Dental Claims Raw X12
This endpoint sends 837D (dental) claims to payers in raw X12 EDI format. This is ideal if you have an existing system that generates X12 EDI files and you want to send them through Stedi’s API.
- Call this endpoint with a payload in 837 X12 EDI format.
- Stedi validates the EDI and sends the claim to the payer.
- The endpoint returns a response from Stedi in JSON format containing information about the claim you submitted and whether the submission was successful.
Send test claims
All claims you submit through this endpoint are sent to the payer as production claims unless you explicitly designate them as test data.
To send test claims, set the usageIndicator
field in the test claim to T
. This allows you to filter for test claims on the Transactions page in the Stedi app.
Note that you will receive a 277 Claim Acknowledgment in response to test claims, allowing you to test your workflow end to end, but you will not receive a test 835 (ERA) response.
Identify service lines
A claim can contain multiple service lines. Since the payer may accept, reject, or pay a subset of those lines, you can receive an 835 response that references a patient control number, but only pertains to some of the service lines.
However, the line item control number serves as a unique identifier for each service line in your claim submission. You can set the line item control number in Loop 2400 REF02
, when REF01
= 6R
. The line item control number appears in the 277CA and 835 ERA responses as the lineItemControlNumber
, allowing you to correlate these responses to specific service lines from the original claim. If you don’t set the line item control number for a service line, Stedi uses a random UUID.
Stedi returns service line identifiers in the claimReference.serviceLines
object of the synchronous API response.
Character restrictions
Only use the following characters as delimiters: ~
, *
, :
and ^
. The X12 format doesn’t support using escape sequences, so you can’t include delimiters or special characters as part of the request data. Stedi returns a 400
error if you include restricted characters as anything other than delimiters in the request.
Authorizations
A Stedi API Key for authentication.
Headers
The outbound transaction setting ID. This option only needs to be specified if a non-default release of the Dental Claims guide needs to be used.
Body
Response
The status of the claim submission.
An identifier for the transaction.
An ID for the payer you identified in the original claim. This value may differ from the tradingPartnerServiceId
you submitted in the original request because it reflects the payer's internal concept of their ID, not necessarily the ID Stedi uses to route requests to this payer.
Information about the claim.
A list of errors. Currently not used.
A 200
response indicates that Stedi successfully generated the X12 EDI claim format required by the payer. It does not indicate whether the payer has accepted the claim - the payer will respond later with a 277CA containing this information. Learn more about 277CAs. A 400
response indicates one or more problems with the claim data in the request. Examples include missing required fields, invalid values, or incorrect data types. The response includes a message describing the problem.
200 OK
, 400 BAD_REQUEST
Metadata from Stedi about the request.
Currently not used.
Currently not used.
Information about the payer for the submitted claim.
Currently not used.
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