Supergood | Gentem API
Programmatically access Gentem's medical billing, revenue cycle, and reimbursement workflows with a stable REST API. Supergood builds and operates production-grade, unofficial Gentem integrations so your team can automate claims, eligibility, prior authorization, remittance posting, and analytics without heavy custom engineering.
In plain English: Gentem helps healthcare practices get paid—handling insurance billing, denials, patient payments, and analytics. An unofficial API lets you create and track claims, run eligibility checks, submit and monitor prior authorizations, ingest remittances, reconcile payments, and surface AR metrics in your product.
If you're another tech company integrating with Gentem—say a practice management system, patient financial experience app, or billing enablement tool—you can push encounters/charges and patient updates to Gentem, pull claim and payment status to drive workflows, sync balances for patient communications, and embed revenue analytics in your dashboards.
What is Gentem?
Gentem is a healthcare revenue cycle platform and billing service for private practices. It streamlines insurance claims, denials management, patient billing, and payment posting while providing analytics across payer mix, reimbursement timelines, CPT/ICD performance, AR aging, and cash flow.
Core product areas include:
- Revenue Cycle and Billing Operations (charge entry, coding, claims submission, denials/appeals)
- Payer Interactions (eligibility and benefits checks, prior authorizations, claim status)
- Payments and Reconciliation (ERAs/EFTs, patient payments, adjustments, write-offs)
- Reporting and Analytics (AR aging, DSO, payer performance, denial reasons, CPT/ICD trends)
- Patient Billing and Communications (statements, balances, payment plans)
Common data entities:
- Patients, providers, and practices
- Payers and plans
- Encounters/charges (CPT/HCPCS, units, modifiers) and diagnoses (ICD-10)
- Claims (professional/institutional) and claim lines
- Eligibility checks and coverage details
- Prior authorization requests and determinations
- Remittances (835s), payments, adjustments, and write-offs
- Denials, appeals, and follow-up tasks
- Dashboards, KPIs, and AR reports
The Gentem Integration Challenge
Practices rely on Gentem for daily billing operations, but turning portal-first workflows into automated pipelines is tough:
- Portal-centric delivery: Key capabilities live in a web app oriented toward billers, not a published public API
- HIPAA/PHI constraints: Secure, compliant automation must respect privacy, access controls, and auditability
- EDI complexity: Eligibility (270/271), claims (837), and remittances (835) require translation and normalization
- Multi-tenant and roles: Practice-level entitlements, payer rules, and nuanced permissions complicate headless access
- Statefulness: Long-running tasks (e.g., prior auths, appeals) need resilient session management and change detection
How Supergood Creates Gentem APIs
Supergood reverse-engineers authenticated browser flows and network interactions to deliver a resilient API endpoint layer over Gentem.
- Handles username/password, SSO/OAuth, and MFA securely with encrypted credential storage
- Maintains session continuity with automated refresh, change detection, and health checks
- Normalizes EDI-derived objects (claims, ERAs, eligibility) into consistent JSON schemas
- Aligns with customer entitlements and practice-level permissions to ensure compliant access
- Supports HIPAA-aligned controls: scoped tokens, least-privilege access, audit logs, and optional data minimization
Use Cases
Eligibility and Benefits Automation
- Trigger real-time eligibility checks before appointments
- Retrieve plan, copay/coinsurance, deductibles, and coverage limits to drive pricing transparency
- Cache and monitor benefit changes with webhook alerts
Claims Lifecycle Orchestration
- Create, validate, and submit claims programmatically from your PMS or EHR
- Track payer status and adjudication events to drive work queues
- Automate resubmissions and secondary claims with proper coordination of benefits
Prior Authorization Management
- Create PA requests with clinical indication and CPT codes
- Poll or subscribe to determination updates and required documentation
- Surface turnaround times and bottlenecks in your product
Payment Posting and Reconciliation
- Ingest ERAs, payments, and adjustments to reconcile balances
- Update patient responsibility and trigger statement workflows
- Produce line-level audit trails for compliance and finance
Revenue Analytics and Alerts
- Pull AR aging, DSO, and payer performance into your BI
- Monitor denial rates by code/modifier and flag regressions
- Enrich provider dashboards with reimbursement forecasts
Available Endpoints
Authentication
POST /sessions: Establish a session using credentials. Supergood manages MFA and SSO/OAuth when enabled. Returns a short-lived auth token maintained by the platform.
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/sessions \
--header 'Authorization: Basic <Base64 encoded token>' \
--header 'Content-Type: application/json' \
--data '{
"username": "[email protected]",
"password": "<password>",
"mfa": { "type": "totp", "code": "123456" }
}'
Example response
{
"authToken": "eyJhbGciOi...",
"expiresIn": 3600,
"user": {
"id": "u_bil01",
"name": "Billing Ops",
"practiceId": "pr_42f9a",
"entitlements": ["claims", "eligibility", "remittances", "authorizations"]
}
}
POST /sessions/refresh: Refresh an existing token to keep sessions uninterrupted.
Eligibility
POST /eligibility-checks: Run an insurance eligibility and benefits check for a patient and service date.
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/eligibility-checks \
--header 'Authorization: Bearer <authToken>' \
--header 'Content-Type: application/json' \
--data '{
"patient": {
"firstName": "Alicia",
"lastName": "Nguyen",
"dateOfBirth": "1990-03-22",
"memberId": "ZXQ1234567",
"groupNumber": "GRP9876"
},
"payerId": "py_anthem_ca",
"serviceDate": "2026-02-14",
"provider": { "npi": "1760456789" },
"location": { "npi": "1586790123", "zip": "94105" },
"coverageType": "medical"
}'
Example response
{
"checkId": "elg_9f2a11",
"status": "complete",
"payer": { "id": "py_anthem_ca", "name": "Anthem Blue Cross CA" },
"plan": {
"name": "PPO Premier",
"effective": "2025-01-01",
"term": null
},
"benefits": {
"copay": { "officeVisit": 25.0 },
"coinsurance": { "inNetwork": 0.2 },
"deductible": { "individualRemaining": 750.0, "familyRemaining": 1500.0 },
"oopMax": { "individualRemaining": 2200.0 }
},
"network": { "inNetwork": true },
"raw": { "edi271": "...redacted..." },
"checkedAt": "2026-02-14T15:42:11Z"
}
Claims
POST /claims: Create a professional claim from charges and diagnoses. Optionally submit immediately.
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/claims \
--header 'Authorization: Bearer <authToken>' \
--header 'Content-Type: application/json' \
--data '{
"patientId": "pt_1083a",
"payerId": "py_anthem_ca",
"claimType": "professional",
"billingProvider": { "npi": "1760456789", "taxId": "12-3456789" },
"renderingProvider": { "npi": "1760456789" },
"placeOfService": "11",
"diagnosisCodes": ["F41.1", "F32.1"],
"lines": [
{ "cpt": "90837", "modifiers": ["95"], "units": 1, "chargeAmount": 180.00 },
{ "cpt": "99051", "units": 1, "chargeAmount": 25.00 }
],
"serviceDate": "2026-02-13",
"submit": true,
"referenceId": "enc-78412"
}'
Example response
{
"claimId": "clm_57e0c9",
"status": "submitted",
"payerClaimId": null,
"createdAt": "2026-02-14T15:47:03Z",
"referenceId": "enc-78412"
}
GET /claims: List claims with filters and summary status.
Query parameters
- status: draft | submitted | accepted | denied | paid | void
- payerId: string
- createdFrom, createdTo: ISO 8601 timestamps
- patientId: string
- referenceId: exact match
Example response
{
"items": [
{
"claimId": "clm_57e0c9",
"patientId": "pt_1083a",
"referenceId": "enc-78412",
"payerId": "py_anthem_ca",
"status": "accepted",
"billedAmount": 205.0,
"paidAmount": 165.0,
"patientResponsibility": 40.0,
"lastUpdateAt": "2026-02-16T10:12:44Z",
"denialReasons": []
}
],
"page": 1,
"pageSize": 50,
"total": 1
}
Remittances
GET /remittances: Retrieve ERA remittances and payment summaries for posting/reconciliation.
Query parameters
- payerId: string
- posted: true | false
- receivedFrom, receivedTo: ISO 8601 timestamps
- claimId: string
Example response
{
"items": [
{
"remittanceId": "era_8ab491",
"payerId": "py_anthem_ca",
"receivedAt": "2026-02-16T08:21:54Z",
"payments": {
"claims": 12,
"totalPaid": 2140.35,
"adjustments": 310.50,
"patientResp": 420.00
},
"posted": false
}
],
"page": 1,
"pageSize": 50,
"total": 1
}
GET /remittances/{remittanceId}: Get line-level payment and adjustment detail.
Example response
{
"remittanceId": "era_8ab491",
"payer": { "id": "py_anthem_ca", "name": "Anthem Blue Cross CA" },
"receivedAt": "2026-02-16T08:21:54Z",
"claims": [
{
"claimId": "clm_57e0c9",
"paidAmount": 165.0,
"patientResponsibility": 40.0,
"lines": [
{
"cpt": "90837",
"allowed": 165.0,
"paid": 145.0,
"adjustments": [
{ "group": "CO", "reasonCode": "45", "amount": 15.0, "description": "Contractual obligation" }
]
},
{
"cpt": "99051",
"allowed": 40.0,
"paid": 20.0,
"adjustments": [
{ "group": "PR", "reasonCode": "2", "amount": 20.0, "description": "Coinsurance" }
]
}
]
}
],
"raw": { "edi835": "...redacted..." },
"posted": false
}
Prior Authorizations
POST /prior-authorizations: Create a prior authorization request for a planned service.
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/prior-authorizations \
--header 'Authorization: Bearer <authToken>' \
--header 'Content-Type: application/json' \
--data '{
"patientId": "pt_1083a",
"payerId": "py_anthem_ca",
"provider": { "npi": "1760456789" },
"procedure": { "cpt": "70551", "description": "MRI brain without contrast" },
"diagnosisCodes": ["G43.909"],
"serviceWindow": { "start": "2026-02-20", "end": "2026-03-20" },
"notes": "Chronic migraines; failed conservative therapy",
"attachments": []
}'
Example response
{
"authorizationId": "pa_33d1fe",
"status": "submitted",
"trackingNumber": null,
"createdAt": "2026-02-14T15:55:26Z"
}
GET /prior-authorizations: List PA requests and determinations.
Query parameters
- status: submitted | in_review | approved | denied | expired
- payerId: string
- patientId: string
- createdFrom, createdTo: ISO 8601 timestamps
Example response
{
"items": [
{
"authorizationId": "pa_33d1fe",
"patientId": "pt_1083a",
"payerId": "py_anthem_ca",
"procedure": { "cpt": "70551" },
"status": "approved",
"trackingNumber": "AUTH-8821449",
"validFrom": "2026-02-20",
"validTo": "2026-03-20"
}
],
"page": 1,
"pageSize": 50,
"total": 1
}
Technical Specifications
- Authentication: Username/password with MFA and SSO/OAuth where enabled; supports service accounts or customer-managed credentials
- Response format: JSON with consistent resource schemas, pagination, and normalized EDI artifacts when needed
- Rate limits: Tuned for production throughput while honoring licensing, usage, and payer submission constraints
- Session management: Automatic reauth, cookie/session rotation, and change detection with health checks
- Data freshness: Near real-time retrieval of claim status, ERA postings, and auth determinations
- Security: Encrypted transport, scoped tokens, audit logging; designed for HIPAA-aligned deployments with PHI minimization options
- Webhooks: Optional events for claim status changes, ERA received, eligibility complete, and PA decisions
Performance Characteristics
- Latency: Sub-second responses for list/detail queries; long-running tasks handled asynchronously with callbacks
- Throughput: Built for high-volume claim creation, eligibility batches, and ERA ingestion
- Reliability: Retry logic, backoff, and idempotency keys to prevent duplicate claims and postings
- Adaptation: Continuous monitoring for UI/flow changes with rapid adapter updates
Getting Started
- Schedule Integration Assessment
Book a 30-minute session to confirm your Gentem modules, practice structure, and authentication model.
- Supergood Builds and Validates Your API
We deliver a hardened Gentem adapter tailored to your workflows, payers, and entitlements.
- Deploy with Monitoring
Go live with continuous monitoring and automatic adjustments as Gentem evolves.
Frequently Asked Questions
Q: Which Gentem functionality can this integration cover?
Coverage typically includes eligibility checks, charge/claim creation and submission, claim status retrieval, ERA remittance ingestion, payment posting, and prior authorization tracking—aligned to your practice's entitlements. Scope is finalized during assessment.
Q: How is PHI handled securely for automation?
We operate with HIPAA-aligned controls: encrypted transport, scoped tokens, least-privilege access, audit logs, and optional data minimization. Credentials remain customer-managed, and all access respects practice-level permissions.
Q: Do you support EDI file flows (835/837/270/271)?
Yes. We normalize EDI artifacts into JSON and expose raw attachments when required. Eligibility, claims submission, and ERAs are orchestrated with resilient retries and idempotency.
Q: Can we push charges from our PMS/EHR and reconcile payments back?
Yes. You can create claims from encounters, then retrieve ERAs and posting results to update balances, trigger statements, or power analytics in your product via webhooks or polling.
Related Integrations
Athenahealth API - Programmatically access Athenahealth with Supergood
Ready to automate your Gentem workflows?
Supergood can have your Gentem integration live in days with no ongoing engineering maintenance.
