10 characters.
          type: string
      type: object
    PayerContactInformation:
      description: The payer's business contact information.
      properties:
        contactMethods:

# --- truncated at 32 KB (67 KB total) ---
# Full source: https://raw.githubusercontent.com/api-evangelist/stedi/refs/heads/main/openapi/stedi-claim-acknowledgments-api-openapi.yml