Register an application in the Change Healthcare developer portal and obtain your client_id and client_secret (YOUR_KEY); authenticate via OAuth 2.0 client credentials to the token endpoint to receive a time-limited access token
Construct the claim request payload in the Change Healthcare JSON claim format, which maps to X12 837P concepts but uses a JSON schema — populate submitter, subscriber, dependent (if applicable), provider, and claim information sections
Include the trading partner service ID for the target payer in the request; this ID routes the claim to the correct payer adjudication system within the Change Healthcare clearinghouse network
POST the claim JSON to the professional claims submission endpoint with the Authorization header containing your bearer token (YOUR_TOKEN) and Content-Type set to application/json
Parse the synchronous response which includes a claim reference ID and an initial status; use the claim reference ID to poll the claim status endpoint for adjudication results
Handle error responses: 400-level errors indicate claim construction problems (invalid NPI, missing required fields); parse the error detail array to identify and correct specific issues before resubmitting
Known gotchas
Change Healthcare's JSON claim API abstracts the X12 837P but still enforces X12 business rules underneath; a claim that looks structurally valid in JSON can still fail with X12-level edit errors returned in the error response
Payer-specific edits are applied after clearinghouse edits — a claim may pass clearinghouse validation and still be rejected by the payer; always inspect the full status history when troubleshooting rejections
The sandbox environment uses a fixed set of test NPIs and payer IDs; production credentials and production trading partner IDs are different — do not mix sandbox and production configuration
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