Claim.MD PHP SDKOverview
An unofficial PHP SDK for the CLAIM.MD API, the clearinghouse for claim submission, eligibility verification, and remittance. Four core flows, each behind typed PHP interfaces:
- Claims management. Submit X12 837P (professional) and 837I (institutional) claims, check acknowledgment status, retrieve scrubber feedback, and resubmit corrected claims.
- Eligibility verification. Send X12 270 requests to payers and get normalized 271 responses back as structured PHP objects, with coverage details, copay, deductible, and remaining benefits.
- Electronic remittance advice. Retrieve X12 835 ERAs, with payer adjustment codes and CARC/RARC reason codes surfaced as enums.
- Provider enrollment. EFT/ERA enrollment workflows, payer roster sync, and provider credential management.
Why it exists
Healthcare claims run on open standards. X12 EDI is decades old. The integration work is another story. Every payer reads the spec a little differently, the failure modes are subtle, and a malformed claim means money stuck in accounts receivable for weeks.
The SDK began as the integration layer behind Nextvisit’s billing pipeline. The goal was same-day claim submission from clinical notes. That meant tying together the LLM-drafted note, ICD-10 / CPT code suggestions, eligibility lookups, and the claim itself. Against a raw HTTP client, type errors and malformed claims surfaced in production.
Open source
There was no maintained PHP SDK for CLAIM.MD. Now any PHP team building healthcare billing can
skip the six weeks of EDI normalization it took to get here. MIT licensed, on Packagist as
nextvisit/claim-md-php.
