The Remittances API from Stedi — 2 operation(s) for remittances.
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
AccountNumberQualifier:
description: Identifies the type of bank account being used for electronic payment transactions. This specifies
whether the account is a checking (demand deposit) or savings account.
enum:
- DA
- SA
type: string
Adjustments:
description: Provider adjustment details including reason codes and amounts.
properties:
adjustmentReasonCode:
description: A code identifying the reason for the adjustment. Visit [Provider Adjustment Reason Codes](https://www.stedi.com/docs/healthcare/claims-code-lists#provider-adjustment-reason-code)
for a complete list and descriptions.
type: string
adjustmentReasonCodeValue:
description: The description of the `adjustmentReasonCode`.
type: string
providerAdjustmentAmount:
description: The amount of the adjustment, per the adjustment reason provided. A negative amount increases
the claim payment and a positive amount decreases the claim payment.
type: string
providerAdjustmentIdentifier:
description: An identifier used to assist the receiver in identifying, tracking, or reconciling the adjustment.
type: string
type: object
BusinessContactInformation:
description: A person or office to whom administrative communications should be directed.
properties:
contactMethods:
items:
$ref: '#/components/schemas/ContactMethod'
type: array
contactName:
description: The name of the contact person or entity.
type: string
type: object
ClaimAdjustmentGroupCode:
description: Defines the category of adjustment reason codes that explain why a claim payment was adjusted.
These codes categorize adjustments into contractual obligations, payer-initiated reductions, patient responsibilities,
and other adjustments.
enum:
- CO
- OA
- PI
- PR
type: string
ClaimAdjustments:
description: Claim-level adjustments with reason codes and amounts.
properties:
adjustmentAmount1:
description: The amount of the adjustment. A negative amount increases the claim payment and a positive
amount decreases the claim payment.
type: string
adjustmentAmount2:
description: The amount of the adjustment. A negative amount increases the claim payment and a positive
amount decreases the claim payment.
type: string
adjustmentAmount3:
description: The amount of the adjustment. A negative amount increases the claim payment and a positive
amount decreases the claim payment.
type: string
adjustmentAmount4:
description: The amount of the adjustment. A negative amount increases the claim payment and a positive
amount decreases the claim payment.
type: string
adjustmentAmount5:
description: The amount of the adjustment. A negative amount increases the claim payment and a positive
amount decreases the claim payment.
type: string
adjustmentAmount6:
description: The amount of the adjustment. A negative amount increases the claim payment and a positive
amount decreases the claim payment.
type: string
adjustmentQuantity1:
description: The units of service being adjusted. A positive value decreases the covered days and a negative
number increases the covered days.
type: string
adjustmentQuantity2:
description: The units of service being adjusted. A positive value decreases the covered days and a negative
number increases the covered days.
type: string
adjustmentQuantity3:
description: The units of service being adjusted. A positive value decreases the covered days and a negative
number increases the covered days.
type: string
adjustmentQuantity4:
description: The units of service being adjusted. A positive value decreases the covered days and a negative
number increases the covered days.
type: string
adjustmentQuantity5:
description: The units of service being adjusted. A positive value decreases the covered days and a negative
number increases the covered days.
type: string
adjustmentQuantity6:
description: The units of service being adjusted. A positive value decreases the covered days and a negative
number increases the covered days.
type: string
adjustmentReason1:
description: A description identifying the detailed reason the adjustment was made.
type: string
adjustmentReason2:
description: A description identifying the detailed reason the adjustment was made.
type: string
adjustmentReason3:
description: A description identifying the detailed reason the adjustment was made.
type: string
adjustmentReason4:
description: A description identifying the detailed reason the adjustment was made.
type: string
adjustmentReason5:
description: A description identifying the detailed reason the adjustment was made.
type: string
adjustmentReason6:
description: A description identifying the detailed reason the adjustment was made.
type: string
adjustmentReasonCode1:
description: A code identifying the detailed reason the adjustment was made. Visit [Claim Adjustment Reason
Codes](https://x12.org/codes/claim-adjustment-reason-codes) in the X12 documentation for a complete
list.
type: string
adjustmentReasonCode2:
description: A code identifying the detailed reason the adjustment was made. Visit [Claim Adjustment Reason
Codes](https://x12.org/codes/claim-adjustment-reason-codes) in the X12 documentation for a complete
list.
type: string
adjustmentReasonCode3:
description: A code identifying the detailed reason the adjustment was made. Visit [Claim Adjustment Reason
Codes](https://x12.org/codes/claim-adjustment-reason-codes) in the X12 documentation for a complete
list.
type: string
adjustmentReasonCode4:
description: A code identifying the detailed reason the adjustment was made. Visit [Claim Adjustment Reason
Codes](https://x12.org/codes/claim-adjustment-reason-codes) in the X12 documentation for a complete
list.
type: string
adjustmentReasonCode5:
description: A code identifying the detailed reason the adjustment was made. Visit [Claim Adjustment Reason
Codes](https://x12.org/codes/claim-adjustment-reason-codes) in the X12 documentation for a complete
list.
type: string
adjustmentReasonCode6:
description: A code identifying the detailed reason the adjustment was made. Visit [Claim Adjustment Reason
Codes](https://x12.org/codes/claim-adjustment-reason-codes) in the X12 documentation for a complete
list.
type: string
claimAdjustmentGroupCode:
$ref: '#/components/schemas/ClaimAdjustmentGroupCode'
description: The code identifying the category of adjustment reason codes. Visit [ERA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#claim-adjustment-group-code)
for a complete list and usage notes.
claimAdjustmentGroupCodeValue:
description: The description of the `claimAdjustmentGroupCode`.
type: string
type: object
ClaimPaymentAdviceFilingIndicatorCode:
description: Identifies the type of health plan or insurance coverage under which the claim was filed. These
codes indicate the specific type of insurance arrangement, government program, or coverage type that applies
to the claim.
enum:
- '12'
- '13'
- '14'
- '15'
- '16'
- '17'
- AM
- CH
- DS
- HM
- LI
- LM
- MA
- MB
- MC
- OF
- TV
- VA
- WC
- ZZ
type: string
ClaimPaymentAdvicePayer:
description: Information about the payer.
properties:
address:
$ref: '#/components/schemas/ClaimPaymentAdvicePayerAddress'
description: The payer's address information.
businessContactInformation:
$ref: '#/components/schemas/BusinessContactInformation'
description: A person or office.
centersForMedicareAndMedicaidServicesPlanId:
deprecated: true
description: Formerly used to report the payer's Health Plan ID (HPID) or Other Entity Identifier (OEID).
The Centers for Medicare and Medicaid Services (CMS) no longer uses HPID, so this property will not
be populated.
type: string
healthIndustryNumber:
description: The payer's health industry number.
type: string
name:
description: The payer's business name, such as Cigna or Aetna.
type: string
nationalAssociationOfInsuranceCommissioners:
description: The payer's National Association of Insurance Commissioners (NAIC) code.
type: string
payerIdentificationNumber:
description: 'An identifier for the payer. For Medicare carriers or intermediaries, this is the Medicare
carrier or intermediary ID number. For Blue Cross and Blue Shield Plans, this is the Blue Cross Blue
Shield association plan code.
Providers rarely use this identifier in practice.'
type: string
payerWebSiteUrl:
description: The payer's web address. The URL is typically provided without the scheme and separator.
For example, `stedi.com`.
type: string
submitterIdentificationNumber:
description: An identifier for the payer. This is used when the original transaction sender is not the
payer or has an identifier other than those already provided.
type: string
technicalContactInformation:
description: A person or office.
items:
$ref: '#/components/schemas/TechnicalContactInformation'
type: array
type: object
ClaimPaymentAdvicePayerAddress:
description: Address information for the payer.
properties:
address1:
description: The first line of the address.
type: string
address2:
description: The second line of the address.
type: string
city:
description: The city where the address is located.
type: string
countryCode:
description: The standard code for the country from Part 1 of ISO 3166.
type: string
countrySubCode:
description: The standard code for the country subdivision from Part 2 of ISO 3166.
type: string
postalCode:
description: The postal code for the address, excluding punctuation and blanks.
type: string
state:
description: The standard code for the state or province. For example `PA` for Pennsylvania.
type: string
type: object
ClaimPaymentAdviceResponse:
description: The complete claim payment advice response from the payer.
properties:
controlNumber:
description: The control number the payer provided in the claim payment response. This is used to identify
the transaction.
type: string
detailInfo:
description: Detailed information about claims in this payment advice.
items:
$ref: '#/components/schemas/DetailInfo'
type: array
financialInformation:
$ref: '#/components/schemas/ClaimPaymentAdviceResponseFinancialInformation'
description: Financial information about the payment including amounts and account details.
foreignCurrency:
description: The standard ISO code for the country whose currency is being used for payments. If this
is not present, the currency is US dollars.
type: string
payee:
$ref: '#/components/schemas/Payee'
description: Information about the payee receiving the payment.
payer:
$ref: '#/components/schemas/ClaimPaymentAdvicePayer'
description: Information about the payer making the payment.
paymentAndRemitReassociationDetails:
$ref: '#/components/schemas/ClaimPaymentAdviceResponsePaymentAndRemitReassociationDetails'
description: Payment and remittance reassociation details for transaction tracking.
productionDate:
description: The end date for the adjudication production cycle for claims included in this ERA.
pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
type: string
providerAdjustments:
description: 'Provider-level adjustment information for debit or credit transactions such as: accelerated
payments, cost report settlements for a fiscal year, and timeliness report penalties unrelated to a
specific claim or service. These adjustments can either decrease the payment (a positive number) or
increase the payment (a negative number).'
items:
$ref: '#/components/schemas/ProviderAdjustments'
type: array
receiverIdentifier:
description: The business identification information for the entity initially receiving the transaction.
This is typically included when the receiver of the transaction is not the payee, such as a clearinghouse
or billing service.
type: string
versionIdentification:
description: The version number of the adjudication system that generated the claim payments.
type: string
type: object
ClaimPaymentAdviceResponseFinancialInformation:
description: Information about a payment, including the payment method, payment amount, and account details
for both the sender and receiver.
properties:
checkIssueOrEFTEffectiveDate:
description: The date the payer considers the transaction to be settled. If the payment is made by automated
clearinghouse (ACH), this is the date the funds are available to the provider. If the payment is made
by check, this is the date the check is issued. If the payment is made by Federal Reserve Funds/wire
transfer, this is the date that the payer anticipates the money to move.
pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
type: string
creditOrDebitFlagCode:
$ref: '#/components/schemas/CreditDebitFlagCode'
description: A code indicating whether the payment is a credit or debit. Can be set to `C` - Credit or
`D` - Debit. Visit [ERA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#credit-or-debit-flag-code)
for usage notes.
originatingCompanySupplementalCode:
description: A code that further identifies the payer by division or region.
type: string
payerIdentifier:
description: A unique identifier for the payer, mutually established between the financial institution
and the payer.
type: string
paymentFormatCode:
$ref: '#/components/schemas/PaymentFormatCode'
description: A code identifying the payment format. Can be set to `CCP` - Cash Concentration/Disbursement
plus Addenda (CCD+) (ACH) or `CTX` - Corporate Trade Exchange (CTX) (ACH).
paymentMethodCode:
$ref: '#/components/schemas/PaymentMethodCode'
description: A code indicating the payment method. For example, `ACH` - Automated Clearing House or `CHK`
- Check. Visit [ERA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#payment-method-code)
for a complete list and usage notes.
receiverAccountDetails:
$ref: '#/components/schemas/ReceiverAccountDetails'
description: Account details for the payment receiver.
senderAccountDetails:
$ref: '#/components/schemas/SenderAccountDetails'
description: Account details for the payment sender.
totalActualProviderPaymentAmount:
description: The total amount of the payment to the provider, expressed as a decimal.
type: string
transactionHandlingCode:
$ref: '#/components/schemas/TransactionHandlingCode'
description: A code indicating the actions taken by both the sender and the receiver. For example, `D`
- Make Payment Only. Visit [ERA code lists](https://www.stedi.com/docs/healthcare/claims-code-lists#transaction-handling-code)
for a complete list and usage notes.
type: object
ClaimPaymentAdviceResponsePaymentAndRemitReassociationDetails:
description: Information to uniquely identify the transaction and help with reassociating payments and remittances
that have been separated.
properties:
checkOrEFTTraceNumber:
description: This value uniquely identifies the transaction. This is either the check number, the EFT
reference number, or a unique remittance advice identification number (for non-payment ERAs).
type: string
originatingCompanyIdentifier:
description: A unique identifier for the payer. This is a 1 followed by the payer's Employer Identification
Number (EIN) or Taxpayer Identification Number (TIN).
type: string
originatingCompanySupplementalCode:
description: A value that identifies a further subdivision within the payer's organization.
type: string
traceTypeCode:
$ref: '#/components/schemas/TraceTypeCode'
description: Code that identifies which transaction is being referenced. This can be set to `1` - Current
Transaction Trace Numbers.
type: object
ClaimPaymentAdviceServiceLines:
description: Information about specific service lines in the claim payment advice.
properties:
healthCareCheckRemarkCodes:
description: Healthcare check remark codes for this service.
items:
$ref: '#/components/schemas/HealthCareCheckRemarkCodes'
type: array
healthCarePolicyIdentification:
description: Healthcare policy identification for this service.
items:
$ref: '#/components/schemas/HealthCarePolicyIdentification'
type: array
lineItemControlNumber:
description: The `providerControlNumber` submitted in the original claim to identify the service line.
type: string
renderingProviderInformation:
$ref: '#/components/schemas/ClaimPaymentAdviceServiceLinesRenderingProviderInformation'
description: Information about the provider who rendered this service.
serviceAdjustments:
description: Adjustments applied to this service line.
items:
$ref: '#/components/schemas/ClaimAdjustments'
type: array
serviceDate:
description: The date the service was rendered. Used for single-day services.
pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
type: string
serviceEndDate:
description: The date the service ended. Used for multi-day services.
pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
type: string
serviceIdentification:
$ref: '#/components/schemas/ClaimPaymentAdviceServiceLinesServiceIdentification'
description: Service identification details.
servicePaymentInformation:
$ref: '#/components/schemas/ClaimPaymentAdviceServiceLinesServicePaymentInformation'
description: Payment information for this service line.
serviceStartDate:
description: The date the service began. Used for multi-day services.
pattern: ^\d{4}(0[1-9]|1[0-2])(0[1-9]|[12]\d|3[01])$
type: string
serviceSupplementalAmounts:
$ref: '#/components/schemas/ClaimPaymentAdviceServiceLinesServiceSupplementalAmounts'
description: Supplemental amount information for this service.
serviceSupplementalQuantities:
$ref: '#/components/schemas/ClaimPaymentAdviceServiceLinesServiceSupplementalQuantities'
description: Supplemental quantity information for this service.
type: object
ClaimPaymentAdviceServiceLinesRenderingProviderInformation:
description: Identifiers for the provider who rendered this service.
properties:
blueCrossProviderNumber:
description: The rendering provider's Blue Cross Provider Number.
type: string
blueShieldProviderNumber:
description: The rendering provider's Blue Shield Provider Number.
type: string
champusIdentificationNumber:
description: The rendering provider's CHAMPUS Identification Number.
type: string
facilityIdNumber:
description: The rendering provider's Facility ID Number.
type: string
federalTaxpayerIdentificationNumber:
description: The rendering provider's Federal Taxpayer Identification Number.
type: string
medicaidProviderNumber:
description: The rendering provider's Medicaid Provider Number.
type: string
medicareProviderNumber:
description: The rendering provider's Medicare Provider Number.
type: string
nationalCouncilForPrescriptionDrugProgramPharmacyNumber:
description: The rendering provider's National Council for Prescription Drug Programs Pharmacy Number.
type: string
npi:
description: The rendering provider's National Provider Identifier (NPI).
pattern: ^\d{10}$
type: string
providerCommercialNumber:
description: The Provider Commercial Number.
type: string
providerUPINNumber:
description: Deprecated; replaced by NPI in 2007.
type: string
ssn:
description: The rendering provider's Social Security Number (SSN).
pattern: ^\d{9}$
type: string
stateLicenseNumber:
description: The rendering provider's State License Number.
type: string
type: object
ClaimPaymentAdviceServiceLinesServiceIdentification:
description: Additional identifiers related to the service line.
properties:
ambulatoryPatientGroupNumber:
description: The service line's Ambulatory Patient Group (APG) Number.
type: string
ambulatoryPaymentClassification:
description: The service line's Ambulatory Payment Classification Number.
type: string
attachmentCode:
description: The service line's Attachment Code.
type: string
authorizationNumber:
description: The service line's Authorization Number.
type: string
locationNumber:
description: The payer's identification for the provider location.
type: string
preDeterminationOfBenefitsIdentificationNumber:
description: The service line's Predetermination of Benefits Identification Number.
type: string
priorAuthorizationNumber:
description: The service line's Prior Authorization Number.
type: string
rateCodeNumber:
description: The service line's Rate code number, a percentage that reflects the Ambulatory Surgical Center
(ASC) rate for Medicare. This is either 0, 50, 100, or 150.
type: string
type: object
ClaimPaymentAdviceServiceLinesServicePaymentInformation:
description: Payment and control information about a provider for a particular service.
properties:
adjudicatedProcedureCode:
description: The adjudicated procedure code - an identifying number for a product or service.
type: string
adjudicatedProcedureModifierCodes:
description: A list of up to four modifiers that identify special circumstances related to the product
or service.
items:
type: string
type: array
lineItemChargeAmount:
description: The submitted service charge, expressed as a decimal.
type: string
lineItemProviderPaymentAmount:
description: "The amount paid for the service, expressed as a decimal. \n\n This amount is calculated\
\ as follows: \n\n`servicePaymentInformation.lineItemProviderPaymentAmount =\n servicePaymentInformation.lineItemChargeAmount\
\ - (sum(serviceAdjustments[].adjustmentAmount1) + sum(serviceAdjustments[].adjustmentAmount2) + sum(serviceAdjustments[].adjustmentAmount3)\
\ + sum(serviceAdjustments[].adjustmentAmount4) + sum(serviceAdjustments[].adjustmentAmount5) + sum(serviceAdjustments[].adjustmentAmount6))`\n\
\nAll properties in the formula are within a single `transactions[].detailInfo[].paymentInfo[].serviceLines`\
\ array entry. Note that `serviceAdjustments` is an object array that could contain up to 99 entries,\
\ each with up to 6 adjustment amounts in separate properties. This allows for up to 594 total adjustments.\n\
\nAdjustments can be either positive or negative. When the adjustment amounts are positive, the payment\
\ decreases. When the adjustment amounts are negative, the payment amount increases, and will be larger\
\ than the `lineItemChargeAmount`."
type: string
nationalUniformBillingCommitteeRevenueCode:
description: The National Uniform Billing Committee Revenue Code.
type: string
originalUnitsOfServiceCount:
description: The original number of units of service submitted, expressed as a decimal.
type: string
productOrServiceIDQualifier:
$ref: '#/components/schemas/ProductServiceIdQualifier'
description: The code identifying the source of the `adjudicatedProcedureCode`.
productOrServiceIDQualifierValue:
description: The description of the `productOrServiceIDQualifier`.
type: string
submittedAdjudicatedProcedureCode:
description: The submitted adjudicated procedure code - an identifying number for a product or service.
type: string
submittedAdjudicatedProcedureModifierCodes:
description: A list of up to four modifiers that identify special circumstances related to the product
or service.
items:
type: string
type: array
submittedProcedureCodeDescription:
description: A free-form description to further clarify the procedure code and any modifiers.
type: string
submittedProductOrServiceIDQualifier:
$ref: '#/components/schemas/ProductServiceIdQualifier'
description: The code identifying the source of the `submittedAdjudicatedProcedureCode`.
submittedProductOrServiceIDQualifierValue:
description: The description of the `submittedProductOrServiceIDQualifier`.
type: string
unitsOfServicePaidCount:
description: The number of units of service that were paid, expressed as a decimal. If not present, the
value is assumed to be one.
type: string
type: object
ClaimPaymentAdviceServiceLinesServiceSupplementalAmounts:
description: Information about the service supplemental amount. All values are expressed as decimals.
properties:
allowedActual:
description: The payer payment plus any assigned patient responsibility.
type: string
deductionAmount:
description: This is the late filing reduction amount.
type: string
federalMedicareOrMedicaidPaymentMandateCategory1:
description: Federal Medicare or Medicaid Payment Mandate - Category 1.
type: string
federalMedicareOrMedicaidPaymentMandateCategory2:
description: Federal Medicare or Medicaid Payment Mandate - Category 2.
type: string
federalMedicareOrMedicaidPaymentMandateCategory3:
description: Federal Medicare or Medicaid Payment Mandate - Category 3.
type: string
federalMedicareOrMedicaidPaymentMandateCategory4:
description: Federal Medicare or Medicaid Payment Mandate - Category 4.
type: string
federalMedicareOrMedicaidPaymentMandateCategory5:
description: Federal Medicare or Medicaid Payment Mandate - Category 5.
type: string
tax:
description: The tax amount.
type: string
totalClaimBeforeTaxes:
description: The total amount for the service charge before taxes.
type: string
type: object
ClaimPaymentAdviceServiceLinesServiceSupplementalQuantities:
description: Additional quantity information about the service. All values are expressed as decimals.
properties:
federalMedicareOrMedicaidPaymentMandateCategory1:
description: Federal Medicare or Medicaid Payment Mandate - Category 1.
type: string
federalMedicareOrMedicaidPaymentMandateCategory2:
description: Federal Medicare or Medicaid Payment Mandate - Category 2.
type: string
federalMedicareOrMedicaidPaymentMandateCategory3:
description: Federal Medicare or Medicaid Payment Mandate - Category 3.
type: string
federalMedicareOrMedicaidPaymentMandateCategory4:
description: Federal Medicare or Medicaid Payment Mandate - Category 4.
type: string
federalMedicareOrMedicaidPaymentMandateCategory5:
description: Federal Medicare or Medicaid Payment Mandate - Category 5.
type: string
type: object
ClaimStatusCode:
description: Indicates the status of the claim after adjudication by the payer. These codes determine whether
the claim was processed as primary, secondary, tertiary, denied, forwarded to other payers, or represents
special processing situations like reversals or predeterminations.
enum:
- '1'
- '2'
- '3'
- '4'
- '19'
- '20'
- '21'
- '22'
- '23'
- '25'
type: string
ContactMethod:
properties:
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
ConvertReport835ResponseContent:
description: Transaction response structure for claim payment advice.
properties:
meta:
$ref: '#/components/schemas/Meta'
description: Metadata that helps Stedi track and debug the response.
transactions:
description: The payer's 835 response.
items:
$ref: '#/components/schemas/ClaimPaymentAdviceResponse'
type: array
required:
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# Full source: https://raw.githubusercontent.com/api-evangelist/stedi/refs/heads/main/openapi/stedi-remittances-api-openapi.yml