Insurance AdjudicationsV1

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_identifier
unionRequired
payee
objectRequired
check_date
dateRequired
claims
map from UUIDs to lists of objectsRequired
post_date
dateOptional
check_number
stringOptional
note
stringOptional

Response

This endpoint returns an object
insurance_adjudication_id
UUID
payer_uuid
UUID
check_date
date
claims
map from UUIDs to lists of objects
post_date
dateOptional
check_number
stringOptional
note
stringOptional

Errors

POST
1curl -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 "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}