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API ReferenceInsurance AdjudicationsV1

Create insurance adjudication

Beta
POST
/api/insurance-adjudications/v1
POST
/api/insurance-adjudications/v1
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": "payer_id",
8    "payer_name": "payer_name"
9  },
10  "payee": {
11    "payee_name": "payee_name",
12    "payee_identifier": {
13      "type": "npi",
14      "value": "payee_identifier"
15    }
16  },
17  "check_date": "2023-01-15",
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": 1
30                },
31                {
32                  "group_code": "CO",
33                  "reason_code": "1",
34                  "amount_cents": 1
35                }
36              ],
37              "rarcs": [
38                {
39                  "reason_code": "M1"
40                },
41                {
42                  "reason_code": "M1"
43                }
44              ]
45            },
46            {
47              "carcs": [
48                {
49                  "group_code": "CO",
50                  "reason_code": "1",
51                  "amount_cents": 1
52                },
53                {
54                  "group_code": "CO",
55                  "reason_code": "1",
56                  "amount_cents": 1
57                }
58              ],
59              "rarcs": [
60                {
61                  "reason_code": "M1"
62                },
63                {
64                  "reason_code": "M1"
65                }
66              ]
67            }
68          ]
69        },
70        "carcs": [
71          {
72            "group_code": "CO",
73            "reason_code": "1",
74            "amount_cents": 1
75          },
76          {
77            "group_code": "CO",
78            "reason_code": "1",
79            "amount_cents": 1
80          }
81        ]
82      },
83      {
84        "claim_status_code": "1",
85        "service_lines": {
86          "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
87            {
88              "carcs": [
89                {
90                  "group_code": "CO",
91                  "reason_code": "1",
92                  "amount_cents": 1
93                },
94                {
95                  "group_code": "CO",
96                  "reason_code": "1",
97                  "amount_cents": 1
98                }
99              ],
100              "rarcs": [
101                {
102                  "reason_code": "M1"
103                },
104                {
105                  "reason_code": "M1"
106                }
107              ]
108            },
109            {
110              "carcs": [
111                {
112                  "group_code": "CO",
113                  "reason_code": "1",
114                  "amount_cents": 1
115                },
116                {
117                  "group_code": "CO",
118                  "reason_code": "1",
119                  "amount_cents": 1
120                }
121              ],
122              "rarcs": [
123                {
124                  "reason_code": "M1"
125                },
126                {
127                  "reason_code": "M1"
128                }
129              ]
130            }
131          ]
132        },
133        "carcs": [
134          {
135            "group_code": "CO",
136            "reason_code": "1",
137            "amount_cents": 1
138          },
139          {
140            "group_code": "CO",
141            "reason_code": "1",
142            "amount_cents": 1
143          }
144        ]
145      }
146    ]
147  }
148}'
Try it
200Successful
1{
2  "insurance_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
3  "payer_uuid": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
4  "check_date": "2023-01-15",
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": 1
18                },
19                {
20                  "group_code": "CO",
21                  "reason_code": "1",
22                  "amount_cents": 1
23                }
24              ],
25              "rarcs": [
26                {
27                  "reason_code": "M1"
28                },
29                {
30                  "reason_code": "M1"
31                }
32              ],
33              "denial_reason": "Authorization Required",
34              "insurance_allowed_amount_cents": 1,
35              "insurance_paid_amount_cents": 1,
36              "deductible_amount_cents": 1,
37              "coinsurance_amount_cents": 1,
38              "copay_amount_cents": 1
39            },
40            {
41              "service_line_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
42              "carcs": [
43                {
44                  "group_code": "CO",
45                  "reason_code": "1",
46                  "amount_cents": 1
47                },
48                {
49                  "group_code": "CO",
50                  "reason_code": "1",
51                  "amount_cents": 1
52                }
53              ],
54              "rarcs": [
55                {
56                  "reason_code": "M1"
57                },
58                {
59                  "reason_code": "M1"
60                }
61              ],
62              "denial_reason": "Authorization Required",
63              "insurance_allowed_amount_cents": 1,
64              "insurance_paid_amount_cents": 1,
65              "deductible_amount_cents": 1,
66              "coinsurance_amount_cents": 1,
67              "copay_amount_cents": 1
68            }
69          ]
70        },
71        "carcs": [
72          {
73            "group_code": "CO",
74            "reason_code": "1",
75            "amount_cents": 1
76          },
77          {
78            "group_code": "CO",
79            "reason_code": "1",
80            "amount_cents": 1
81          }
82        ],
83        "insurance_allowed_amount_cents": 1,
84        "insurance_paid_amount_cents": 1,
85        "charge_amount_cents": 1,
86        "payer_claim_number": "payer_claim_number"
87      },
88      {
89        "claim_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
90        "service_lines": {
91          "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32": [
92            {
93              "service_line_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
94              "carcs": [
95                {
96                  "group_code": "CO",
97                  "reason_code": "1",
98                  "amount_cents": 1
99                },
100                {
101                  "group_code": "CO",
102                  "reason_code": "1",
103                  "amount_cents": 1
104                }
105              ],
106              "rarcs": [
107                {
108                  "reason_code": "M1"
109                },
110                {
111                  "reason_code": "M1"
112                }
113              ],
114              "denial_reason": "Authorization Required",
115              "insurance_allowed_amount_cents": 1,
116              "insurance_paid_amount_cents": 1,
117              "deductible_amount_cents": 1,
118              "coinsurance_amount_cents": 1,
119              "copay_amount_cents": 1
120            },
121            {
122              "service_line_adjudication_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
123              "carcs": [
124                {
125                  "group_code": "CO",
126                  "reason_code": "1",
127                  "amount_cents": 1
128                },
129                {
130                  "group_code": "CO",
131                  "reason_code": "1",
132                  "amount_cents": 1
133                }
134              ],
135              "rarcs": [
136                {
137                  "reason_code": "M1"
138                },
139                {
140                  "reason_code": "M1"
141                }
142              ],
143              "denial_reason": "Authorization Required",
144              "insurance_allowed_amount_cents": 1,
145              "insurance_paid_amount_cents": 1,
146              "deductible_amount_cents": 1,
147              "coinsurance_amount_cents": 1,
148              "copay_amount_cents": 1
149            }
150          ]
151        },
152        "carcs": [
153          {
154            "group_code": "CO",
155            "reason_code": "1",
156            "amount_cents": 1
157          },
158          {
159            "group_code": "CO",
160            "reason_code": "1",
161            "amount_cents": 1
162          }
163        ],
164        "insurance_allowed_amount_cents": 1,
165        "insurance_paid_amount_cents": 1,
166        "charge_amount_cents": 1,
167        "payer_claim_number": "payer_claim_number"
168      }
169    ]
170  },
171  "post_date": "2023-01-15",
172  "check_number": "check_number",
173  "note": "note"
174}
Creates a new insurance adjudication record and returns the newly created InsuranceAdjudication object.
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Delete insurance adjudication
Creates a new insurance adjudication record and returns the newly created InsuranceAdjudication object.

Authentication

AuthorizationBearer

OAuth authentication of the form <token>.

Request

This endpoint expects an object.
payer_identifierobjectRequired
payeeobjectRequired
check_datedateRequired
claimsmap from UUIDs to lists of objectsRequired
post_datedateOptional
check_numberstringOptional
check_amount_centsintegerOptional
notestringOptional
remit_draft_idUUIDOptional

Response

This endpoint returns an object.
insurance_adjudication_idUUID
payer_uuidUUID
check_datedate
claimsmap from UUIDs to lists of objects
post_datedate or null
check_numberstring or null
notestring or null

Errors