Retrieve and correlate responses (277s and ERAs)

There are two steps to retrieve payer responses from Stedi:

1. Discover responses by polling for processed transactions or listening for event-driven webhooks.
2. Call Stedi’s APIs to retrieve processed responses from Stedi.

Once you have the responses, you can correlate them with the original claim and specific service lines.

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Response types

After you submit a professional or institutional claim, you may receive asychronous 277CA and 835 ERA responses.

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Claim Acknowledgment (277CA)

The 277CA indicates whether the claim was accepted or rejected and (if relevant) the reasons for rejection. Though it can contain claim status information, the 277CA is different from the synchronous 277 Claim Status response you receive after submitting a real-time claim status request.

You’ll receive multiple separate 277CAs for each claim you submit.

• You’ll receive the first 277CA from Stedi within about 30 minutes of submitting the claim. This 277 is the result of Stedi’s internal claim validation and may contain rejection message(s) and warnings, if applicable.
• You may receive a second 277CA from Stedi around the same time. This 277CA can contain additional information from the payer, but is often identical to the first one. You can think of this as an initial validation 277 from the payer.
• You’ll receive a final 277CA from the payer containing summary counts of transactions received and accepted as well as detailed information for rejected transactions, including payer-specific validations and HIPAA validations. This 277 has the payer’s name in the transactions.payers.organizationName property.

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Electronic Remittance Advice (835 ERA)

The 835 ERA, also known as a claim payment, contains details about payments for specific services and explanations for any adjustments or denials.

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Discover processed responses

You can discover processed responses by either listening for webhooks or polling for transactions.

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Listen for webhooks

Instead of polling for transactions, you can set up webhooks that automatically send events for processed 277CAs and 835 ERAs to your endpoint. You can either create a single webhook for all inbound transactions or create a separate webhook for each transaction type.

These webhooks are triggered by the transaction processed event Stedi emits after it successfully processes a response from the payer or intermediary clearinghouse.

{
  "version": "0",
  "id": "f972fb53-653a-1747-ce30-bed15fc04f5c",
  "detail-type": "transaction.processed.v2",
  "source": "stedi.core",
  "account": "000000112345",
  "time": "2024-07-18T16:21:24Z",
  "region": "us-east-1",
  "resources": [
    "https://core.us.stedi.com/2023-08-01/transactions/f0d3f790-0bc9-432b-93kd-e4b7ece67946"
  ],
  "detail": {
    "transactionId": "f0d4f780-0ec9-432b-93gd-e4b7ece93946",
    "direction": "INBOUND",
    "mode": "test",
    "fileExecutionId": "9f76b485-6hca-43bf-917e-d5b54bec6234",
    "processedAt": "2024-07-18T16:21:24.658Z",
    "fragments": null,
    "artifacts": [
      {
        "artifactType": "application/edi-x12",
        "usage": "input",
        "url": "https://core.us.stedi.com/2023-08-01/transactions/f0d9f790-0ec9-431b-93fd-e4h7ece63946/input",
        "sizeBytes": 1313,
        "model": "transaction"
      },
      {
        "artifactType": "application/json",
        "usage": "output",
        "url": "https://core.us.stedi.com/2023-08-01/transactions/f0d3f740-0ec9-432b-98fd-e4b7ece63946/output",
        "sizeBytes": 5602,
        "model": "transaction"
      }
    ],
    "partnership": {
      "partnershipId": "local-clearinghouse-test",
      "partnershipType": "x12",
      "sender": {
        "profileId": "clearinghouse-test"
      },
      "receiver": {
        "profileId": "local"
      }
    },
    "x12": {
      "transactionSetting": {
        "guideId": "01J1M50C1Q44KYDZY8V7R1TPBW",
        "transactionSettingId": "01J1M50P9623BFE0FFT5Q2BR49"
      },
      "metadata": {
        "interchange": {
          "acknowledgmentRequestedCode": "0",
          "controlNumber": 11
        },
        "functionalGroup": {
          "controlNumber": 11,
          "release": "005010X214",
          "date": "2024-07-18",
          "time": "16:20:47",
          "functionalIdentifierCode": "HN"
        },
        "transaction": {
          "controlNumber": "1001",
          "transactionSetIdentifier": "277"
        },
        "receiver": {
          "applicationCode": "001690149382",
          "isa": {
            "qualifier": "ZZ",
            "id": "001690149382"
          }
        },
        "sender": {
          "applicationCode": "STEDITEST",
          "isa": {
            "qualifier": "ZZ",
            "id": "STEDITEST"
          }
        }
      }
    },
    "connectionId": "01J1M5124B2HWMNN91Q3Z6AM61"
  }
}

As these events are emitted, you can:

• Determine the transaction type from the x12.transactionSetIdentifier field: 277 (Claim Acknowledgment) or 835 (ERA).
• Use the transactionId to retrieve the transaction from Stedi.

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Poll for transactions

Call the Poll Transactions endpoint to return a list of transactions in your Stedi account.

You must include the following information in the request:

• Your Stedi API key as the Authorization header.
• Either the startDateTime or pageToken query parameters. To retrieve a list of transactions after a specific date, use startDateTime. To retrieve the next page of transactions, use pageToken (you can find this value in the nextPageToken field in the response).

The following example shows an API call to retrieve transactions after a specific date:

  curl --request GET -L \
    --url https://core.us.stedi.com/2023-08-01/polling/transactions?startDateTime=2023-08-28T00:00:00Z \
    --header "Authorization: ${STEDI_API_KEY}" 

Filter for 277CA and 835 ERA transactions

The response includes all transactions that have been sent or received, including all 837 claims you have submitted and all 277CA and 835 ERA responses you have received from payers. You must filter for transactions that match the following criteria:

• direction: INBOUND - This indicates that the transaction came from the payer or intermediary clearinghouse.
• x12.transactionSetIdentifier: 277 or 835

The following example shows a response containing a processed 277CA transaction:

{
  "items": [
    {
      "direction": "INBOUND",
      "mode": "production",
      "fileExecutionId": "f75168e4-e682-4410-bfec-b5b1541c7f21",
      "transactionId": "a15b68ca-fae0-42de-b8a3-f436668b8604",
      "processedAt": "2023-08-28T09:00:28.354Z",
      "artifacts": [
        {
          "artifactType": "application/edi-x12",
          "sizeBytes": 490,
          "usage": "input",
          "url": "https://core.us.stedi.com/2023-08-01/transactions/a15b68ca-fae0-42de-b8a3-f436668b8604/input"
        },
        {
          "artifactType": "application/json",
          "sizeBytes": 51,
          "usage": "output",
          "url": "https://core.us.stedi.com/2023-08-01/transactions/a15b68ca-fae0-42de-b8a3-f436668b8604/output"
        }
      ],
      "partnership": {
        "partnershipId": "customer_availity",
        "partnershipType": "x12",
        "sender": {
          "profileId": "availity_sender"
        },
        "receiver": {
          "profileId": "availity_receiver"
        }
      },
      "x12": {
        "metadata": {
          "interchange": {
            "acknowledgmentRequestedCode": "0",
            "controlNumber": 2
          },
          "functionalGroup": {
            "controlNumber": 2,
            "release": "008010",
            "date": "2023-08-28",
            "time": "09:00:20",
            "functionalIdentifierCode": "HN"
          },
          "transaction": {
            "controlNumber": "1",
            "transactionSetIdentifier": "277"
          },
          "receiver": {
            "applicationCode": "AV01101957",
            "isa": {
              "qualifier": "ZZ",
              "id": "AV01101957"
            }
          },
          "sender": {
            "applicationCode": "030240928",
            "isa": {
              "qualifier": "01",
              "id": "030240928"
            }
          }
        },
        "transactionSetting": {
          "guideId": "01H8PSWG4ZD6QPKC9VSD42PQX3",
          "transactionSettingId": "01H8PSWG4ZD6QPKC9VSD42PQX3"
        }
      }
    }
  ],
  "nextPageToken": "945ff6de213d3ef481d028065d4c12fb996a166a3a90ef98564318decfae50ce4b36d74b7e9d9bafa6e1d169"
}

For each matching transaction, extract the transactionId and x12.transactionSetIdentifier type to use when mapping the data.

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Retrieve responses from Stedi

Use the following APIs to retrieve 277CA and 835 ERA responses from Stedi in JSON format:

• Get 277CA Report: Retrieve 277CA responses
• Get 835 ERA Report: Retrieve 835 ERA responses

You must include the following information in the request:

• Your Stedi API key as the Authorization header.
• The transactionId query parameter, which specifies the processed transaction you want to retrieve. You can find this ID in the response from either the Poll Transactions API or the configured webhook.

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Correlate responses with original claim

You can use the following identifiers from the original claim to correlate the 277CA and 835 ERA responses.

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Entire claim

Use the claimInformation.patientControlNumber from the original claim.

• In the 277CA response, this number is returned as the transactions.payers.claimStatusTransactions.claimStatusDetails.patientClaimStatusDetails.claims.claimStatus.patientAccountNumber.
• In the 835 response, this number is returned as the transactions.detailInfo.paymentInfo.claimPaymentInfo.patientControlNumber.

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Specific service lines

The professional and institutional claim types use different names for the same identifier:

• Professional: Use claimInformation.serviceLines.providerControlNumber from the original claim, if provided.
• Institutional: Use claimInformation.serviceLines.lineItemControlNumber from the original claim, if provided.

Location in responses:

• In the 277CA response, this number is returned as the transactions.payers.claimStatusTransactions.claimStatusDetails.patientClaimStatusDetails.claims.serviceLines.lineItemControlNumber. However, a 277CA only contains a serviceLines object if it was rejected because of issues with the information provided for the service line.
• In the 835 response, this number is returned as the transactions.detailInfo.paymentInfo.serviceLines.lineItemControlNumber.