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API ReferenceInsurance AdjudicationsV1

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}
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Delete insurance adjudication

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

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