Billed Right API
Billed Right is a healthcare revenue cycle management (RCM) and medical billing company that helps clinics and provider groups get paid correctly and on time. An unofficial API would let your startup pull live claim statuses, ERAs (835s), denials, patient balances, and payer inform
What is Billed Right?
Billed Right provides outsourced medical billing, coding, credentialing, and practice management services for healthcare providers. Their teams and tooling support charge capture, coding audits, claim submission, insurance follow-up, denial management, payment posting, and analytics across commercial payers and Medicare/Medicaid. Practices rely on Billed Right to manage day-to-day revenue operations, interface with clearinghouses, and keep reimbursement flowing.
Core product areas include:
- Medical billing and coding (CPT/HCPCS, ICD-10, modifiers)
- Claims submission and clearinghouse management (837P/I)
- Denial management and AR follow-up
- ERA/EOB payment posting (835) and reconciliation
- Eligibility and authorization coordination
- Provider credentialing and payer enrollment
- Reporting and practice performance analytics
Common data entities:
- Patients and guarantors
- Insurance policies and payers
- Encounters and charges (procedures, diagnoses, DOS, POS)
- Claims (status, rejection/denial codes, control numbers)
- Remittances/ERAs (payments, adjustments, CARC/RARC codes)
- Denials and appeal artifacts
- Providers (NPI, specialties) and credentialing status
- Facilities/locations and billing entities
The Billed Right Integration Challenge
Teams depend on Billed Right to run revenue operations, but turning portal- and file-based billing workflows into automated pipelines is tricky:
- Payer variability: Rules for coding, modifiers, and submission differ across payers and lines of business; edits and resubmissions require precise audit trails
- Enterprise security: SSO/MFA and IP controls complicate headless automation from your app or backend
- Portal-first processes: Key claim status, denial queues, and payment artifacts often live behind web UIs or batch exports—not unified public APIs
- EDI interfaces and timing windows: 837/835 flows run via clearinghouses, SFTP, and batched submission schedules that must be respected
- Compliance and privacy: PHI/PII handling, least-privilege access, and retention rules demand disciplined automation
How Supergood Creates Billed Right APIs
Supergood reverse-engineers authenticated browser flows, batch interfaces, and network interactions to deliver a resilient API endpoint layer.
- Handles username/password, SSO/OAuth, and MFA (SMS, email, TOTP) securely
- Maintains session continuity with automated refresh and change detection
- Normalizes patients, encounters, claims, remittances, and denials across payer workflows
- Aligns with customer entitlements and licensing constraints to ensure compliant access
- Bridges clearinghouse/SFTP/EDI flows with signed URL retrieval, delivery, and artifact management
Getting Started
- Schedule Integration Assessment
Book a 30-minute session to confirm your Billed Right product mix, licensing, and authentication model.
- Supergood Builds and Validates Your API
We deliver a hardened Billed Right adapter tailored to your workflows and entitlements.
- Deploy with Monitoring
Go live with continuous monitoring and automatic adjustments as Billed Right evolves.
API Endpoints
Authentication
/sessionsEstablish a session using credentials. Supergood manages MFA (SMS, email, TOTP) and SSO/OAuth when enabled. Returns a short-lived auth token maintained by the platform.
Patients
/patientsRetrieve patient and insurance profiles used for billing. Use this to synchronize demographics, guarantors, and primary/secondary insurance.
Encounters & Charges
/encountersCreate or update an encounter and associated charge lines (procedures, diagnoses, modifiers). Supports coding edits and audit notes.
Claims
/claimsAssemble and stage an 837P/I claim from approved encounters. Supergood normalizes service lines and can route the generated file to the configured clearinghouse.
Claims
/claimsRetrieve claims with current statuses, payer responses, and rejection/denial codes.
Remittances (835)
/remittancesRetrieve ERA payment summaries, including claim- and service-line-level adjustments (CARC/RARC) for reconciliation.
Use Cases
EHR-to-Billing Synchronization
- Push patient demographics and insurance from your EHR into Billed Right - Create encounters/charges automatically from documentation, ensuring CPT/ICD-10 alignment - Maintain a single source of truth for eligibility and payers
Authorization-Aware Encounter Creation
- Validate active insurance and authorization requirements before capturing charges - Surface payer-specific rules to clinicians and billers at time of service - Prevent over-utilization with unit tracking for authorized services
Denial Worklists and AR Automation
- Pull denial queues with CARC/RARC codes for triage and appeals - Route tasks to staff with context (claim history, payer notes, requested documents) - Automate resubmission once corrections and appeal artifacts are attached
Claims Generation and Reimbursement Tracking
- Assemble 837P/I claims from approved encounters - Submit via configured clearinghouse and track control numbers - Reconcile ERAs (835) and post payments with adjustments back to your system
Audit and Compliance
- Export machine-readable claim/encounter packets with coding audits and edits - Maintain audit trails for changes to charges and resubmissions - Provide transparency for payer communications and credentialing milestones
Technical Specifications
Authentication
Username/password with MFA (SMS, email, TOTP) and SSO/OAuth where enabled; supports service accounts or customer-managed credentials
Response format
JSON with consistent resource schemas and pagination
Rate limits
Tuned for enterprise throughput while honoring licensing and usage controls
Session management
Automatic reauth and cookie/session rotation with health checks
Data freshness
Near real-time retrieval of patients, encounters, claims, and ERA artifacts
Security
Encrypted transport, scoped tokens, and audit logging; respects Billed Right entitlements and compliance requirements
Webhooks
Optional asynchronous delivery for claim status changes, ERA posting, and denial updates
Latency
Sub-second responses for list/detail queries under normal load
Throughput
Designed for high-volume charge capture and batch claims pipelines
Reliability
Retry logic, backoff, and idempotency keys minimize duplicate actions
Adaptation
Continuous monitoring for UI/API changes with rapid adapter updates
Frequently asked questions
Supergood supports common RCM workflows subject to your licensing and entitlements, including patients/insurance sync, encounters/charges, claim assembly and submission, denial queues, and ERA payment retrieval/posting.
We support username/password + MFA (SMS, email, TOTP) and can operate behind SSO/OAuth when enabled. For batch flows, we manage clearinghouse submission windows, generate 837 files, and retrieve ERAs with signed URL retrieval or SFTP.
Yes. You can assemble 837P/I from approved encounters with payer-specific formatting. We can route submissions via your configured clearinghouse and return statuses, control numbers, and payment artifacts for reconciliation.