EDI

The EDI tools - upload and parse 835 / 837 zips, batches and feeds, Browse EDI data, denials, payment variance, the EDI explorer, verified datasets and their report.

These tools read your team's EDI data. edi_add_batch, edi_create_dataset, the verdict, sign-off and report tools write to your account. edi_next_step and the next_step on the batch tools walk the assistant through them.

edi_next_step

Parameter	Type	Default	What it does

edi_create_upload

Parameter	Type	Default	What it does
`filename`	string	required	The name of the file to upload, with its extension (.xlsx, .xls or .csv).

edi_add_batch

Parameter	Type	Default	What it does
`description`	string	none	What the dataset holds and the study it is for; required for a new dataset.
`name`	string	none	The study name.
`owner`	string	none	The provider the rates belong to: a provider id or name in your account. A new name becomes a custom provider.
`upload_id`	string	required	The id create_upload returned for the file.

edi_reparse

Parameter	Type	Default	What it does
`batch_id`	string	required

edi_list_batches

Parameter	Type	Default	What it does
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`status`	string	none

edi_get_batch

Parameter	Type	Default	What it does
`batch_id`	string	required

edi_feeds

Parameter	Type	Default	What it does

edi_feed

Parameter	Type	Default	What it does
`folder`	string	required
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.

edi_remits_by_payer

Parameter	Type	Default	What it does
`coverage`	string	none
`date_from`	string	none
`date_to`	string	none
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`payer`	string	none	Only this insurer, as named in the data.
`status`	string	none

edi_claims_by_payer

Parameter	Type	Default	What it does
`date_from`	string	none
`date_to`	string	none
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`payer`	string	none	Only this insurer, as named in the data.

edi_remits

Parameter	Type	Default	What it does
`coverage`	string	none
`date_from`	string	none
`date_to`	string	none
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`payer`	string	none	Only this insurer, as named in the data.
`status`	string	none

edi_claims

Parameter	Type	Default	What it does
`date_from`	string	none
`date_to`	string	none
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`payer`	string	none	Only this insurer, as named in the data.

edi_export

Parameter	Type	Default	What it does
`coverage`	string	none
`date_from`	string	none
`date_to`	string	none
`include_duplicates`	boolean	false
`kind`	workbook \| csv_zip \| remits \| claims	workbook	set_strategic_pricing_goal: max_revenue_within_market or revenue_neutral_optics. set_study_dataset: volume or cost. update_strategic_pricing_settings: the goal kind to switch to.
`payer`	string	none	Only this insurer, as named in the data.
`sets`	list of string	none
`status`	string	none

edi_denials_top

Parameter	Type	Default	What it does
`date_from`	string	none
`date_to`	string	none
`group_code`	CO \| PR \| OA \| PI \| CR	none
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`payer`	string	none	Only this insurer, as named in the data.

edi_denials_trend

Parameter	Type	Default	What it does
`group_code`	CO \| PR \| OA \| PI \| CR	none
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`payer`	string	none	Only this insurer, as named in the data.
`window_days`	integer	30

edi_variance_summary

Parameter	Type	Default	What it does
`cpt_code`	string	none
`date_from`	string	none
`date_to`	string	none
`direction`	underpaid \| overpaid	underpaid
`limit`	integer	10	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`owner`	string	required	The provider the rates belong to: a provider id or name in your account. A new name becomes a custom provider.
`payer_id`	string	none

edi_variance_by_payer

Parameter	Type	Default	What it does
`cpt_code`	string	none
`date_from`	string	none
`date_to`	string	none
`direction`	underpaid \| overpaid	underpaid
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`owner`	string	required	The provider the rates belong to: a provider id or name in your account. A new name becomes a custom provider.
`payer_id`	string	none

edi_variance_by_code

Parameter	Type	Default	What it does
`cpt_code`	string	none
`date_from`	string	none
`date_to`	string	none
`direction`	underpaid \| overpaid	underpaid
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.
`owner`	string	required	The provider the rates belong to: a provider id or name in your account. A new name becomes a custom provider.
`payer_id`	string	none

edi_ask

Parameter	Type	Default
`batch_ids`	list of string	none
`max_rows`	integer	50
`question`	string	required

edi_list_datasets

Parameter	Type	Default	What it does

edi_create_dataset

Parameter	Type	Default	What it does
`batch_ids`	list of string	none
`include_duplicates`	boolean	false
`name`	string	required	The study name.
`payers`	list of string	none	Only these insurers, as named in the data.
`service_from`	string	none
`service_to`	string	none

edi_get_dataset

Parameter	Type	Default	What it does
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.

edi_filter_options

Parameter	Type	Default	What it does

edi_dataset_population

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_integrity

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_payers

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_match

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_ratios

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_lag

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_denials

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_providers

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_plans

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_medicare

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_cms

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_summary

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_analysis

Parameter	Type	Default	What it does
`card`	string	none
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`payers`	list of string	none	Only these insurers, as named in the data.

edi_dataset_verdict

Parameter	Type	Default	What it does
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`note`	string
`step`	string	required
`verdict`	good \| problem \| unsure \| later	required

edi_dataset_sign_off

Parameter	Type	Default	What it does
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.

edi_dataset_report_add

Parameter	Type	Default	What it does
`card`	string
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`date_from`	string	none
`date_to`	string	none
`has_835`	with \| without	none
`note`	string
`payers`	list of string	none	Only these insurers, as named in the data.
`step`	string	required

edi_dataset_report

Parameter	Type	Default	What it does
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.
`limit`	integer	50	Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for.
`offset`	integer	0	Rows to skip, for paging.

edi_dataset_report_pdf

Parameter	Type	Default	What it does
`dataset_id`	string	required	An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping.

edi_next_stepCopy Anchor Link

edi_create_uploadCopy Anchor Link

edi_add_batchCopy Anchor Link

edi_reparseCopy Anchor Link

edi_list_batchesCopy Anchor Link

edi_get_batchCopy Anchor Link

edi_feedsCopy Anchor Link

edi_feedCopy Anchor Link

edi_remits_by_payerCopy Anchor Link

edi_claims_by_payerCopy Anchor Link

edi_remitsCopy Anchor Link

edi_claimsCopy Anchor Link

edi_exportCopy Anchor Link

edi_denials_topCopy Anchor Link

edi_denials_trendCopy Anchor Link

edi_variance_summaryCopy Anchor Link

edi_variance_by_payerCopy Anchor Link

edi_variance_by_codeCopy Anchor Link

edi_askCopy Anchor Link

edi_list_datasetsCopy Anchor Link

edi_create_datasetCopy Anchor Link

edi_get_datasetCopy Anchor Link

edi_filter_optionsCopy Anchor Link

edi_dataset_populationCopy Anchor Link

edi_dataset_integrityCopy Anchor Link

edi_dataset_payersCopy Anchor Link

edi_dataset_matchCopy Anchor Link

edi_dataset_ratiosCopy Anchor Link

edi_dataset_lagCopy Anchor Link

edi_dataset_denialsCopy Anchor Link

edi_dataset_providersCopy Anchor Link

edi_dataset_plansCopy Anchor Link

edi_dataset_medicareCopy Anchor Link

edi_dataset_cmsCopy Anchor Link

edi_dataset_summaryCopy Anchor Link

edi_dataset_analysisCopy Anchor Link

edi_dataset_verdictCopy Anchor Link

edi_dataset_sign_offCopy Anchor Link

edi_dataset_report_addCopy Anchor Link

edi_dataset_reportCopy Anchor Link

edi_dataset_report_pdfCopy Anchor Link

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