Guides

Find a dental payer, resolve any payer ID or alias to one stable ID, and read what each payer supports.

The payer directory lists every dental payer Claim House reaches and what each one supports. Use it to find the payer for a check, and to know before you build what a payer returns.

The same directory is public, without a key, on the payer network page, and as a CSV download. The API gives you the same data as JSON.

One ID that never changes#

Every payer has a Claim House ID, pyr_..., that never changes. It is the best ID to store. Everywhere an endpoint takes a payer, including payer_id on a check, you can send:

• the Claim House ID (pyr_...),
• the payer's own payer ID (the routing ID that is printed on a card or in a PMS), or
• an alias: the short names that practice-management systems use.

When several payers share a payer ID or an alias, the first active one by name is used. A Claim House ID is never ambiguous.

Find a payer#

Search payers takes part of a name, a payer ID or an alias, and answers the best matches first, at most 25. The query q is required and up to 100 characters. Search has no pages: next_cursor is always null.

curl "https://sandbox.myclaimhouse.com/api/v1/payers/search?q=delta&supports=eligibility" -H "Authorization: Bearer $CLAIMHOUSE_KEY"

List payers returns the whole directory by name, in pages of 25 (up to 100 with limit). Pass next_cursor back as cursor for the next page.

curl "https://sandbox.myclaimhouse.com/api/v1/payers?supports=eligibility&limit=2" -H "Authorization: Bearer $CLAIMHOUSE_KEY"

Both take the same filters:

Get a payer reads one by any of the IDs above. A removed payer is still found by it, with status: "removed".

What a payer object tells you#

The main fields of a payer (abridged: the reference lists every one):

{
  "id": "pyr_...",
  "object": "payer",
  "payer_id": "...",
  "name": "...",
  "aliases": ["..."],
  "status": "active",
  "transactions": {
    "eligibility": {
      "supported": true,
      "enrollment_required": false,
      "connection_type": "real_time",
      "response_level": "detailed",
      "returns": { "coinsurance": true, "deductibles": true, "benefit_descriptions": true, "benefit_limitations": true, "frequency_limitations": true }
    }
  }
}

For eligibility, the fields that matter before you build:

• supported says whether the payer answers eligibility checks electronically. A check for a payer that does not is refused with the finding PAYER_NOT_SUPPORTED_FOR_ELIGIBILITY.
• response_level is detailed or general: how much a payer usually returns.
• returns says which kinds of benefit information the payer returns (coinsurance, deductibles, benefit descriptions, benefit limits, frequency limits). What it does not return arrives as null and is listed in not_returned.
• enrollment_required and enrollment_type say whether the payer needs an enrollment first, and what kind.

The object also records what each payer supports for claims, attachments and remittances (ERAs): a payer must take attachments for an attachment to be sent to it, and must send remittances (ERAs) for its payments to arrive as ERAs (some need enrollment first).

A payer with status: "removed" has left the directory. Its Claim House ID and aliases stay, so an old ID still resolves.

Not found#

An ID or alias that matches no payer is 404 NOT_FOUND. A search with no matches is 200 with an empty data.