Claims QueryResponse

Description

This is the format of the response you will get for a ClaimsQuery event.

API Endpoints for ClaimsResponse

Sync REST API Endpoint to call the API: https://{base_url}/api/v1/claim/queryresponse.

Async REST API Endpoint to call the API: https://{base_url}/api/v1/endpoint.

Data Model JSON for Claims Query Response

QueryResponse - Sample Payload

{
    "Meta": {
        "DataModel": "Claim",
        "EventType": "QueryResponse",
        "Raw": [],
        "Source": {
            "ID": "8366d1d7-1fd4-4c05-a867-9d516ed79d77",
            "Name": "EHR Bridge Dev Tools"
        }
    },
    "BillingProvider": {
        "ID": "4356789876",
        "IDType": "NPI",
        "TIN": null,
        "FirstName": "John",
        "MiddleName": "Henry",
        "LastName": "Franklin",
        "OrganizationName": null,
        "Specialty": {
            "ID": null,
            "Description": null
        },
        "Address": {
            "StreetAddress": "123 Main St.",
            "City": "San Jose",
            "State": "CA",
            "ZIP": "53703",
            "County": "Santa Clara",
            "Country": "USA"
        },
        "EmailAddress": null,
        "PhoneNumber": {
            "Office": "+16085551234",
            "Fax": null
        }
    },
    "Patient": {
        "Identifiers": [
            {
                "ID": "0000000001",
                "IDType": "MR"
            },
            {
                "ID": "47c69863-e9a0-4b27-9495-1b370b0ed376",
                "IDType": "EHRID"
            },
            {
                "ID": "9332613a-8787-4c0b-9728-9ff5464ed8d6",
                "IDType": "NIST"
            }
        ],
        "Demographics": {
            "FirstName": "Ronnie",
            "MiddleName": "Patricks",
            "LastName": "Oliver",
            "DOB": "2008-01-06",
            "SSN": "101-01-0001",
            "Sex": "Male",
            "Race": "White",
            "IsHispanic": null,
            "Religion": null,
            "MaritalStatus": "Single",
            "IsDeceased": null,
            "DeathDateTime": null,
            "PhoneNumber": {
                "Home": "+18088675601",
                "Office": null,
                "Mobile": null
            },
            "EmailAddresses": [],
            "Language": "en",
            "Citizenship": [],
            "Address": {
                "StreetAddress": "4762 High Street",
                "City": "San Jose",
                "State": "CA",
                "ZIP": "53566",
                "County": "Santa Clara",
                "Country": "USA"
            }
        }
    },
    "Claims": [
        {
            "ID": "123456889",
            "Type": "Admit thrthroughu Discharge Claim",
            "TotalAmount": "200.00",
            "CopayAmount": "10.00",
            "IsProviderSignatureOnFile": true,
            "IsReleaseOfInformationOnFile": true,
            "ReferenceNumbers": [
                {
                    "ID": "AUTH000000",
                    "Type": null
                }
            ],
            "Visit": {
                "VisitNumber": null,
                "DateTime": "2016-10-08",
                "DischargeDateTime": null,
                "Type": null,
                "Location": {
                    "Type": "Outpatient Clinic",
                    "Facility": "RHS City Hall Clinic",
                    "Department": "City Hall Clinic",
                    "Room": null
                },
                "PreviousLocation": {
                    "Type": null,
                    "Facility": null,
                    "Department": null,
                    "Room": null
                }
            },
            "AdditionalDates": [
                {
                    "Type": "Service Period Start",
                    "DateTime": "2016-10-08"
                }
            ],
            "Diagnoses": [
                {
                    "Code": "M54.5",
                    "Codeset": "ICD-10",
                    "Name": "Lower back pain",
                    "Type": null
                },
                {
                    "Code": "J45.909",
                    "Codeset": "ICD-10",
                    "Name": "Unspecified asthma, uncomplicated",
                    "Type": null
                }
            ],
            "DiagnosisRelatedGroup": null,
            "Procedures": [],
            "Transaction": {
                "ID": "94151100100",
                "IDType": null,
                "Type": "Professional",
                "Submitter": {
                    "ID": null,
                    "IDType": null,
                    "Name": null,
                    "EmailAddress": null,
                    "PhoneNumber": {
                        "Office": null,
                        "Fax": null
                    }
                },
                "Receiver": {
                    "ID": null,
                    "IDType": null,
                    "Name": null
                }
            },
            "Providers": [
                {
                    "ID": "4236464757",
                    "IDType": "NPI",
                    "Role": "Attending",
                    "FirstName": "Mark",
                    "MiddleName": null,
                    "LastName": "Johnson",
                    "Specialty": {
                        "ID": "1223G0001X",
                        "Description": "General Practice"
                    }
                }
            ]
        }
    ]
}