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.

5 APIs 0 Features

HealthcareMedical ClaimsClearinghouseEDIX12Revenue Cycle

APIs

Claim.MD Claim Submission API

Upload batches of 1-2000 claims in 837P, 837I, CSV, JSON, XML, XLS, or XLSX format for scrubbing and routing to payers, then list and reconcile uploaded files.

Claim.MD Claim Status API

Incrementally retrieve claim status responses, acknowledgements, and claim modification and note history using ResponseID-based polling.

Claim.MD ERA / Remits API

List electronic remittance advice (ERA) and retrieve remittance detail as raw 835 X12, structured XML/JSON, or a printable PDF.

Claim.MD Eligibility API

Run real-time eligibility and benefit verification by submitting an X12 270 file or structured field data, returning a 271 response in XML or JSON (one request per patient).

Claim.MD Responses & Files API

Look up the payer directory, manage provider enrollment and appeals, and receive asynchronous enrollment and appeal updates via webhook.

Collections

Claim.MD API

OPEN

Pricing Plans

Claim Md Plans Pricing

2 plans

PLANS

Rate Limits

Claim Md Rate Limits

4 limits

RATE LIMITS

FinOps

Claim Md Finops

FINOPS

Resources

Sources

opencollection: 1.0.0
info:
  name: Claim.MD API
  version: '1.0'
request:
  auth:
    type: apikey
    key: AccountKey
    value: '{{AccountKey}}'
    in: query
items:
- info:
    name: Claims
    type: folder
  items:
  - info:
      name: Upload a batch claim file
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/upload/
      body:
        type: multipart-form
        data: []
    docs: Upload 1-2000 claims in 837P, 837I, CSV, JSON, XML, XLS, or XLSX format.
  - info:
      name: List uploaded files
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/uploadlist/
      body:
        type: urlencoded
        data: []
    docs: List previously uploaded claim files with counts and amounts.
- info:
    name: Claim Status
    type: folder
  items:
  - info:
      name: Retrieve claim status responses
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/response/
      body:
        type: urlencoded
        data: []
    docs: Incrementally retrieve claim status responses. Use ResponseID=0 initially.
  - info:
      name: Retrieve claim modification events
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/modify/
      body:
        type: urlencoded
        data: []
    docs: Incrementally retrieve claim field modification history.
  - info:
      name: Retrieve claim notes
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/notes/
      body:
        type: urlencoded
        data: []
    docs: Incrementally retrieve user notes attached to claims.
  - info:
      name: Archive a claim
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/archive/
      body:
        type: urlencoded
        data: []
    docs: Archive or delete one or more claims by claim identifier.
- info:
    name: ERA
    type: folder
  items:
  - info:
      name: List electronic remittance advice
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/eralist/
      body:
        type: urlencoded
        data: []
    docs: List ERA (835) with payment details and incremental retrieval via ERAID.
  - info:
      name: Retrieve raw 835 ERA
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/era835/
      body:
        type: urlencoded
        data: []
    docs: Retrieve the raw X12 835 transaction for a single ERA.
  - info:
      name: Retrieve structured ERA detail
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/eradata/
      body:
        type: urlencoded
        data: []
    docs: Retrieve claim-level remittance detail as structured XML or JSON.
  - info:
      name: Retrieve ERA as PDF
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/erapdf/
      body:
        type: urlencoded
        data: []
    docs: Retrieve a printable remittance report as a Base64-encoded PDF.
- info:
    name: Eligibility
    type: folder
  items:
  - info:
      name: Submit eligibility request (270 file)
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/elig/
      body:
        type: multipart-form
        data: []
    docs: Submit a real-time eligibility request as an X12 270 file (one per patient).
  - info:
      name: Submit eligibility request (field data)
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/eligdata/
      body:
        type: urlencoded
        data: []
    docs: Submit a real-time eligibility request using structured field data.
- info:
    name: Reference
    type: folder
  items:
  - info:
      name: Retrieve the payer directory
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/payerlist/
      body:
        type: urlencoded
        data: []
    docs: Look up payers and their supported service capabilities.
  - info:
      name: Request provider enrollment
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/enroll/
      body:
        type: urlencoded
        data: []
    docs: Initiate a provider enrollment request and receive an enrollment link.
  - info:
      name: Request a claim appeal
      type: http
    http:
      method: POST
      url: https://svc.claim.md/services/appeal/
      body:
        type: urlencoded
        data: []
    docs: Initiate a claim appeal and receive an appeal form link.