How Submit Shield works

Three steps from install to validated claims. The SDK runs on your machine, strips PHI before anything leaves your network, and returns actionable verdicts linked to CMS source documents.

Install the SDK

Choose the integration method that fits your workflow. All three options de-identify PHI locally before sending anything to the Submit Shield API.

Python (pip)

pip install submitshield

Docker (folder-watcher)

# Mount your claims directory and the watcher validates on arrival
docker run -d \
  -v /path/to/claims:/watch \
  -e SUBMITSHIELD_API_KEY=your_key \
  submitshield/sdk:latest

Windows installer

# Download and run the installer
submitshield-setup.exe

# The system tray app watches a configured folder
# and validates claims as they appear

Submit claims for validation

The SDK accepts five input formats and auto-detects which one you are using. No format configuration required.

Supported formats

837P (ANSI X12 professional claims)
FHIR R4 (Claim resource bundles)
CSV (column-mapped flat files)
Canonical JSON (Submit Shield schema)
X12 835 (remittance for denial feedback)

Sample CSV input

claim_id,cpt,icd10,modifier,npi,dob,dos
CLM-4821,99214,J06.9,,1234567890,1955-03-12,2026-04-01
CLM-4822,99213;99214,M54.5,,1234567890,1980-07-22,2026-04-01

Python example

from submitshield import SubmitShield

client = SubmitShield(api_key="your_key")

# Validate a batch of claims from a CSV file
verdicts = client.validate("claims.csv")

for v in verdicts:
    if v.status == "flagged":
        for flag in v.flags:
            print(f"{v.claim_id}: {flag.rule} - {flag.message}")
            print(f"  Source: {flag.source_url}")

Fix before you file

Each verdict includes the rule ID, a plain-English explanation, and a direct URL to the CMS source document. Your billers know exactly what to fix and why.

Sample verdict output

{
  "claim_id": "CLM-4822",
  "status": "flagged",
  "flags": [
    {
      "rule": "NCCI-PTP-097",
      "family": "NCCI PTP",
      "tier": "critical",
      "message": "CPT 99214 is bundled with 99213 per NCCI PTP edits. Submit the higher-valued code only, or append modifier 25 if a separately identifiable E/M service was performed.",
      "source_url": "https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits"
    }
  ],
  "clean_line_count": 0,
  "flagged_line_count": 1
}