Beta

Create insurance adjudication

POST

/api/insurance-adjudications/v1

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 }'

Play

200Successful

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

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

remit_draft_idUUIDOptional

Response

This endpoint returns an object.

insurance_adjudication_idUUID

payer_uuidUUID

check_datedate

claimsmap from UUIDs to lists of objects