Product Docs Security FAQ

Payer infrastructure, API-first

Build healthcare workflows without managing payer complexity.

Verify eligibility, discover insurance, submit claims, and track claim status — all through one API. Payerkart handles payer connections, formats, and edge cases so your team ships the workflow, not the plumbing.

Start Building → Explore APIs

→ Eligibility in real time

→ Nationwide payer reach

→ Sandbox in minutes

Claim trace · #PK-88213 live

09:41:02 eligibility.verify → member active 200

09:41:03 insurance.discover → 2 plans found 200

09:41:19 claims.submit → accepted by payer 202

09:44:51 claims.status → in adjudication pending

Built for clearinghouses, RCM platforms, and digital health apps

Nationwide payer coverage Real-time eligibility checks One schema across payers

The workflow

Four payer workflows. One API.

Every stage of the payer relationship, behind a single consistent schema — so switching payers never means switching integrations.

01 POST /v1/eligibility

Verify eligibility

Confirm active coverage, plan type, and cost-share details before a visit or claim is filed — in real time, not overnight batch files.

02 POST /v1/insurance/discover

Discover insurance

Find active coverage for a patient when the payer or plan isn't on file yet, using demographic and identity matching.

03 POST /v1/claims

Submit claims

Send structured claims to the correct payer endpoint without hand-building payer-specific formats or clearinghouse config.

04 GET /v1/claims/:id

Track claim status

Poll or subscribe to status changes — submitted, in adjudication, paid, denied — with reason codes normalized across payers.

Built for healthcare developers

One integration, not one per payer.

A single request shape covers eligibility, discovery, claims, and status — Payerkart maps it to whatever the payer on the other end actually speaks.

—Consistent JSON in, JSON out, across payers
—Sandbox environment with test payers
—Webhooks for claim status changes
—Idempotent writes, versioned endpoints

eligibility.sh

curl https://api.payerkart.com/v1/eligibility \
  -H "Authorization: Bearer $PAYERKART_KEY" \
  -H "Content-Type: application/json" \
  -d '{
    "patient": { "member_id": "W12345678" },
    "payer": "auto-detect",
    "service_type": "office_visit"
  }'

→ 200 OK
{ "status": "active", "plan": "PPO Gold", "copay": 25 }

From first call to paid claim

Step 1

Connect

Generate an API key and point requests at one endpoint — no per-payer setup.

Step 2

Verify

Check eligibility and discover coverage before care is delivered.

Step 3

Submit

File the claim through the same schema Payerkart routes to the payer.

Step 4

Track

Poll status or get a webhook the moment adjudication changes.

Security & compliance

Handled like the healthcare data it is

Payerkart is built around HIPAA-aligned data handling — encryption in transit and at rest, scoped access, and full audit logs on every request.

✓Encrypted in transit & at rest

✓Scoped, revocable API keys

✓Full request audit logs

✓BAAs available on request

Frequently asked

A clearinghouse routes files between you and payers in whatever format each side expects. Payerkart gives you one modern API — eligibility, discovery, claims, and status — and handles the payer-specific translation behind it.

Payerkart connects to commercial and government payers across the US. New payers are added on an ongoing basis; check the docs for current coverage before going live.

No. You can start in the sandbox with test payers immediately, and Payerkart's existing payer relationships mean you don't negotiate connections one by one.

Yes. Data is encrypted in transit and at rest, access is scoped per API key, every request is logged, and a BAA is available for teams that need one.

Pricing is usage-based and scales with the workflows you run. Reach out through Start Building to get a plan sized to your volume.

Ready to build on Payerkart?

Get sandbox access and a live key in minutes. No payer contracts to negotiate before your first request.

Start Building → Explore APIs

Product Docs Security FAQ