Claim.MD website screenshot

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 APIs 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.

Claim.MD’s developer surface includes authentication, documentation, engineering blog, and 7 more developer resources.

🌐 Visit website 📡 Source on GitHub
34.6/100 thin ▬ flat Agent 29/100 agent aware Full breakdown ↓
scored 2026-08-20 · rubric v0.12.0
AccessSelf serve
5 APIs
HealthcareMedical ClaimsClearinghouseEDIX12Revenue Cycle

Kin Score

Kin Score Kin Score How this is scored →
scored 2026-08-20 · rubric v0.12.0
Composite quality — 34.6/100 · thin
Contract Quality 11.1 / 21
Developer Ergonomics 4.0 / 17
Access Clarity 4.9 / 17
Operational Transparency 3.5 / 11
Contract Governance 0.0 / 10
Discoverability 6.3 / 9
Regulatory Posture 2.3 / 15
Agent readiness — 29/100 · 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
Regulatory Posture applies to this provider. Its tags matched the Health 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.
The six quality facets above are damped to 85 points between them, because the conditional facet above carries the other 15. That is why each facet's contribution is shown against a damped maximum: raising a quality facet moves the composite by 85% of its nominal weight, not 100%. The full arithmetic is at apis.io/rating/.
Improve this rating by publishing the missing artifacts — every area above can be raised, and the full rubric is at apis.io/rating/. This rating is computed from github.com/api-evangelist/claim-md: open an issue to ask a question, or submit a pull request to add artifacts. Want it done for you? Prioritized profiling — $2,500 →

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 7

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

API Collection

OPEN COLLECTION

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

Scroll for all 7

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

FinOps 1

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

Claim Md Finops

FINOPS

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 · 15 acting

15 operations · 15 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
LinkedIn
 Website
Website
 Blog
Blog

Source (apis.yml)

apis.yml Raw ↑ 
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.
accessModel:
  pricing: unknown
  onboarding: self-serve
  trial: false
  try_now: false
  public: false
  label: Self-serve signup
  confidence: high
  source:
  - plans
  - authentication
  generated: '2026-07-22'
  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
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: 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