Seamless API Access for EHR & EMR Platforms

Modern REST APIs, Built for Real Developers

Unlock everything ClaimRev can do straight from your system. If it works in our portal, it’s available in our API. No limitations. No hidden features. Just full programmatic control.
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Integrate in Hours, Not Weeks

Our JSON based APIs give you instant access to everything you need
// Create and submit a claim in one API call
POST
/api/v1/claims { "patient": { "firstName": "John", "lastName": "Smith", "memberId": "ABC123456" }, "services": [ { "procedureCode": "99213", "diagnosisCodes": ["Z00.00"], "charge": 150.00 } ] }
// We handle all EDI conversion automatically
// You never touch complex transaction sets

Everything You Need in One API

Complete Feature Parity

Get instant access to:

  • Claim creation & submission
  • Eligibility verification
  • Real time claim status
  • ERA retrieval
  • Denial insights
  • Analytics & reporting data

Skip the EDI Complexity

You never have to parse, generate, or even look at complex EDI transaction sets. ClaimRev handles claim submission, eligibility verification, claim status inquiries, and remittance advice behind the scenes.

Your integration speaks clean JSON. We handle EDI conversion, payer routing, and standards compliance automatically. Focus on building great software, not decoding cryptic formats.

Clear Documentation

The entire ClaimRev API is documented with Swagger/OpenAPI, giving your developers a live, interactive reference. Explore endpoints, view sample requests and responses, and test calls in real time before writing a single line of code.

Every endpoint includes request and response examples, error code explanations, and field-level descriptions.

Built for Multi Tenant EMR Platforms

Every practice account in ClaimRev has its own client ID and secret. Your EMR passes the appropriate credentials per account and the API automatically scopes all requests to the correct practice. No custom routing logic. No shared data between accounts.

This architecture is designed for EMR platforms managing claims across dozens or hundreds of provider accounts from a single integration point.

Why Developers Choose ClaimRev API

Fast Integration

Hours, not weeks. Our clean API design and comprehensive docs get you up and running fast.
🔒

Secure by Default

OAuth 2.0, encrypted connections, and isolated tenant data keep everything protected.
📊

Full Transparency

Detailed logs, structured error messages, and real-time status updates mean you always know exactly what happened to every claim and exactly what to fix when something goes wrong.

Supported Transactions

The ClaimRev API covers the full healthcare claims transaction set. Every major EDI workflow is accessible through clean, documented REST endpoints that accept and return JSON.

Claims Submission — 837P & 837I

Submit professional (837P) and institutional (837I) claims programmatically. Pass patient demographics, provider details, procedure codes, and diagnosis codes as JSON. ClaimRev handles EDI generation, payer routing, and acknowledgment tracking automatically.

Real-Time Eligibility — 270/271

Verify patient coverage before billing with real-time eligibility transactions. Pass patient and payer identifiers and receive a structured response in milliseconds — active coverage status, copay, deductible, coinsurance, and plan limits.

Claim Status — 276/277

Query claim status programmatically without logging into payer portals. The API returns current adjudication status, payer acknowledgment codes, and any rejection reasons — surfaced automatically without portal-hopping.

ERA Retrieval — 835

Retrieve Electronic Remittance Advice files as structured JSON. ERA data is delivered automatically when payers release payment decisions, with each claim line item broken out for easy posting to your practice management system. No manual file downloads.

Developer FAQ

What transactions does the API support?
Claim submission (837P and 837I), real-time eligibility (270/271), claim status (276/277), and electronic remittance advice (835). All handled server-side — you send and receive JSON.

How do I handle multiple practices in one integration?
Each practice account has its own client ID and secret. Your platform passes the appropriate credentials per account and the API scopes all data automatically. No custom routing logic required.

How does ERA data get delivered?
ERA files are retrieved automatically from payers when payment decisions are made. Poll the ERA endpoint or configure webhook notifications — no manual downloads required.

What payers are supported?
Major commercial payers, Medicare, Medicaid (state-specific), Tricare, Workers Comp, and IHS. See the full payer list.

What does API access cost?
API access is available on ClaimRev subscription plans, with pricing based on submission volume. See pricing or discuss your volume needs when you book a demo.

Ready to Integrate?

Talk to our team about API access and see how easy it is to add ClaimRev to your platform.