Reports
Overview
The Claims Responses and Reports v2 API provides a direct connection to your mailbox where payers send their responses and reports to your claims. Use this API to access your mailbox for claim payments, claim status updates, and other communications regarding the revenue cycle from the payer.
Reports are not available for retrieval indefinitely; they are kept for a limited period of 30 days. To preserve them for potential future reprocessing and debugging, we store the files in S3.
Reports prefixes and types
X3
This report returns the solicited claim status x12 raw data that matches exactly what is returned by the payer and can be translated into JSON. This file is received from payers when claim status is requested and not returned in real time
We use a translation service to return this data as json, and contains the combination and reception of multiple Professional claims in a single 277 response.
EC
Submitted claims that were not received by the payer since validations error happens at change level. We are not checking for these files since we store all responses at DB.
Related claims will be marked as manually_revision_required
AC
We are going to have one of these reports for each claim acknowledge by the payer. This status will be retrieved also at X3 files hence we are not going to process this files.
R5 and ZZ
These files contain the remittance information. R5 file is the raw data and the ZZ file is the human-readable file.