API Reference Insurance Adjudications V1

Create insurance adjudication

Beta

POST

Creates a new insurance adjudication record and returns the newly created InsuranceAdjudication object.

Request

This endpoint expects an object.

payer_identifierobjectRequired

payeeobjectRequired

check_datedateRequired

claimsmap from UUIDs to lists of objectsRequired

post_datedateOptional

check_numberstringOptional

notestringOptional

Response

This endpoint returns an object.

insurance_adjudication_idUUID

payer_uuidUUID

check_datedate

claimsmap from UUIDs to lists of objects

post_datedateOptional

check_numberstringOptional

notestringOptional

Errors

POST

1 curl -X POST https://api.joincandidhealth.com/api/insurance-adjudications/v1 \
2      -H "Authorization: Bearer <token>" \
3      -H "Content-Type: application/json" \
4      -d '{
5   "payer_identifier": {
6     "type": "payer_info",
7     "payer_id": "string",
8     "payer_name": "string"
9   },
10   "payee": {
11     "payee_name": "string",
12     "payee_identifier": {
13       "type": "npi",
14       "value": "string"
15     }
16   },
17   "check_date": "2023-01-01",
18   "claims": {
19     "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
20       {
21         "claim_status_code": "1",
22         "service_lines": {
23           "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
24             {
25               "carcs": [
26                 {
27                   "group_code": "CO",
28                   "reason_code": "1",
29                   "amount_cents": 0
30                 }
31               ],
32               "rarcs": [
33                 {
34                   "reason_code": "M1"
35                 }
36               ]
37             }
38           ]
39         },
40         "carcs": [
41           {
42             "group_code": "CO",
43             "reason_code": "1",
44             "amount_cents": 0
45           }
46         ]
47       }
48     ]
49   }
50 }'

1 {
2   "insurance_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
3   "payer_uuid": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
4   "post_date": "2023-01-01",
5   "check_number": "string",
6   "check_date": "2023-01-01",
7   "note": "string",
8   "claims": {
9     "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
10       {
11         "claim_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
12         "insurance_allowed_amount_cents": 0,
13         "insurance_paid_amount_cents": 0,
14         "charge_amount_cents": 0,
15         "service_lines": {
16           "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
17             {
18               "service_line_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
19               "denial_reason": "Authorization Required",
20               "insurance_allowed_amount_cents": 0,
21               "insurance_paid_amount_cents": 0,
22               "deductible_amount_cents": 0,
23               "coinsurance_amount_cents": 0,
24               "copay_amount_cents": 0,
25               "carcs": [
26                 {
27                   "group_code": "CO",
28                   "reason_code": "1",
29                   "amount_cents": 0
30                 }
31               ],
32               "rarcs": [
33                 {
34                   "reason_code": "M1"
35                 }
36               ]
37             }
38           ]
39         },
40         "payer_claim_number": "string",
41         "carcs": [
42           {
43             "group_code": "CO",
44             "reason_code": "1",
45             "amount_cents": 0
46           }
47         ]
48       }
49     ]
50   }
51 }

Built with

1	curl -X POST https://api.joincandidhealth.com/api/insurance-adjudications/v1 \
2	-H "Authorization: Bearer <token>" \
3	-H "Content-Type: application/json" \
4	-d '{
5	"payer_identifier": {
6	"type": "payer_info",
7	"payer_id": "string",
8	"payer_name": "string"
9	},
10	"payee": {
11	"payee_name": "string",
12	"payee_identifier": {
13	"type": "npi",
14	"value": "string"
15	}
16	},
17	"check_date": "2023-01-01",
18	"claims": {
19	"d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
20	{
21	"claim_status_code": "1",
22	"service_lines": {
23	"d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
24	{
25	"carcs": [
26	{
27	"group_code": "CO",
28	"reason_code": "1",
29	"amount_cents": 0
30	}
31	],
32	"rarcs": [
33	{
34	"reason_code": "M1"
35	}
36	]
37	}
38	]
39	},
40	"carcs": [
41	{
42	"group_code": "CO",
43	"reason_code": "1",
44	"amount_cents": 0
45	}
46	]
47	}
48	]
49	}
50	}'

1	{
2	"insurance_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
3	"payer_uuid": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
4	"post_date": "2023-01-01",
5	"check_number": "string",
6	"check_date": "2023-01-01",
7	"note": "string",
8	"claims": {
9	"d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
10	{
11	"claim_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
12	"insurance_allowed_amount_cents": 0,
13	"insurance_paid_amount_cents": 0,
14	"charge_amount_cents": 0,
15	"service_lines": {
16	"d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
17	{
18	"service_line_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
19	"denial_reason": "Authorization Required",
20	"insurance_allowed_amount_cents": 0,
21	"insurance_paid_amount_cents": 0,
22	"deductible_amount_cents": 0,
23	"coinsurance_amount_cents": 0,
24	"copay_amount_cents": 0,
25	"carcs": [
26	{
27	"group_code": "CO",
28	"reason_code": "1",
29	"amount_cents": 0
30	}
31	],
32	"rarcs": [
33	{
34	"reason_code": "M1"
35	}
36	]
37	}
38	]
39	},
40	"payer_claim_number": "string",
41	"carcs": [
42	{
43	"group_code": "CO",
44	"reason_code": "1",
45	"amount_cents": 0
46	}
47	]
48	}
49	]
50	}
51	}