Claim.MD

Claim.MD is a medical-claims clearinghouse that connects healthcare providers and software vendors to thousands of payers. Its REST API (authenticated with an AccountKey) supports electronic claim submission (837P/837I), claim status tracking, electronic remittance advice (835 ERA), real-time eligibility (270/271), and file upload/download workflows.

Claim.MD publishes 5 API contracts indexed on the APIs.io network, including Claim Status API, Claims API, Eligibility API, and 2 more. Tagged areas include Healthcare, Medical Claims, Clearinghouse, EDI, and X12.

The Claim.MD catalog on APIs.io includes 1 Spectral governance ruleset.

Claim.MD’s developer surface includes authentication, documentation, engineering blog, and 8 more developer resources.

🌐 Visit website 📡 Profile data on GitHub

26.6/100 thin ▬ flat Agent 20/100 agent aware Front door AI 2/6 trace Heartbeat 64/100 slowing saas Full breakdown ↓
scored 2026-11-06 · rubric v0.27.0 · Show this score on your site →

AccessEnterprise

1 published contract

Healthcare Medical Claims Clearinghouse EDI X12 Revenue Cycle Health Insurance

What this lets a business do 2

Business capabilities this provider's published APIs can perform, derived from its own contracts. Browse all capabilities →

Healthcare Revenue Cycle Management

BC-2870

Claim StatusClaimsERA

POST /services/response/ POST /services/upload/ POST /services/eralist/

Patient Access Management

BC-2800

Eligibility

POST /services/elig/

Kin Score

Kin Score How this is scored →
scored 2026-11-06 · rubric v0.27.0

Composite quality — 26.6/100 · thin

Contract Quality 8.6 / 19

Developer Ergonomics 4.8 / 15

Access Clarity 0.8 / 15

Operational Transparency 0.8 / 10

Contract Governance 1.2 / 9

Discoverability 5.0 / 8

Regulatory Posture 1.6 / 15

Create-or-Update Ergonomics 0.0 / 10

Agent readiness — 20/100 · agent aware

Machine-Readable Contract 18 / 18

Agentic Access Contract 10 / 10

Documented Reversibility 0 / 6

MCP Server 0 / 12

Machine-Readable Auth 10 / 10

Idempotency 0 / 9

Stable Error Semantics 0 / 8

Request/Response Examples 0 / 7

Rate-Limit Signaling 7 / 7

Typed Event Surface 0 / 6

Agent Skills 0 / 5

Well-Known Catalog 0 / 4

Consent & Bot Identity 0 / 3

A2A Agent Card 0 / 8

Dry-Run / Simulate Mode 0 / 4

Delegated User Identity 0 / 6

Protected Resource Metadata 0 / 5

Registration Without a Human 0 / 6

Agentic Commerce Well-Known Document 0 / 5

Pagination 5 / 5

Distinct Operations 3 / 3

MCP Tool Quality 6 / 6

Regulatory Posture applies to this provider. Its tags matched the Insurance regime, so Regulatory Posture carries 15 points of the composite. If this regime is wrong for your business, say so on your provider repo — the applicability map is public and we will correct it.

Create-or-Update Ergonomics applies to this provider. This API accepts writes, so it carries 10 points of the composite. It is scored from the published contracts themselves: whether a caller can create-or-update in one call, whether the write accepts a key the caller already holds, and whether the response says which branch ran. Without that, every write needs a search-and-branch in front of it, and the first time that check is skipped a duplicate record is created. Scored against the observed mean rather than raw — a provider at the catalog average is unchanged by this facet, not penalised by it.

The six quality facets above are damped to 75 points between them, because the conditional facet above carries the other 25. That is why each facet's contribution is shown against a damped maximum: raising a quality facet moves the composite by 75% of its nominal weight, not 100%. The full arithmetic is at apis.io/rating/.

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Agent readiness — checks not met, largest first (exact, from this profile):

MCP Server +12 pts — deployment.mode + probe verdict on the mcp/ manifest, not the pointer; an unprobed slug falls back to authorship
Idempotency +9 pts — OpenAPI mutating operations declare an idempotency key — a header, a request-body property, or a named de-duplication token whose own description says so (verified); else common[].type matches /idempoten/i (documented)
Stable Error Semantics +8 pts — OpenAPI $refs a shared error schema across 4xx/5xx responses (verified), else common[].type includes ErrorCatalog / ErrorCodes / DeclineCodes
A2A Agent Card +8 pts — a2a/-a2a.yml manifest, graded on conformance.grade against A2A 1.0.0
Request/Response Examples +7 pts — share of operations carrying request/response examples; else an Examples / Code Samples link
Registration Without a Human +6 pts — a `registration_endpoint` in the served RFC 8414 / OIDC discovery document

9 more unmet checks in the Agent Readiness table above.

Kin Score — facets with the most composite points still available (weight × headroom):

Access Clarity scores 5.3 — up to +18.9 composite points
Developer Ergonomics scores 32.1 — up to +13.6 composite points
Contract Quality scores 45.9 — up to +13.5 composite points

Each check links to what satisfies it. Publish the artifact, or tell us where it already lives, and the score moves on the next scoring run.

Improve this rating by publishing the missing artifacts — every area above can be raised, and the full rubric is at apis.io/rating/. Every facet and dimension name above is a link: it opens that measurement's own page — what it means, the exact checks that feed it, how the whole catalog distributes on it, and the providers at the top of it. This rating is computed from the provider profile at artifacts.apis.io/claim-md/apis.yml: open an issue on github.com/api-evangelist/claim-md to ask a question or point us at an artifact you publish. Submit an artifact on GitHub — free → Manage your own listing — the Influence plan, $499/mo →

Markets this provider is in provisional

The Kin Score Market layer reads a provider inside its market: its position, and how deep its integrations go. Depth is only comparable within a position. Provisional and unweighted: not part of the Kin Score or agent readiness.

Market	Position	Depth	Registered MCP server	Declares compatibility
Certified Health IT (health IT accreditation and certification registers)	standard	57.7	-	-
Payer Interoperability (CAQH CORE, X12, Da Vinci, WEDI)	standard	57.7	-	-

Registered MCP server and declares compatibility are report only — not weighted. Undeclared means we found nothing we can read, so there is no number: we never infer integrations.

Standards implemented 1

Standards this provider implements or carries. De facto ones are profiled and measured by the API Commons; formal ones come from the standards directory and are linked by the provider's own tags. The evidence column says how each claim was established — not that it was made.

OpenAPI

measured — observed by APIs.io (published)

APIs 5

Individual APIs this provider publishes, each with its own machine-readable definition.

Claim.MD Claim Status API

Claim status responses, modifications, and notes.

Claim.MD Claims API

Claim file upload and reconciliation.

Claim.MD Eligibility API

Real-time eligibility and benefit verification (270/271).

Claim.MD ERA API

Electronic remittance advice (835) listing and retrieval.

Claim.MD Reference API

Payer directory, enrollment, appeals, and webhooks.

Open Collections 6

Open, tool-agnostic API collections (OpenAPI-derived and Bruno).

Claim.MD Claim Status API

OPEN COLLECTION

Claim.MD Claim Status Claims API

OPEN COLLECTION

Claim.MD Claim Status Eligibility API

OPEN COLLECTION

Claim.MD Claim Status ERA API

OPEN COLLECTION

Claim.MD Claim Status Reference API

OPEN COLLECTION

Claim.MD API

OPEN COLLECTION

Claim.MD API pricing

Not yet checked against Claim.MD's own pricing page. Compiled by API Evangelist on 2026-06-21 from www.claim.md/services-providers; confirm before you rely on a figure.

Plan	Price
Provider subscription	—
Software Vendor enterprise	—

Plan details, limits and sources →

Rate limits

Requests Per Minute: 100 requests
Claims Per Upload: 2000 claims
Response Results Per Request: 20000 results

Compiled by API Evangelist, not yet checked against Claim.MD's documentation. All 4 limits →

Pricing Plans 1

Published pricing tiers and plan structures.

Claim Md Plans Pricing

2 plans

PLANS

Rate Limits 1

Documented rate limits and quota policies.

Claim Md Rate Limits

4 limits

RATE LIMITS

Service Levels 1

Uptime the provider promises or reports, as SLA4OAI. Read from its own pages; APIs.io runs no monitors.

Claim.MD

SLA

FinOps 1

Cost, billing, and metering signals for API financial operations.

Claim Md Finops

FINOPS

Spectral Rules 1

Spectral governance rulesets for linting and validating these APIs.

Claim.MD API Rules

58 rules · 56 errors 1 warnings 1 info

SPECTRAL

Security Posture 2

Authentication, domain security, vulnerability disclosure, and trust-center signals.

Claim Md Authentication

apiKey · 1 scheme

SECURITY

Claim Md Domain Security

TLSv1.3 · HSTS · DNSSEC · DMARC

SECURITY

Agentic Access 1

Recommended x-agentic-access execution contracts for AI agents.

Claim Md Agentic Access

15 operations · 6 acting

AGENTIC

Resources

Documentation 1

Reference material describing how the API behaves

Documentation

Documentation

Agent Surfaces 1

MCP servers, agent skills, and machine-readable catalogs

AgenticAccess

AgenticAccess

Access & Security 2

Authentication, authorization, and security posture

DomainSecurity

DomainSecurity

Authentication

Authentication

Operate 1

Status, limits, changes, and where to get help

RateLimits

RateLimits

Commercial 2

Pricing, plans, and the legal terms of use

Plans

Plans

FinOps

FinOps

Company 3

The organization behind the API

LinkedIn

Website

Website

Blog

Blog

Other 1

Properties that don't map to a standard resource type

CapabilityMap

CapabilityMap

Source (apis.yml)

aid: claim-md
url: https://raw.githubusercontent.com/api-evangelist/claim-md/refs/heads/main/apis.yml
name: Claim.MD
kind: company
description: Claim.MD is a medical-claims clearinghouse that connects healthcare providers and software vendors to thousands
  of payers. Its REST API (authenticated with an AccountKey) supports electronic claim submission (837P/837I), claim status
  tracking, electronic remittance advice (835 ERA), real-time eligibility (270/271), and file upload/download workflows.
deliveryModel:
  model: saas
  open_source: false
  commercial: true
  callable_host: true
  label: Hosted service · you call their endpoint
  confidence: high
  source:
  - openapi
  - pricing
  generated: '2026-08-28'
  method: derived
accessModel:
  pricing: enterprise
  onboarding: unknown
  trial: false
  try_now: false
  public: false
  label: Enterprise
  confidence: medium
  source:
  - plans
  - authentication
  - security
  generated: '2026-11-06'
  method: derived
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/icons/claim-md.png
tags:
- Healthcare
- Medical Claims
- Clearinghouse
- EDI
- X12
- Revenue Cycle
- Health Insurance
created: '2026-06-21'
modified: '2026-06-21'
specificationVersion: '0.23'
apis:
- aid: claim-md:claim-md-claim-status-api
  name: Claim.MD Claim Status API
  description: Claim status responses, modifications, and notes.
  humanURL: https://docs.claim.md/docs/api
  baseURL: https://svc.claim.md/services
  tags:
  - Claim Status
  properties:
  - type: OpenAPI
    url: openapi/claim-md-claim-status-api-openapi.yml
  - type: Documentation
    url: https://docs.claim.md/docs/api
  - type: APIReference
    url: https://api.claim.md/
  - type: PostmanCollection
    url: collections/claim-md.postman_collection.json
  - type: OpenCollection
    url: collections/claim-md.opencollection.json
- aid: claim-md:claim-md-claims-api
  name: Claim.MD Claims API
  description: Claim file upload and reconciliation.
  humanURL: https://docs.claim.md/docs/api
  baseURL: https://svc.claim.md/services
  tags:
  - Claims
  properties:
  - type: OpenAPI
    url: openapi/claim-md-claims-api-openapi.yml
  - type: Documentation
    url: https://docs.claim.md/docs/api
  - type: APIReference
    url: https://api.claim.md/
  - type: PostmanCollection
    url: collections/claim-md.postman_collection.json
  - type: OpenCollection
    url: collections/claim-md.opencollection.json
- aid: claim-md:claim-md-eligibility-api
  name: Claim.MD Eligibility API
  description: Real-time eligibility and benefit verification (270/271).
  humanURL: https://docs.claim.md/docs/api
  baseURL: https://svc.claim.md/services
  tags:
  - Eligibility
  properties:
  - type: OpenAPI
    url: openapi/claim-md-eligibility-api-openapi.yml
  - type: Documentation
    url: https://docs.claim.md/docs/api
  - type: APIReference
    url: https://api.claim.md/
  - type: PostmanCollection
    url: collections/claim-md.postman_collection.json
  - type: OpenCollection
    url: collections/claim-md.opencollection.json
- aid: claim-md:claim-md-era-api
  name: Claim.MD ERA API
  description: Electronic remittance advice (835) listing and retrieval.
  humanURL: https://docs.claim.md/docs/api
  baseURL: https://svc.claim.md/services
  tags:
  - ERA
  properties:
  - type: OpenAPI
    url: openapi/claim-md-era-api-openapi.yml
  - type: Documentation
    url: https://docs.claim.md/docs/api
  - type: APIReference
    url: https://api.claim.md/
  - type: PostmanCollection
    url: collections/claim-md.postman_collection.json
  - type: OpenCollection
    url: collections/claim-md.opencollection.json
- aid: claim-md:claim-md-reference-api
  name: Claim.MD Reference API
  description: Payer directory, enrollment, appeals, and webhooks.
  humanURL: https://docs.claim.md/docs/api
  baseURL: https://svc.claim.md/services
  tags:
  - Reference
  properties:
  - type: OpenAPI
    url: openapi/claim-md-reference-api-openapi.yml
  - type: Documentation
    url: https://docs.claim.md/docs/api
  - type: APIReference
    url: https://api.claim.md/
  - type: PostmanCollection
    url: collections/claim-md.postman_collection.json
  - type: OpenCollection
    url: collections/claim-md.opencollection.json
common:
- type: CapabilityMap
  url: capabilities/claim-md-capability-edges.yml
  name: Claim.MD Business Capability Map
- type: AgenticAccess
  url: agentic-access/claim-md-agentic-access.yml
- type: DomainSecurity
  url: security/claim-md-domain-security.yml
- type: Authentication
  url: authentication/claim-md-authentication.yml
- type: LinkedIn
  url: https://www.linkedin.com/company/claim.md
- type: Website
  url: https://www.claim.md
- type: Documentation
  url: https://docs.claim.md/docs/index
- type: Plans
  url: plans/claim-md-plans-pricing.yml
- type: RateLimits
  url: rate-limits/claim-md-rate-limits.yml
- type: FinOps
  url: finops/claim-md-finops.yml
- url: https://www.claim.md/news
  type: Blog
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com

Claim.MD API — frequently asked questions

Does Claim.MD have an API?

Yes. APIs.io lists 5 APIs from Claim.MD, including Claim.MD Claim Status API, Claim.MD Claims API and Claim.MD Eligibility API, and 2 more.

Is there an OpenAPI specification for the Claim.MD API?

Yes. APIs.io indexes 5 OpenAPI specifications for Claim.MD, each linked for download from this page.

How do I authenticate with the Claim.MD API?

Claim.MD uses bearer-token authentication (apiKey · 1 scheme). The details are profiled on APIs.io as Claim Md Authentication.

How much does the Claim.MD API cost?

APIs.io lists 2 pricing plans for Claim.MD, with each plan's price, limits and inclusions under Pricing on this page.

Is the Claim.MD API ready for AI agents?

Claim.MD has a Kin Score of 26.6 out of 100 (thin) and an Agent Readiness score of 19.6 (agent-aware), scored by API Evangelist on 2026-11-06.

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get_provider_toolsEvery MCP tool they ship, with the operation each wraps.
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