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ClaimRev Developer Portal

A REST API for the US healthcare claims lifecycle: submit X12 837 claims, run real-time eligibility and claim-status checks, retrieve payer remittance (835 ERAs), and create secondary (COB) claims — all over JSON.

What you can do today​

  • Submit 837P / I / D claims as raw EDI, or submit professional claims as JSON and let ClaimRev build the EDI for you
  • Run real-time eligibility (270 / 271) with no prior patient setup — pass patient and payer info inline, get the 271 synchronously
  • Ping payers for real-time claim status (276 / 277) when a claim has gone quiet and you need to know whether the payer actually has it
  • Retrieve ERAs as structured JSON — search payment-advice headers, fetch one in full, drill into per-claim service-line breakdowns, export to CSV
  • Build secondary claims (COB) derived from a primary claim's matched 835 — adjudication data carries forward automatically
  • Replay inbound EDI — the same upload endpoint accepts raw 835s, so you can backfill historical remits and feed analytics

What makes integration smoother​

  • JSON in, JSON and raw EDI back. Eligibility and claim-status responses include both the parsed structured fields and the raw 271 / 277 EDI in one payload — no separate fetch, no translation library required.
  • Credentials in the portal. Once ClaimRev provisions your account, retrieve your client id and secret yourself from the Client Connect menu in the portal — no back-and-forth to get the API credentials. One client id per account.
  • Deterministic test data. The test environment returns predictable mock results based on subscriber name patterns, so you can build a full integration-test suite without any real PHI. See the SharpRevenue Testing Guide.
  • Two B2C environments. Test (testapi.claimrev.com) and production (api.claimrev.com), each with its own credentials and isolated data.

Who this is for​

  • EMRs and practice-management systems integrating claim submission and status tracking into clinical workflows
  • Billing service providers managing claims for many practices through a single integration
  • Healthtech apps that need claims-lifecycle primitives without writing X12 EDI from scratch

Where to start​

If you're…Go to
New to ClaimRevConcepts — accounts, claims, payers, ERAs, eligibility, COB
Ready to write codeQuickstart — token, auth check, real eligibility call in ~10 minutes
Wiring up authAuthentication — test + production endpoints, credentials, errors
Submitting your first 837Submitting a Claim
Looking up an endpointAPI Reference — every endpoint, rendered from the live OpenAPI spec

Support​

For onboarding, credential issuance, or production access, contact ClaimRev support through your account manager or via the portal's support channel.