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Developer API

837P, 837I, 270 EDI Transactions

Mahler Health's web based API (RESTful) makes implementing EDI claims within your web application easy and includes access to over 5,000 Insurance Payers. All data is transmitted via SSL connections and the data-interchange is done via JSON. Our system does all the EDI work for you, enabling you to concentrate on the user interface and usability of your platform. The Mahler Health application programming interface for insurance claims creates the EDI files for you, submits the claims, and parses the responses for you. If you already generate EDI files/data, there probably isn't a reason to use this API. If you are looking for an easy to use Web API that does all the EDI work for you, then this API is for you.

  • 837P Claims - Submit the claims, retrieve status information, refile denied claims.
  • 837I Claims - Same functionality available as 837P.
  • 270 - Eligibility/status
  • No need to learn anything about EDI or ASC X12. Our Web API takes care of all that. You just submit human readable data.
  • JSON data-interchange.
  • Real Time data checking.
  • Our server clusters (yes, multiple clusters around the U.S.) are top of the line, reliable, and deliver extremely fast services for our users. Our infrastructure team has vast experience creating environments that are ideal for web services API's (fast and reliable).
  • Fast, Reliable, Intuitive


Interested in using the Mahler Health EDI Insurance Claims and/or Eligibility Checks API? Contact Us

What is EDI X12?

EDI X12 is a data format based on ASC X12 standards. It is used as the standard to exchange data between multiple trading partners. A trading partner could represent an organization, individual, company, or some other entity. An EDI X12 file contains information about an invoice, purchase order, healthcare claim, etc. For the purposes of this site, we will be concentrating on healthcare claims, in particular, EDI 837 and EDI 270/271 using release X12 5010(this is just the standards release version, healthcare claims were using 4010 and now use 5010. Mahler Health API makes it so you don't have to worry about this). Standard EDI X12 data is separated by segment, element, and sub-element delimiters/separators. The data is most commonly saved in a text file.

Click Here for an example EDI file that includes one claim(sensitive data has been removed).

Each segment is displayed on a separate line and ends with a tilde as the segment separator. Each segment starts with a 2-3 letter code that identifies that segment. Some segments repeat more than once and have different qualifiers inside in order to be identified - these are called loops. We could go on and on (the official ASC X12 guides from Washington publishing are several hundred pages long for each claim type) but that is what this Mahler Health Web API was built for - to speed up development time, drastically reduce costs, and improve quality of EDI insurance claims features of your site. You keep your branding and your users in your site and use our backend system for the insurance claims.

Pricing

Prices range from $0.05 per claim to $0.25 depending on the API.

Contact Us for more information on pricing and the API options available.

Integrated API - Practice Management Solution

Have an amazing EHR/EMR system? Have a fantastic scheduling platform? Have a need to integrate a revenue cycle management system? Our Integrated API is your solution to including full revenue cycle management all within your current system you have developed. Included in our Integrated API are the eligibility check API, insurance claims API, and the ability to easily transfer your users to our system with all their data for a seamless transfer and interaction with our revenue cycle management system. We give you control over headers and styles. Your users will be in one complete, integrated solution, and will reap the huge benefits obtained having one solution for their entire practice management.

Contact Us for more information on pricing and the API options available.

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Developer API

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