Modmed

Last reviewed: July 2026

Overview

Integuru's Modmed integration provides production-ready HTTP API access to Modmed EMA, the specialty EHR platform widely used by dermatology, ophthalmology, and other specialty practices, at <SUBDOMAIN>.ema.md, covering 21 actions across claims management, insurance policy workflows, payer lookup, payment processing, and drug code search. All 21 actions carry richer documentation. Integuru is HIPAA-compliant and signs BAAs at no additional cost. Calls complete in under 3 seconds with a 99.9%+ success rate via direct HTTP requests rather than browser automation.

Specialty billing depth. Modmed EMA's claim workflow is structured around queued claims identified by alphanumeric claim IDs (format: CB0020B45C017). Integuru's integration exposes this full billing surface: from retrieving queued claims and their detail, through updating authorization numbers, place-of-service codes, ICD-10 diagnoses, diagnosis ordering, and NDC drug codes on J-code service lines, to posting payer payments from ERA files and managing insurance policy archives. The search_ndc action supports specialty-specific drug code workflows common in dermatology and ophthalmology infusion billing.

The integration spans the complete specialty billing lifecycle: claim retrieval via list_queued_claims and get_claim_detail, claim edits via update_claim_authorization, update_claim_place_of_service, update_claim_diagnoses, update_claim_diagnosis_order, and update_claim_ndc, scrub override via override_scrubs, payer and policy management via list_payers, list_payer_types, get_patient_active_policies, get_policy_details, get_insurance_card_images, and archive_and_create_policy, and payment workflows via list_payment_batch_line_items, list_payer_payments_unallocated, get_claim_payment_detail, post_and_create_claim, post_payer_payment, and associate_payer_payment. See the eClinicalWorks integration for a broad ambulatory EHR, or browse the full integrations catalogue.

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Use Cases

Integuru's Modmed integration covers the claims, insurance, payment, and drug code workflows that specialty healthcare engineering and billing teams need to automate.

• Claim queue retrieval: Call list_queued_claims with no parameters to retrieve all currently queued claims and their claim_id strings. Call get_claim_detail with a claim_id to retrieve full detail for a specific claim.
• Claim authorization updates: Call update_claim_authorization with claim_id and authorization_number to set the prior auth on a queued claim. The authorization number must match one of the available authorizations for the patient's active insurance policy.
• Place of service correction: Call update_claim_place_of_service with claim_id and a CMS place_of_service code to update the service location on a bill.
• ICD-10 diagnosis management: Call update_claim_diagnoses with claim_id and add and/or remove arrays of ICD-10 codes to add or remove diagnoses idempotently. Call update_claim_diagnosis_order with claim_id, procedure_code, and a complete diagnosis_order array to reorder diagnosis pointers on a specific service line.
• NDC drug code updates: Call search_ndc with hcpcs_code (J-code) to find valid 11-digit NDCs. Then call update_claim_ndc with claim_id, procedure_code, and the 11-digit ndc (no dashes) to set the drug code on a service line.
• Scrub override: Call override_scrubs with a claim_ids array to override scrub failures on multiple queued claims in a single call.
• Insurance policy lookup: Call get_patient_active_policies with patient_id or first_name plus last_name to retrieve active policies. Call get_policy_details with policy_id and patient_id for full policy detail. Call get_insurance_card_images to retrieve card images for a policy.
• Policy archiving and replacement: Call archive_and_create_policy with payer_id and patient_id to archive the current active policy and create a replacement.
• Payer reference data: Call list_payers with no parameters to retrieve all payers and their numeric IDs. Call list_payer_types to retrieve payer type classifications.
• Unallocated payment processing: Call list_payer_payments_unallocated with date_from and date_to to retrieve unposted ERA payment records. Use get_claim_payment_detail and associate_payer_payment to link and post payments. Call post_payer_payment with unposted_claim_id to post the payment to a patient account.
• Payment batch line items: Call list_payment_batch_line_items with a date to retrieve line items for payment batches deposited on that date.

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Setup Notes

Integuru's Modmed integration authenticates against https://<SUBDOMAIN>.ema.md/ema/ProviderLogin.action. Configure your Modmed practice's specific subdomain once during Integuru setup; Integuru manages session authentication automatically.

Most claim actions depend on claim_id values retrieved from list_queued_claims. The typical claim workflow sequence is: call list_queued_claims to get claim_id strings, call get_claim_detail to inspect a specific claim, then apply updates via update_claim_authorization, update_claim_place_of_service, update_claim_diagnoses, update_claim_diagnosis_order, or update_claim_ndc as needed.

For payment workflows: call list_payer_payments_unallocated with date_from and date_to to get unposted_claim_id values (the id field in the unposted_claims array), then use those IDs with post_payer_payment, associate_payer_payment, or get_claim_payment_detail.

For update_claim_ndc: the ndc must be exactly 11 digits with no dashes. Use search_ndc first to retrieve the correctly-formatted NDC for a given hcpcs_code. For update_claim_diagnosis_order: procedure_position is only needed when the bill has multiple service lines with the same procedure_code.

All 21 actions carry richer documentation available via the Integuru dashboard after setup.