EncounterClaim

  • claim_id
    Type: string
    required

    Branches claim id for the latest claim on the encounter.

  • eras
    Type: array object[]
    required

    Electronic remittance advices associated with the claim.

    • check_date
      Type: string
      required
    • check_number
      Type: string
      required
    • era_id
      Type: string
      required
  • service_lines
    Type: array object[]
    required

    Service lines associated with the latest claim.

    • claim_id
      Type: string
      required
    • created_at
      Type: string
      required
    • date_of_service
      Type: string
      required
    • date_of_service_range
      Type: object
      required
    • procedure_code
      Type: string
      required
    • quantity
      Type: string
      required
    • service_line_id
      Type: string
      required
    • units
      Type: stringenum
      required
      values
      • MJ
      • UN
    • allowed_amount_cents
      Type: number
    • charge_amount_cents
      Type: number
    • coinsurance_cents
      Type: number
    • copay_cents
      Type: number
    • deductible_cents
      Type: number
    • denial_reason
      Type: object
    • description
      Type: string
    • diagnosis_id_one
      Type: string
    • diagnosis_id_three
      Type: string
    • diagnosis_id_two
      Type: string
    • diagnosis_id_zero
      Type: string
    • drug_identification
      Type: object
    • end_date_of_service
      Type: string
    • external_id
      Type: string
    • has_epsdt_indicator
      Type: boolean
    • has_family_planning_indicator
      Type: boolean
    • insurance_balance_cents
      Type: number
    • modifiers
      Type: array string[]enum
      values
      • 10
      • 11
      • 12
      • 13
      • 14
    • note
      Type: string
    • ordering_provider
      Type: object
    • paid_amount_cents
      Type: number
    • patient_balance_cents
      Type: number
    • patient_responsibility_cents
      Type: number
    • place_of_service_code
      Type: stringenum
      values
      • 10
      • 11
      • 12
      • 13
      • 14
    • place_of_service_code_as_submitted
      Type: stringenum
      values
      • 10
      • 11
      • 12
      • 13
      • 14
    • primary_paid_amount_cents
      Type: number
    • prior_authorization_number
      Type: string
    • related_invoice_info
      Type: array object[]
    • related_invoices
      Type: array object[]
    • revenue_code
      Type: string
    • secondary_paid_amount_cents
      Type: number
    • service_line_era_data
      Type: object
    • service_line_manual_adjustments
      Type: array object[]
    • tertiary_paid_amount_cents
      Type: number
    • test_results
      Type: array object[]
  • status
    Type: string · EncounterClaimStatusenum
    required

    Claim status vocabulary accepted by claim_status and returned on claims.

    values
    • biller_received
    • coded
    • submitted_to_payer
    • missing_information
    • not_billable
  • clearinghouse
    Type: string
  • clearinghouse_claim_id
    Type: string
  • clia_number
    Type: string
  • payer_claim_id
    Type: string