New member - Need information about few APIs

[Shahul Hameed]

Hello Team

I have joined new to this team. My organization is a medical billing company which integrates with EPIC and generates 837 files and sends it to various payors like Blue Cross. I am trying to identify if there are any available APIs that provides 

Financial information relating to the claim like payment accepted, denied, denial reasons, partial payments etc. (similar to 835/277 files)

Please help. Thanks in advance.

[Data at the Point of Care (DPC) Community]

Hello,

Thanks for your question regarding claims data. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission

[Data at the Point of Care (DPC) Community]

Hello,

Thank you for reaching out! The DPC API currently supports the Patient, Coverage, and ExplanationOfBenefit (EOB) FHIR resources in the STU3 version. The EOB resource is likely the best one to review to determine if it meets your use case for financial data related to patient claims. This resource can provide related data such as: claim details, claim processing outcomes, adjudication details.

Please note that we've paused on fulfilling requests for production access while we improve the onboarding experience. We don't have a specific date to share yet for onboarding to resume. We’ll continue to provide updates in the Google Group and the updates page on our website.

Let me know if you have any further questions!

Best,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission