Can the Claim.MD API be used to replicate the Claim.MD user interface?

Question:
Is the Claim.MD API intended to function as a remote or embedded version of the Claim.MD user interface?

Answer:
No. The Claim.MD API is not designed to replicate or replace the Claim.MD user interface. Instead, the API provides a data feed for claim status information and Electronic Remittance Advice (ERA), which is intended to be pulled into your own system for processing and tracking claim activity.

This approach works best when the API is used alongside a billing system. A billing system can account for actions such as claim resubmissions or the application of paper remittances—events that may occur outside of Claim.MD and are not always reflected in API data alone.

In the context of a third-party system, it may not be possible to fully recreate views such as a “rejected claims” list, since the API may not be aware of claims that have already been addressed or resolved outside of Claim.MD.

The primary API services to review are:

• Claim Status APIs:

  • https://docs.claim.md/docs/test-account-quickstart-guide#claim-status

  • https://api.claim.md/#/paths/~1services~1response~1/post

• ERA APIs:

  • https://docs.claim.md/docs/test-account-quickstart-guide#electronic-remittance-advice-era

  • https://api.claim.md/#/paths/~1services~1eralist~1/post

Both the Claim Status and ERA APIs allow you to retrieve all status messages and remittance data since the account’s inception. Accessing this data through the API does not interfere with other applications or users accessing the same information simultaneously.