For payers, networks and service vendors
A trading partner that does the work right the first time.
Connecting to Payerworks is an agreement, a key exchange and a test batch. This page says what you can expect from us and what we will ask of you.
The connection
What a trading partner can expect
To start a connection, send the name of your organization and the desk that handles EDI enrollment. A person at Payerworks replies by email with our trading partner details and the next step.
What we send and receive
- Professional claims as 837P, version 005010X222A1, one interchange per batch, one claim reference of ours carried round trip.
- Remittances as 835 (005010X221A1), acknowledgments as 999 and 277CA, and interchange answers as TA1, each read on arrival: a TA1’s accept or reject and its note code, in words.
- Eligibility as 270 and 271, and claim status as 276 and 277, in real time where you offer it and in batch where you do not.
- Attachments only on request, in the shape you take them, with fax and portal as the fallbacks, never an unsolicited file.
How files move
- Over SFTP, to an endpoint of ours or to yours. Each partner has its own folder and authenticates with its own public key; we never generate a key on your behalf.
- A file you place with us is kept as you sent it. Nothing on our endpoint is ever deleted by the product.
- Test files are marked as test in the interchange and routed to a test folder. A production file leaves only once the pair has been switched on by a person, after your acceptance.
What we ask of you
- Your trading partner agreement, the companion guide for each transaction set, and the desk that answers questions about them.
- A test identifier and the criteria your acceptance uses, so our test batch is the one you want to see.
- The authorization steps for remittances, since you authorize one receiver and the move is yours to confirm.
What you will never get from us
- A file that fails your envelope checks. Every interchange is read back through our own reader before it leaves.
- The same question twice. An answer you gave is kept and consulted before anything is asked again.
- Patient information by email. Identifiers travel in the files, under the agreement, and nowhere else.
Talk to us
What happens next
- 1
A person at Payerworks reads what you sent, usually within a business day.
- 2
One reply by email names the next step: our trading partner details, where each of your payers stands, or a key for the API.
- 3
Nothing follows unless you answer. There is no sequence behind this form.
Or write to hello@payerworks.com.