STstedi

GET /claims/{id}

Changed on

Retrieve summary information for a claim, including current processing status and key details from its most recent submission

Request

  • Base URL
    https://claims.us.stedi.com/2025-03-07
  • URL
    https://claims.us.stedi.com/2025-03-07/claims/{id}
  • Auth
    API key in header Authorization

Path parameters

idstring required

A unique identifier for the claim within Stedi. You can retrieve this ID from the claimId property in the Create Professional Claim JSON endpoint response or from the List Claims lifecycle endpoint.

Response

GetClaim 200 response

idstring required

A unique identifier for the claim within Stedi. This ID stays the same throughout the claim's entire lifecycle. For example, the claim ID is the same for the initial submission and any resubmissions.

patientControlNumberstring required

The patient control number you assigned to the claim.

status'SUBMITTED' | 'RECEIVED' | 'ACCEPTED' | 'REJECTED' | 'PROCESSED' | 'DENIED' | 'UNKNOWN' required

The claim's current processing status.

  • SUBMITTED: You submitted the claim to Stedi but haven't yet received a 277CA response from Stedi or the payer.
  • RECEIVED: The clearinghouse or payer has acknowledged receipt of the claim. This doesn't mean the claim has been accepted for adjudication.
  • ACCEPTED: The payer has accepted the claim into their adjudication system and it's currently being processed or adjudicated.
  • REJECTED: Either Stedi or the payer rejected the claim before the start of adjudication. This can happen even when the payer has acknowledged receipt.
  • PROCESSED: The payer has adjudicated the claim. Check totalClaimPaidAmount to see how much was paid.
  • DENIED: The payer has denied the claim.
  • UNKNOWN: Stedi can't determine a single status for this claim, usually because the payer's responses are mixed or incomplete.
statusReportedBy'PAYER' | 'CLEARINGHOUSE' required

The entity that reported a claim status.

  • PAYER: The payer reported the status, in a 277CA claim acknowledgment or an 835 ERA.
  • CLEARINGHOUSE: A clearinghouse reported the status, either Stedi or an intermediary clearinghouse between Stedi and the payer.
stediPayerIdstring

The payer identifier in Stedi's system. This is the Stedi payer ID listed in the Stedi Payer Network.

submittedAtstring date-time required

The time Stedi processed the claim's most recent submission.

totalClaimChargeAmountstring required

The total charge amount of the claim's most recent submission.

totalClaimPaidAmountstring

The total amount payers have paid on this claim, summed across every claim payment information record linked to it. Excludes claim payment information with the PREDETERMINATION_PRICING_ONLY status, where the payer priced the claim without paying it. Reversals carry a negative amount, so they subtract from the total. Absent until Stedi receives an 835 ERA for the claim.

type'DENTAL' | 'INSTITUTIONAL' | 'PROFESSIONAL' required

The type of claim. Each type corresponds to a different 837 transaction set and paper claim form.

  • DENTAL: An 837D dental claim, the electronic equivalent of the ADA Dental Claim Form.
  • INSTITUTIONAL: An 837I institutional claim, the electronic equivalent of the UB-04 form.
  • PROFESSIONAL: An 837P professional claim, the electronic equivalent of the CMS-1500 form.

Changes