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Quickstart

A first 275

A claim that announces its attachment, and the 275 that carries it under the same control number.

Read as markdown

Payerworks writes and explains files; it sends nothing to a payer. Every file a route writes says transmitted: false, and is yours to send on your own connection. A test key is for invented data only, never a real patient.

What you need

  • A test key, from the developers page. It is for invented data only.
  • Node 18 or later, the JavaScript client payerworks.mjs, and sample-data.mjs, the invented patient and clinic every example uses, in one folder.
  • Two environment variables: PAYERWORKS_API_KEY (your key) and PAYERWORKS_BASE_URL (the base URL shown with your key).

The steps

  1. 1. Announce the attachment on the claim: a report type, the transmission code EL (sent electronically) and a control number, in claimInformation.claimSupplementalInformation.reportInformations.
  2. 2. Check the claim with POST /v1/claims/validate. It is valid, and it carries the warning pwk_el_needs_attachment: the payer will wait for a 275 under that control number.
  3. 3. Write the attachment with POST /v1/attachments/275 under the same control number: each file base64 in its own segment, with its LOINC document type when you give one. The payer matches the two by that number.
  4. 4. Read the answer’s shape: the 275 is written as public payer companion guides show it, not from the licensed implementation guide. Check your payer’s own guide before you send it.

The code

attachment-275.mjs runs every step below against the API with a test key. It needs payerworks.mjs and sample-data.mjs beside it.

attachment-275.mjsJavaScript
// Payerworks example: a claim attachment as an X12 275. Docs: https://payerworks.com/docs/quickstart-first-275
//
// Run it with Node 18 or later, with the JavaScript client (https://payerworks.com/sdk/payerworks.mjs)
// and sample-data.mjs beside this file:
//   PAYERWORKS_API_KEY=pw_test_... PAYERWORKS_BASE_URL=<the base URL shown with your key> node attachment-275.mjs
// A test key and invented data only. Payerworks sends nothing to a payer: every file it writes is yours.
import { pathToFileURL } from 'node:url';
import { Payerworks, PayerworksError } from './payerworks.mjs';
import { CLAIM, SENDER_ID, PAYER_ID, copy, refusalOf } from './sample-data.mjs';

/** The control number the claim announces and the 275 carries: the payer matches the two by it. */
const ATTACHMENT = 'EXATT0001';

/** @param {Payerworks} pw */
export async function run(pw) {
  // 1. The claim announces its attachment: report type 09 (a progress report), sent electronically (EL), under ATTACHMENT.
  const claim = copy(CLAIM);
  claim.claimInformation.claimSupplementalInformation = { reportInformations: [{ attachmentReportTypeCode: '09', attachmentTransmissionCode: 'EL', attachmentControlNumber: ATTACHMENT }] };
  const checked = await pw.postClaimsValidate({ claim });

  // 2. The attachment itself, as a 275 under the same control number. An invented one-page PDF here.
  const file = Buffer.from('%PDF-1.4\n% an invented progress note\n1 0 obj<<>>endobj\ntrailer<<>>\n%%EOF\n').toString('base64');
  const written = await pw.postAttachments275({
    sender_id: SENDER_ID, receiver_id: PAYER_ID, control_number: 7, claim,
    attachments: [{ control_number: ATTACHMENT, content_type: 'application/pdf', content_base64: file, filename: 'progress note.pdf', loinc: '11506-3' }],
  });

  // 3. The failure path: a control number the claim does not announce is refused, so the payer is never sent an attachment it cannot match.
  const refused = await refusalOf(() => pw.postAttachments275({
    sender_id: SENDER_ID, receiver_id: PAYER_ID, control_number: 8, claim,
    attachments: [{ control_number: 'EXATT0002', content_type: 'application/pdf', content_base64: file, filename: 'other.pdf' }],
  }), { PayerworksError });

  return {
    claim_valid: checked.valid,
    warnings: checked.claims[0].warnings.map((w) => w.code),
    written: { transmitted: written.transmitted, has_trn: written.x12.includes(`TRN*1*${ATTACHMENT}`), shape_verified: written.shape?.verified },
    refused,
  };
}

// Run as a script: node <this file>, with PAYERWORKS_API_KEY and PAYERWORKS_BASE_URL set.
if (process.argv[1] && import.meta.url === pathToFileURL(process.argv[1]).href) {
  console.log(JSON.stringify(await run(new Payerworks()), null, 2));
}
What it answered, run against the API in Payerworks’ own tests (your request ids will differ)JSON
{
  "claim_valid": true,
  "warnings": [
    "pwk_el_needs_attachment"
  ],
  "written": {
    "transmitted": false,
    "has_trn": true,
    "shape_verified": false
  },
  "refused": {
    "status": 422,
    "code": "invalid_attachments",
    "request_id": "req_3"
  }
}

What you should see

  • warnings is the reminder that a 275 must follow; has_trn says the 275 carries the claim’s control number; refused is a control number the claim never announced.

Next

  • The other documents (the CMS-1500, the remittance and eligibility PDFs, Medicare’s appeal forms) are on Documents and attachments.

Talk to us

What happens next

  1. 1

    A person at Payerworks reads what you sent, usually within a business day.

  2. 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. 3

    Nothing follows unless you answer. There is no sequence behind this form.

Or write to hello@payerworks.com.

Talk to Payerworks

Who you are and what you want to connect. A person replies by email, usually within a business day, and there is no follow-up sequence.

Used to reply to you and for nothing else.