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ClaimRev API (Public) (v1)

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ClaimRev REST API — external integrator endpoints.

AccountPayerManagment

Adds a customer-specific override that maps an inbound payer to a different payer for this account.

Request Body schema:
inboundPayerNumber
string or null
claimRevPayerNumber
string or null
preserveClaimPayerName
boolean
overridePayerName
string or null

Responses

Request samples

Content type
{
  • "inboundPayerNumber": "string",
  • "claimRevPayerNumber": "string",
  • "preserveClaimPayerName": true,
  • "overridePayerName": "string"
}

Response samples

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No sample

Returns the SFTP gateways configured for the current account, filtered by optional gateway name, host, user, disabled flag, and login-error flag.

query Parameters
gatewayName
string
hostName
string
userName
string
disabled
boolean
loginError
boolean

Responses

Response samples

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No sample

Returns a single SFTP gateway by id, scoped to the current account.

query Parameters
gatewayId
integer <int64>

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No sample

Creates or updates an SFTP gateway for the current account and returns its id.

Request Body schema:
customerPayerSftpGatewayId
integer <int64>
accountNumber
string or null
gatewayName
string or null
hostName
string or null
port
integer <int32>
userName
string or null
password
string or null
downloadFolder
string or null
uploadFolder
string or null
deleteFileAfterDownload
boolean
message
string or null
disabled
boolean
loginError
boolean
lastDownloadTime
string or null <date-time>
lastUploadTime
string or null <date-time>

Responses

Request samples

Content type
{
  • "customerPayerSftpGatewayId": 0,
  • "accountNumber": "string",
  • "gatewayName": "string",
  • "hostName": "string",
  • "port": 0,
  • "userName": "string",
  • "password": "string",
  • "downloadFolder": "string",
  • "uploadFolder": "string",
  • "deleteFileAfterDownload": true,
  • "message": "string",
  • "disabled": true,
  • "loginError": true,
  • "lastDownloadTime": "2019-08-24T14:15:22Z",
  • "lastUploadTime": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Updates the stored password for an existing SFTP gateway.

Request Body schema:
customerPayerSftpGatewayId
integer <int64>
accountNumber
string or null
gatewayName
string or null
hostName
string or null
port
integer <int32>
userName
string or null
password
string or null
downloadFolder
string or null
uploadFolder
string or null
deleteFileAfterDownload
boolean
message
string or null
disabled
boolean
loginError
boolean
lastDownloadTime
string or null <date-time>
lastUploadTime
string or null <date-time>

Responses

Request samples

Content type
{
  • "customerPayerSftpGatewayId": 0,
  • "accountNumber": "string",
  • "gatewayName": "string",
  • "hostName": "string",
  • "port": 0,
  • "userName": "string",
  • "password": "string",
  • "downloadFolder": "string",
  • "uploadFolder": "string",
  • "deleteFileAfterDownload": true,
  • "message": "string",
  • "disabled": true,
  • "loginError": true,
  • "lastDownloadTime": "2019-08-24T14:15:22Z",
  • "lastUploadTime": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Deletes an SFTP gateway belonging to the current account.

Request Body schema:
customerPayerSftpGatewayId
integer <int64>
accountNumber
string or null
gatewayName
string or null
hostName
string or null
port
integer <int32>
userName
string or null
password
string or null
downloadFolder
string or null
uploadFolder
string or null
deleteFileAfterDownload
boolean
message
string or null
disabled
boolean
loginError
boolean
lastDownloadTime
string or null <date-time>
lastUploadTime
string or null <date-time>

Responses

Request samples

Content type
{
  • "customerPayerSftpGatewayId": 0,
  • "accountNumber": "string",
  • "gatewayName": "string",
  • "hostName": "string",
  • "port": 0,
  • "userName": "string",
  • "password": "string",
  • "downloadFolder": "string",
  • "uploadFolder": "string",
  • "deleteFileAfterDownload": true,
  • "message": "string",
  • "disabled": true,
  • "loginError": true,
  • "lastDownloadTime": "2019-08-24T14:15:22Z",
  • "lastUploadTime": "2019-08-24T14:15:22Z"
}

Response samples

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Returns the list of provider-to-payer overrides defined for the given account and transaction type.

query Parameters
accountNumber
string
transationTypeId
integer <int32>

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Saves a single provider-match override for the current account.

Request Body schema:
payerNumber
string or null
payerId
integer <int32>
accountNumber
string or null
preserveClaimPayerName
boolean
overridePayerName
string or null

Responses

Request samples

Content type
{
  • "payerNumber": "string",
  • "payerId": 0,
  • "accountNumber": "string",
  • "preserveClaimPayerName": true,
  • "overridePayerName": "string"
}

Response samples

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No sample

Saves a batch of provider-match overrides for the current account.

Request Body schema:
Array
payerNumber
string or null
payerId
integer <int32>
accountNumber
string or null
preserveClaimPayerName
boolean
overridePayerName
string or null

Responses

Request samples

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[
  • {
    }
]

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Updates the payer associated with a claim based on a user-supplied match override.

Request Body schema:
payerNumber
string or null
payerId
integer <int32>
accountNumber
string or null
claimObjectIds
Array of strings or null

Responses

Request samples

Content type
{
  • "payerNumber": "string",
  • "payerId": 0,
  • "accountNumber": "string",
  • "claimObjectIds": [
    ]
}

Response samples

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No sample

Deletes a provider-match override for the current account.

Request Body schema:
payerNumber
string or null
payerId
integer <int32>
accountNumber
string or null
preserveClaimPayerName
boolean
overridePayerName
string or null

Responses

Request samples

Content type
{
  • "payerNumber": "string",
  • "payerId": 0,
  • "accountNumber": "string",
  • "preserveClaimPayerName": true,
  • "overridePayerName": "string"
}

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AiModelConfig

Returns the AI model config for the caller's current account.

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Returns the list of AI models available to the caller. Admins see every active model; non-admins see only the models enabled for their account.

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Checks whether the given feature flag is enabled for the caller's current account.

query Parameters
featureKey
string

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Resolves which AI model will be used for the given feature, considering account config, system defaults, and the optional user-picked model. Returns an object { model: string }.

query Parameters
featureKey
string
userPickedModel
string

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Analytics

Returns the configured age-group buckets used by analytics reports for the given account.

query Parameters
accountNumber
string

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Updates the account's age-group bucket configuration. At least one group is required.

Request Body schema:
id
string or null
accountNumber
string or null
configName
string or null
isActive
boolean
Array of objects or null (ClaimRev_Business_Analytics_Interfaces_AgeGroupViewModel)
createdAt
string <date-time>
createdBy
string or null

Responses

Request samples

Content type
{
  • "id": "string",
  • "accountNumber": "string",
  • "configName": "string",
  • "isActive": true,
  • "groups": [
    ],
  • "createdAt": "2019-08-24T14:15:22Z",
  • "createdBy": "string"
}

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Returns the account's fiscal calendar configuration (fiscal year start month, etc.).

query Parameters
accountNumber
string

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Updates the fiscal calendar configuration. Fiscal year start month must be 1–12.

Request Body schema:
id
string or null
accountNumber
string or null
fiscalYearStartMonth
integer <int32>
isActive
boolean
createdBy
string or null

Responses

Request samples

Content type
{
  • "id": "string",
  • "accountNumber": "string",
  • "fiscalYearStartMonth": 0,
  • "isActive": true,
  • "createdBy": "string"
}

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Returns the SharpInsight enablement/configuration record for an account.

query Parameters
accountNumber
string

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Updates the SharpInsight config for the supplied account.

Request Body schema:
id
string or null
accountNumber
string or null
isEnabled
boolean
enabledDate
string or null <date-time>
enabledBy
string or null
disabledDate
string or null <date-time>
disabledBy
string or null
varianceThresholdAmount
number <double>
varianceThresholdPercent
number <double>
minSimilarityScore
number <double>
maxSimilarityResults
integer <int32>
excludedCarcCodes
Array of strings or null
Array of objects or null (ClaimRev_Business_Analytics_Interfaces_CarcCategoryMappingViewModel)
denialReasonCodes
Array of strings or null
writeOffThresholdDays
integer <int32>
appealDetectionEnabled
boolean

Responses

Request samples

Content type
{
  • "id": "string",
  • "accountNumber": "string",
  • "isEnabled": true,
  • "enabledDate": "2019-08-24T14:15:22Z",
  • "enabledBy": "string",
  • "disabledDate": "2019-08-24T14:15:22Z",
  • "disabledBy": "string",
  • "varianceThresholdAmount": 0.1,
  • "varianceThresholdPercent": 0.1,
  • "minSimilarityScore": 0.1,
  • "maxSimilarityResults": 0,
  • "excludedCarcCodes": [
    ],
  • "carcCategoryMappings": [
    ],
  • "denialReasonCodes": [
    ],
  • "writeOffThresholdDays": 0,
  • "appealDetectionEnabled": true
}

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Returns all contracted-rate records (per-payer reimbursement contracts) for the account.

query Parameters
accountNumber
string

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Creates or updates a contracted-rate record and stamps the current user as updater.

Request Body schema:
id
string or null
accountNumber
string or null
payerId
integer <int32>
payerName
string or null
feeScheduleName
string or null
contractStartDate
string or null
contractEndDate
string or null
Array of objects or null (ClaimRev_Business_Analytics_Interfaces_ContractedRateEntryViewModel)
contractType
string or null
medicareMultiplier
number or null <double>
importedFrom
string or null
lastUpdated
string or null
updatedBy
string or null

Responses

Request samples

Content type
{
  • "id": "string",
  • "accountNumber": "string",
  • "payerId": 0,
  • "payerName": "string",
  • "feeScheduleName": "string",
  • "contractStartDate": "string",
  • "contractEndDate": "string",
  • "rates": [
    ],
  • "contractType": "string",
  • "medicareMultiplier": 0.1,
  • "importedFrom": "string",
  • "lastUpdated": "string",
  • "updatedBy": "string"
}

Response samples

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Returns the contracted-rate record for a specific payer, or 404 if not configured.

path Parameters
payerId
required
integer <int32>
query Parameters
accountNumber
string

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Deletes a contracted-rate record for the account. 404 if it does not exist.

path Parameters
id
required
string
query Parameters
accountNumber
string

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Bulk-imports contracted rates from a CSV file for a payer/fee-schedule combination. Returns a summary of rows added/updated/skipped.

Request Body schema: multipart/form-data
accountNumber
string
payerId
integer <int32>
payerName
string
feeScheduleName
string
contractType
string
medicareMultiplier
number <double>
file
string <binary>

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Returns the per-account overrides that map ERA payer numbers to specific internal payers.

query Parameters
accountNumber
string

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Creates or updates a fee-schedule payer override.

Request Body schema:
id
string or null
accountNumber
string or null
eraPayerNumber
string or null
eraPayerName
string or null
payerId
integer <int32>
payerName
string or null
lastUpdated
string or null
updatedBy
string or null

Responses

Request samples

Content type
{
  • "id": "string",
  • "accountNumber": "string",
  • "eraPayerNumber": "string",
  • "eraPayerName": "string",
  • "payerId": 0,
  • "payerName": "string",
  • "lastUpdated": "string",
  • "updatedBy": "string"
}

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Deletes a fee-schedule payer override for the account.

path Parameters
id
required
string
query Parameters
accountNumber
string

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Returns the list view of all fee schedules configured for the account.

query Parameters
accountNumber
string

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Returns a fee schedule's full detail (rates + payer assignments) by id.

path Parameters
id
required
string
query Parameters
accountNumber
string

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Finds claims semantically similar to the given claim using vector similarity search. Returns 404 if the source claim id cannot be found.

path Parameters
claimId
required
string
query Parameters
accountNumber
string
minSimilarity
number <double>
Default: 0.75
limit
integer <int32>
Default: 10

Responses

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Returns CARC (denial reason) trend counts with optional group-code and payer filters.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
groupCode
string
payerId
integer <int32>
topN
integer <int32>
Default: 10

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Returns a procedure-code integrity report (invalid/unused codes, mismatches). Response is PHI-obfuscated before return.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns payment-variance metrics (paid vs allowed, underpaid vs overpaid) for the range.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Flags claims paid below contracted rates and surfaces potential underpayment dollars. Response is PHI-obfuscated.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns average days-to-payment metrics grouped by payer/time bucket.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns acceptance-rate metrics (first-pass claim acceptance by payer).

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns outcome distributions per 277CA status-category code.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Estimates revenue left on the table (adjustments, write-offs, never-paid claims).

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Detects statistically anomalous payer behavior over the window (outlier denial spikes, etc.).

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Returns profitability metrics by CPT/HCPCS procedure code.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns distribution of how many times each claim was "touched" before final resolution.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns clean-claim-rate metrics (percentage of claims that pass without rework).

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns a composite scorecard (volume, payment timing, denial rate) for a single payer.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerNumber
string

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Returns summary roll-up metrics across all payers for the date range.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Returns AR-aging buckets (0-30, 31-60, 61-90, 90+) by payer.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns appeal-success metrics (denials appealed vs overturned, dollars recovered).

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns the top denial root-cause buckets with counts and dollar impact.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns lag metrics between date-of-service and charge-submission date.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Returns write-off totals attributable to denials (dollars the account gave up on).

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>

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Drill-down: returns per-claim payment-event detail for a filtered slice. PHI-obfuscated.

Request Body schema:
accountNumber
string or null
payerName
string or null
procedureCode
string or null
revenueCode
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
page
integer <int32>
pageSize
integer <int32>
sortField
string or null
sortDirection
integer <int32>
carcCodes
Array of strings or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerName": "string",
  • "procedureCode": "string",
  • "revenueCode": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "page": 0,
  • "pageSize": 0,
  • "sortField": "string",
  • "sortDirection": 0,
  • "carcCodes": [
    ]
}

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Estimates the dollar impact of MIPS penalties on Medicare revenue. PHI-obfuscated.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Aggregate regulatory-penalty impact (combined MIPS, sequestration, etc.). PHI-obfuscated.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Per-claim detail rows behind the aggregate regulatory-penalty report. PHI-obfuscated.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Per-claim detail rows behind the aggregate MIPS-penalty report. PHI-obfuscated.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Reports biller productivity (claims touched, denials worked, recoveries). PHI-obfuscated.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>

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Returns repeating denial patterns with enough volume to suggest rule-engine rules for them.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>
minClaimCount
integer <int32>
Default: 5
topN
integer <int32>
Default: 25

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Evaluates whether reordering diagnosis codes on claims materially affects payment outcomes.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
payerId
integer <int32>
minClaimsPerOrdering
integer <int32>
Default: 3
minPaymentDifferencePercent
number <double>
Default: 5
topN
integer <int32>
Default: 50

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Drill-down into the claims behind a specific diagnosis-ordering pattern.

Request Body schema:
accountNumber
string or null
payerName
string or null
procedureCode
string or null
diagnosisOrder
Array of strings or null
startDate
string <date-time>
endDate
string <date-time>

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Request samples

Content type
{
  • "accountNumber": "string",
  • "payerName": "string",
  • "procedureCode": "string",
  • "diagnosisOrder": [
    ],
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z"
}

Response samples

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Given a denial pattern, asks the rule-suggestion engine for a concrete rule that would have caught it pre-submission.

Request Body schema:
object (ClaimRevModels_Analytics_Reports_DenialPatternRow)
accountNumber
string or null

Responses

Request samples

Content type
{
  • "denialPattern": {
    },
  • "accountNumber": "string"
}

Response samples

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ClaimCompare

Returns two claims prepared for side-by-side comparison. Responses are PHI-obfuscated and have heavy claim-text blobs stripped to keep the payload small. Returns 400 with an error message if either claim cannot be loaded for this account.

query Parameters
claimIdA
string
claimIdB
string

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Returns the current user's recent claim-comparison history for this account.

query Parameters
limit
integer <int32>
Default: 20

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ClaimEditor

Loads a claim into the editor view model, including the rendered EDI text split by segment. Returns 204 when the claim cannot be found or no editor view is available. PHI is obfuscated and the EDI text is suppressed for users with the hide-PHI scope.

query Parameters
claimId
string

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Persists edits made in the claim editor and returns the updated view model. If the caller has the hide-PHI scope the save is skipped and the posted payload is echoed back.

Request Body schema:
claimId
string or null
sharpRcmClaimId
integer or null <int64>
object (ClaimRevModels_EditorViews_ReceiverEditorViewModel)
object (ClaimRevModels_EditorViews_SubmitterEditorViewModel)
object (ClaimRevModels_EditorViews_BillingProviderEditorViewModel)
object (ClaimRevModels_EditorViews_Professional_SubscriberEditorViewModel)
object (ClaimRevModels_EditorViews_PayerEditorViewModel)
object (ClaimRevModels_EditorViews_PatientEditorViewModel)
object (ClaimRevModels_EditorViews_Professional_ClaimEditorViewModel)
object (ClaimRevModels_EditorViews_PayToPlanEditorViewModel)
object (ClaimRevModels_EditorViews_PayToAddressEditorViewModel)
Array of objects or null (ClaimRevModels_EditorViews_Professional_ClaimServiceLineViewModel)
Array of objects or null (ClaimRevModels_EditorViews_SecondaryViewModel)
claimStatusId
integer <int32> (ClaimRevModels_Enums_ClaimStatus)
Enum: "CustomerValidation" "PayerMatch" "ProviderMatch" "PrimaryEdits" "AdvancedRules" "TraceNumber" "ValidationCheck" "ReadyToSend" "MergedToPayer" "SentToPayer" "Error" "Reprocess" "FailedPayerMatch" "FailedProviderMatch" "Editing" "CheckAttachments" "ClaimReview" "NeedAttachments" "Void" "FindPrevious" "ClientSplit" "CheckDeductible" "HoldForDeductible" "RunFeatureModules"
claimText
Array of strings or null
Array of objects or null (ClaimRevModels_ClaimErrorModel)

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Request samples

Content type
{
  • "claimId": "string",
  • "sharpRcmClaimId": 0,
  • "receiverViewModel": {
    },
  • "submitterEditViewModel": {
    },
  • "billingProviderEditorView": {
    },
  • "subscriberEditorView": {
    },
  • "payerEditerView": {
    },
  • "patientEditorView": {
    },
  • "claimEditorView": {
    },
  • "payToPlanView": {
    },
  • "payToAddressView": {
    },
  • "serviceLinesEditorView": [
    ],
  • "secondaryEditorView": [
    ],
  • "claimStatusId": "CustomerValidation",
  • "claimText": [
    ],
  • "claimErrors": [
    ]
}

Response samples

Content type
No sample

Creates a replacement or void version of an existing claim based on the supplied data, saves it as a new claim, and returns its identifiers. Responds 204 when the source claim is not found.

Request Body schema:
claimObjectId
string or null
controlNumber
string or null
freqCode
string or null

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "controlNumber": "string",
  • "freqCode": "string"
}

Response samples

Content type
No sample

Computes the claim's current total charge by summing service-line amounts in the editor view. Returned as a decimal string. Responds 204 when the claim or editor view is unavailable.

query Parameters
claimId
string

Responses

Response samples

Content type
No sample

Returns the list of edit-history entries recorded for the claim, newest first. Responds 204 when the claim is not found.

query Parameters
claimId
string
limit
integer <int32>
Default: 50

Responses

Response samples

Content type
No sample

Returns the total number of edit-history entries recorded for the claim. Responds 204 when the claim is not found.

query Parameters
claimId
string

Responses

Response samples

Content type
No sample

ClaimManager

Reverts edits applied to a claim, restoring it to its pre-edit state. Returns true on success and false if the underlying operation throws.

Request Body schema:
objectId
string or null
statusId
integer <int32>

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "statusId": 0
}

Response samples

Content type
No sample

Marks the specified claim as voided so it is no longer considered active. Returns true on success and false if the operation throws.

Request Body schema:
objectId
string or null
statusId
integer <int32>

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "statusId": 0
}

Response samples

Content type
No sample

Marks the specified claim as worked to indicate a user has reviewed and handled it. Returns true on success and false if the operation throws.

Request Body schema:
objectId
string or null
statusId
integer <int32>

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "statusId": 0
}

Response samples

Content type
No sample

Attaches a user-supplied error/message to a claim so it can be tracked in the error list. Returns true on success and false if the operation throws.

Request Body schema:
objectId
string or null
error
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "error": "string"
}

Response samples

Content type
No sample

Removes a previously recorded error from a claim. Returns true on success and false if the operation throws.

Request Body schema:
objectId
string or null
errorKey
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "errorKey": "string"
}

Response samples

Content type
No sample

Marks the supplied claims for reprocessing by setting their status to Reprocess.

Request Body schema:
Array
string

Responses

Request samples

Content type
[
  • "string"
]

Response samples

Content type
No sample

ClaimView

Search Claims in the system based on the ClaimSearchModel object passed in

Request Body schema:

Claim Search Object contains every possible way to search for a claim

objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Search Claims in the system based on the ClaimSearchModel object passed in

Request Body schema:

Claim Search Object contains every possible way to search for a claim

objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Search Claims in the system based on the ClaimSearchModel object passed in

Request Body schema:

Claim Search Object contains every possible way to search for a claim

objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

This gets claims that are related to the ID passed in.

query Parameters
claimId
string
matchOnTraceNumber
boolean

if true will use trace number not the claim/patient control number

Responses

Response samples

Content type
No sample

Gets a list of errors or messages associated with a claim

query Parameters
claimId
string

Responses

Response samples

Content type
No sample

Submits a claim-error question to the AI assistant and streams the response back as server-sent events (text/event-stream).

Request Body schema:
accountNumber
string or null
claimObjectId
string or null
question
string or null
specificErrorKey
string or null
model
string or null
webSearch
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "claimObjectId": "string",
  • "question": "string",
  • "specificErrorKey": "string",
  • "model": "string",
  • "webSearch": true
}

Response samples

Content type
No sample

Returns the user-authored notes attached to a claim, ordered for display in the UI.

query Parameters
claimId
string

Responses

Response samples

Content type
No sample

Get a list of available claim status, used to populate drop down and select listbox controls

Responses

Response samples

Content type
No sample

Returns all tags currently attached to the specified claim.

query Parameters
claimObjectId
string

Responses

Response samples

Content type
No sample

Removes the specified tag from the claim.

query Parameters
claimObjectId
string
tagId
integer <int64>

Responses

Response samples

Content type
No sample

Adds the specified tag to the claim, optionally propagating it to past revisions.

query Parameters
claimObjectId
string
tagId
integer <int64>
applyToPastRevisions
boolean

Responses

Response samples

Content type
No sample

Removes all tags from the claim, optionally propagating the change to past revisions.

query Parameters
claimObjectId
string
applyToPastRevisions
boolean

Responses

Response samples

Content type
No sample

Returns the list of attachment requests associated with the claim (for example, records of payer requests for supporting documentation).

query Parameters
claimId
string

Responses

Response samples

Content type
No sample

ClientConnectConfig

Returns the active client-app configuration for the current caller's account.

Responses

Response samples

Content type
No sample

Saves the supplied client-app configuration and returns whether the save succeeded.

Request Body schema:
accountNumber
string or null
scanTimeInMinutes
integer or null <int32>
eraDownloadPath
string or null
fileAcceptanceDownloadPath
string or null
claimAcceptanceDownloadPath
string or null
scanPath
string or null
moveToPath
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "scanTimeInMinutes": 0,
  • "eraDownloadPath": "string",
  • "fileAcceptanceDownloadPath": "string",
  • "claimAcceptanceDownloadPath": "string",
  • "scanPath": "string",
  • "moveToPath": "string"
}

Response samples

Content type
No sample

ClientManagement

Returns the caller's account-access status (including disabled/suspended state) used by the portal to gate feature access.

Responses

Response samples

Content type
No sample

Codes

Returns all EDI service type codes for use in dropdowns and lookups.

Responses

Response samples

Content type
No sample

Looks up the description for a benefit information (EB) code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for a benefit coverage level code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for a DTP (date/time period) qualifier code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for a REF (reference identification) qualifier code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Generic EDI element code description lookup by element name, element position, and code value.

query Parameters
elementName
string
position
integer <int32>
code
string

Responses

Response samples

Content type
No sample

Looks up the description for the HSD01 quantity qualifier code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for the HSD03 unit or basis for measurement code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for the HSD05 time period qualifier code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for the HSD07 frequency code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Looks up the description for the HSD08 ship, delivery, or calendar pattern time code.

query Parameters
code
string

Responses

Response samples

Content type
No sample

Returns a paged list of diagnosis codes filtered by code, description, and effective date range.

query Parameters
diagnosisCode
string
diagnosisDescription
string
startDate
string <date-time>
endDate
string <date-time>
pageIndex
integer <int32>
pageSize
integer <int32>

Responses

Response samples

Content type
No sample

Communication

Issues a short-lived Azure Communication Services access token for the current user so the portal can establish voice/chat sessions. Returns 500 if the token service is unavailable.

Responses

Response samples

Content type
No sample

Creates a new support call request for the current user under their default account.

Request Body schema:
description
string or null

Responses

Request samples

Content type
{
  • "description": "string"
}

Response samples

Content type
No sample

Retrieves a single support request by its identifier.

query Parameters
requestId
string

Responses

Response samples

Content type
No sample

Returns all support requests currently awaiting agent pickup, for the support dashboard.

Responses

Response samples

Content type
No sample

Returns the most recent support requests (completed, cancelled, or otherwise) for the support dashboard.

query Parameters
limit
integer <int32>
Default: 50

Responses

Response samples

Content type
No sample

Accepts a pending support request and assigns it to the current agent.

Request Body schema:
requestId
string or null

Responses

Request samples

Content type
{
  • "requestId": "string"
}

Response samples

Content type
No sample

Cancels a support request that has not yet been accepted by an agent.

query Parameters
requestId
string

Responses

Response samples

Content type
No sample

Marks an in-progress support request as completed.

query Parameters
requestId
string

Responses

Response samples

Content type
No sample

Attaches a text message to an existing support request (e.g., voicemail transcription or callback note).

Request Body schema:
requestId
string or null
message
string or null

Responses

Request samples

Content type
{
  • "requestId": "string",
  • "message": "string"
}

Response samples

Content type
No sample

Creates a message-only (non-live) support request so the user can leave a note for support when no agent is available.

Request Body schema:
description
string or null

Responses

Request samples

Content type
{
  • "description": "string"
}

Response samples

Content type
No sample

Returns whether any support agents are currently available to take calls.

Responses

Response samples

Content type
No sample

Returns the calling agent's current availability flag.

Responses

Response samples

Content type
No sample

Sets the calling agent's availability to accept support requests.

query Parameters
isAvailable
boolean

Responses

Response samples

Content type
No sample

Records the start of a communication session for usage metering under the caller's default account.

Request Body schema:
sessionId
string or null
sessionType
string or null

Responses

Request samples

Content type
{
  • "sessionId": "string",
  • "sessionType": "string"
}

Response samples

Content type
No sample

Records the end of a communication session and finalises its usage metrics.

Request Body schema:
sessionId
string or null
Array of objects or null (ClaimRevModels_Communication_EndSessionParticipant)
screenShareSeconds
integer <int32>
chatMessageCount
integer <int32>

Responses

Request samples

Content type
{
  • "sessionId": "string",
  • "participants": [
    ],
  • "screenShareSeconds": 0,
  • "chatMessageCount": 0
}

Response samples

Content type
No sample

Returns communication-service usage records for the caller's default account within an optional date range.

query Parameters
startDate
string <date-time>
endDate
string <date-time>

Responses

Response samples

Content type
No sample

Returns the communication feature settings (enabled features, working hours, etc.) for the caller's default account.

Responses

Response samples

Content type
No sample

Saves the communication feature settings for the caller's default account.

Request Body schema:
object (MongoDB_Bson_ObjectId)
accountNumber
string or null
supportFabEnabled
boolean
providerCallEnabled
boolean
updatedAt
string <date-time>
updatedBy
string or null

Responses

Request samples

Content type
{
  • "id": { },
  • "accountNumber": "string",
  • "supportFabEnabled": true,
  • "providerCallEnabled": true,
  • "updatedAt": "2019-08-24T14:15:22Z",
  • "updatedBy": "string"
}

Response samples

Content type
No sample

CoverageResearch

Search CMS national (NCD) or local (LCD) coverage documents. Returns 400 if no keyword is supplied.

Request Body schema:
keyword
string or null
documentType
string or null
stateId
integer or null <int32>
offset
integer <int32>
count
integer <int32>

Responses

Request samples

Content type
{
  • "keyword": "string",
  • "documentType": "string",
  • "stateId": 0,
  • "offset": 0,
  • "count": 0
}

Response samples

Content type
No sample

Get all US states for LCD filtering.

Responses

Response samples

Content type
No sample

DashboardPreferences

Returns the dashboard widget preferences for the current user under their default account.

Responses

Response samples

Content type
No sample

Saves the dashboard widget preferences for the current user. Returns 400 if the payload or widget list is missing.

Request Body schema:
id
string or null
accountNumber
string or null
userEmail
string or null
Array of objects or null (ClaimRev_Business_Dashboard_DashboardWidgetPreferenceViewModel)

Responses

Request samples

Content type
{
  • "id": "string",
  • "accountNumber": "string",
  • "userEmail": "string",
  • "widgets": [
    ]
}

Response samples

Content type
No sample

DenialWorkbench

Returns the effective denial workbench classification config for the caller's default account, falling back to system defaults when no account override exists.

Responses

Response samples

Content type
No sample

Returns the out-of-the-box default classification config (not account-specific).

Responses

Response samples

Content type
No sample

Returns the filtered denial work queue for the caller's default account with PHI obfuscation applied.

query Parameters
Status
string
Priority
string
PayerName
string
AssignedTo
string
DenialCategory
string
EraClassification
string
StartDate
string <date-time>
EndDate
string <date-time>
MinAmount
number <double>
MaxAmount
number <double>
SortBy
string
SortDesc
boolean
Skip
integer <int32>
Take
integer <int32>

Responses

Response samples

Content type
No sample

Returns aggregate statistics for the denial work queue under the caller's default account.

Responses

Response samples

Content type
No sample

Returns a single denial work item (with PHI obfuscated). Returns 404 when not found under the caller's account.

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

Creates a new denial work item from an ERA record for the caller's default account. Returns 404 if the source ERA record cannot be resolved.

Request Body schema:
singleClaimPaymentId
string or null
priority
string or null
assignedTo
string or null
initialNote
string or null

Responses

Request samples

Content type
{
  • "singleClaimPaymentId": "string",
  • "priority": "string",
  • "assignedTo": "string",
  • "initialNote": "string"
}

Response samples

Content type
No sample

Updates the workflow status of a denial work item (e.g., Open, InProgress, Resolved).

path Parameters
id
required
string
Request Body schema:
status
string or null

Responses

Request samples

Content type
{
  • "status": "string"
}

Assigns a denial work item to a user by email.

path Parameters
id
required
string
Request Body schema:
assignedTo
string or null

Responses

Request samples

Content type
{
  • "assignedTo": "string"
}

Updates the priority of a denial work item.

path Parameters
id
required
string
Request Body schema:
priority
string or null

Responses

Request samples

Content type
{
  • "priority": "string"
}

Appends a note to the denial work item's activity log.

path Parameters
id
required
string
Request Body schema:
noteId
string or null
timestamp
string <date-time>
userId
string or null
userName
string or null
noteType
string or null
actionTaken
string or null
finding
string or null
nextStep
string or null
freeText
string or null

Responses

Request samples

Content type
{
  • "noteId": "string",
  • "timestamp": "2019-08-24T14:15:22Z",
  • "userId": "string",
  • "userName": "string",
  • "noteType": "string",
  • "actionTaken": "string",
  • "finding": "string",
  • "nextStep": "string",
  • "freeText": "string"
}

Closes a denial work item with the supplied resolution outcome and notes.

path Parameters
id
required
string
Request Body schema:
type
string or null
date
string or null <date-time>
amount
number or null <double>
reason
string or null
approvedBy
string or null

Responses

Request samples

Content type
{
  • "type": "string",
  • "date": "2019-08-24T14:15:22Z",
  • "amount": 0.1,
  • "reason": "string",
  • "approvedBy": "string"
}

Returns the chronological timeline of events (notes, status changes, etc.) for a denial work item with PHI obfuscated.

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

Checks whether an open denial work item already exists for the given distinct claim id under the caller's account.

path Parameters
distinctClaimId
required
string

Responses

Response samples

Content type
No sample

Searches user profiles within the caller's account (typically used to populate assignee pickers).

Request Body schema:
firstName
string or null
lastName
string or null
emailAddress
string or null
hasClientId
boolean or null

Responses

Request samples

Content type
{
  • "firstName": "string",
  • "lastName": "string",
  • "emailAddress": "string",
  • "hasClientId": true
}

Response samples

Content type
No sample

Generates a draft appeal letter for the specified work item and appeal level. Returns 404 if the work item does not exist under the caller's account.

path Parameters
id
required
string
query Parameters
level
integer <int32>
Default: 1

Responses

Response samples

Content type
No sample

Records an appeal submission against the specified work item. Returns 404 if the work item does not exist under the caller's account.

path Parameters
id
required
string
Request Body schema:
level
integer <int32>
letterBody
string or null
submissionMethod
string or null
deadline
string or null <date-time>

Responses

Request samples

Content type
{
  • "level": 0,
  • "letterBody": "string",
  • "submissionMethod": "string",
  • "deadline": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Records the outcome of a previously submitted appeal (e.g., approved, denied, partial).

path Parameters
id
required
string
appealId
required
string
Request Body schema:
outcome
string or null
outcomeDate
string or null <date-time>
outcomeNotes
string or null
recoveredAmount
number or null <double>

Responses

Request samples

Content type
{
  • "outcome": "string",
  • "outcomeDate": "2019-08-24T14:15:22Z",
  • "outcomeNotes": "string",
  • "recoveredAmount": 0.1
}

Response samples

Content type
No sample

Generates a PDF rendering of an appeal letter for the specified work item. Returns 404 if the work item does not exist under the caller's account.

path Parameters
id
required
string
Request Body schema:
letterBody
string or null

Responses

Request samples

Content type
{
  • "letterBody": "string"
}

Response samples

Content type
No sample

Returns the account's appeal letter templates, optionally filtered by payer name and appeal level.

query Parameters
payerName
string
level
integer <int32>

Responses

Response samples

Content type
No sample

Creates or updates an appeal template for the caller's default account.

Request Body schema:
object (MongoDB_Bson_ObjectId)
accountNumber
string or null
payerName
string or null
payerId
integer or null <int32>
level
integer <int32>
name
string or null
letterBody
string or null
submissionMethod
string or null
notes
string or null
createdDate
string <date-time>
createdBy
string or null
lastModifiedDate
string <date-time>
lastModifiedBy
string or null

Responses

Request samples

Content type
{
  • "id": { },
  • "accountNumber": "string",
  • "payerName": "string",
  • "payerId": 0,
  • "level": 0,
  • "name": "string",
  • "letterBody": "string",
  • "submissionMethod": "string",
  • "notes": "string",
  • "createdDate": "2019-08-24T14:15:22Z",
  • "createdBy": "string",
  • "lastModifiedDate": "2019-08-24T14:15:22Z",
  • "lastModifiedBy": "string"
}

Response samples

Content type
No sample

Deletes an appeal template belonging to the caller's default account.

path Parameters
templateId
required
string

Responses

Returns payer-specific appeal filing information (addresses, deadlines, etc.) for the caller's account.

query Parameters
payerId
integer <int32>

Responses

Response samples

Content type
No sample

Generates appeal letters for a batch of denial work items using the specified template and level.

Request Body schema:
workItemIds
Array of strings or null
level
integer <int32>
templateId
string or null

Responses

Request samples

Content type
{
  • "workItemIds": [
    ],
  • "level": 0,
  • "templateId": "string"
}

Response samples

Content type
No sample

Uploads a supporting document (multipart form) and attaches it to the specified denial work item. Returns 400 if no file was provided, 404 if the work item does not exist under the caller's account.

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

Downloads a supporting document attached to the specified denial work item. Returns 400 if bucketFileName is missing and 404 if no matching document exists.

path Parameters
id
required
string
query Parameters
bucketFileName
string

Responses

Response samples

Content type
No sample

Deletes a supporting document attached to the specified denial work item. Returns 400 if bucketFileName is missing and 404 if no matching document exists.

path Parameters
id
required
string
query Parameters
bucketFileName
string

Responses

Response samples

Content type
No sample

Returns CMS appeal forms available in the system, optionally filtered by appeal level.

query Parameters
level
integer <int32>

Responses

Response samples

Content type
No sample

Downloads a CMS appeal form by id. Returns 404 if the form does not exist.

path Parameters
formId
required
string

Responses

Response samples

Content type
No sample

Builds the full appeal packet (letter + supporting documents + CMS forms) for the specified appeal. Returns 404 if the work item or appeal cannot be found under the caller's account.

path Parameters
id
required
string
appealId
required
string
Request Body schema:
letterBody
string or null

Responses

Request samples

Content type
{
  • "letterBody": "string"
}

Response samples

Content type
No sample

Downloads a previously generated appeal packet. Returns 404 if the work item, appeal, or packet cannot be found.

path Parameters
id
required
string
appealId
required
string

Responses

Response samples

Content type
No sample

EdiEditor

Returns the loop/segment map describing the structure of the given EDI format (e.g. 837P, 837I) for use by the front-end editor. Returns 400 if the format is invalid.

path Parameters
format
required
string

Responses

Response samples

Content type
No sample

Validates an edited EDI payload without persisting it and returns the verification result with any errors or warnings. Returns 400 when the request body is missing.

Request Body schema:
ediText
string or null
format
string or null

Responses

Request samples

Content type
{
  • "ediText": "string",
  • "format": "string"
}

Response samples

Content type
No sample

Saves an edited raw-EDI claim after validation. Returns 400 with validation details when the payload is invalid, or 403 when the caller lacks access to the target claim.

Request Body schema:
claimId
string or null
accountNumber
string or null
ediText
string or null
format
string or null

Responses

Request samples

Content type
{
  • "claimId": "string",
  • "accountNumber": "string",
  • "ediText": "string",
  • "format": "string"
}

Response samples

Content type
No sample

Saves an edited raw-EDI claim and queues it for outbound transmission. Returns 400 with validation details when the payload is invalid, or 403 when the caller lacks access.

Request Body schema:
claimId
string or null
accountNumber
string or null
ediText
string or null
format
string or null

Responses

Request samples

Content type
{
  • "claimId": "string",
  • "accountNumber": "string",
  • "ediText": "string",
  • "format": "string"
}

Response samples

Content type
No sample

EdiResponseFile

Get the EDI Response files that are waiting to download by type

query Parameters
ediType
string

835,277, 999, ZIP

Responses

Response samples

Content type
No sample

EnrollmentPublic

Validates an enrollment invitation token and, if valid, returns the associated form type so the public UI can render the correct form. Always returns 200 with a Valid flag.

path Parameters
token
required
string

Responses

Response samples

Content type
No sample

Accepts a completed enrollment form for the given invitation token and persists it for admin review. Returns 400 when the token or submission is missing or the link is invalid/expired.

path Parameters
token
required
string
Request Body schema:
object (MongoDB_Bson_ObjectId)
invitationToken
string or null
formType
string or null
status
string or null
submittedAt
string <date-time>
reviewedAt
string or null <date-time>
reviewedByEmail
string or null
createdAccountNumber
string or null
object or null

Responses

Request samples

Content type
{
  • "id": { },
  • "invitationToken": "string",
  • "formType": "string",
  • "status": "string",
  • "submittedAt": "2019-08-24T14:15:22Z",
  • "reviewedAt": "2019-08-24T14:15:22Z",
  • "reviewedByEmail": "string",
  • "createdAccountNumber": "string",
  • "formData": {
    }
}

Response samples

Content type
No sample

EraEnrollment

Returns the ERA enrollment configuration associated with the given ClaimRev payer id. Returns 404 when no config is linked to the payer.

path Parameters
payerId
required
integer <int32>

Responses

Response samples

Content type
No sample

Downloads a config attachment as a file stream. Returns 404 when the configuration, attachment metadata, or backing bucket object cannot be found.

path Parameters
id
required
string
fileName
required
string

Responses

Response samples

Content type
No sample

Generates a filled PDF for the given enrollment request and returns it as a download. Returns 400 when the PDF cannot be produced (for example, no template is configured).

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

Returns the providers belonging to the caller's default account that can be used to auto-populate an enrollment form. PHI fields are obfuscated before return.

Responses

Response samples

Content type
No sample

Resolves the auto-fill field values for the given provider against a specific configuration's template, returning a field-name to value map with PHI obfuscated.

Request Body schema:
providerId
integer <int64>
configId
string or null

Responses

Request samples

Content type
{
  • "providerId": 0,
  • "configId": "string"
}

Response samples

Content type
No sample

Returns the caller's enrollment requests (scoped to their default account) matching the supplied filter. PHI fields are obfuscated before return.

query Parameters
AccountNumber
string
Status
string
AssignedTo
string
PayerName
string
StartDate
string <date-time>
EndDate
string <date-time>
SortBy
string
SortDesc
boolean
Skip
integer <int32>
Take
integer <int32>

Responses

Response samples

Content type
No sample

Returns a single enrollment request for the caller's account, stripping internal comments and non-visible steps for non-admin callers. Returns 404 when not found.

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

Updates the field values on an enrollment request after sanitizing input. Returns 404 when the request is not found for the caller.

path Parameters
id
required
string
Request Body schema:
property name*
additional property
any

Responses

Request samples

Content type
{
  • "property1": null,
  • "property2": null
}

Response samples

Content type
No sample

Creates a new enrollment request for the caller's default account.

Request Body schema:
claimRevPayerId
integer <int32>
payerName
string or null
enrollmentConfigId
string or null
object or null
status
string or null
accountNumber
string or null
requestedByEmail
string or null
requestedByName
string or null

Responses

Request samples

Content type
{
  • "claimRevPayerId": 0,
  • "payerName": "string",
  • "enrollmentConfigId": "string",
  • "fieldValues": {
    },
  • "status": "string",
  • "accountNumber": "string",
  • "requestedByEmail": "string",
  • "requestedByName": "string"
}

Response samples

Content type
No sample

Transitions an enrollment request to a new status, optionally capturing a status-change note.

path Parameters
id
required
string
Request Body schema:
status
string or null
note
string or null

Responses

Request samples

Content type
{
  • "status": "string",
  • "note": "string"
}

Adds an internal note to an enrollment request's history.

path Parameters
id
required
string
Request Body schema:
noteText
string or null
userName
string or null

Responses

Request samples

Content type
{
  • "noteText": "string",
  • "userName": "string"
}

Adds a comment to an enrollment request. Comments marked internal are not shown to the customer.

path Parameters
id
required
string
Request Body schema:
message
string or null
userName
string or null
isInternal
boolean

Responses

Request samples

Content type
{
  • "message": "string",
  • "userName": "string",
  • "isInternal": true
}

Adds a comment to an enrollment request together with an uploaded attachment.

path Parameters
id
required
string
Request Body schema: multipart/form-data
message
string
userName
string
isInternal
boolean
file
string <binary>

Responses

Marks the specified workflow step on an enrollment request as complete.

path Parameters
id
required
string
stepId
required
string

Responses

Uploads a file against an enrollment request and returns the stored file name and bucket path. Returns 400 when no file is supplied.

path Parameters
id
required
string
Request Body schema: multipart/form-data
file
string <binary>

Responses

Response samples

Content type
No sample

Downloads a file attachment posted on a comment of an enrollment request. Returns 404 when the request, comment, attachment metadata, or bucket object is missing.

path Parameters
id
required
string
commentId
required
string
fileName
required
string

Responses

Response samples

Content type
No sample

Generates a populated Excel workbook for the given enrollment request and returns it as a download. Returns 400 when the workbook cannot be produced (for example, no template is configured).

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

EraQuickReports

Indicates whether the given payment advice has already been indexed into the Quick Reports store.

query Parameters
adviceId
string

Responses

Response samples

Content type
No sample

Returns the payee-level summary (totals, payer info, header metadata) for the given payment advice, with PHI obfuscated.

query Parameters
adviceId
string

Responses

Response samples

Content type
No sample

Returns the claim-payment list for the supplied search/filter with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns detailed claim-header rows (adjustments, service lines, etc.) for the supplied search with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Generates a translated-ERA claim-detail PDF and returns it as a base64-encoded file payload.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the claim-status report rows for the supplied search with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the claim-status report as a CSV download payload with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns service-line rows that had adjustments applied, for the supplied search, with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the adjusted service-line report as a CSV download payload with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns service-line rows containing patient-deductible amounts for the supplied search, with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the deductible service-line report as a CSV download payload with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns service-line rows containing patient-coinsurance amounts for the supplied search, with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the coinsurance service-line report as a CSV download payload with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns service-line rows containing both coinsurance and deductible amounts for the supplied search, with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the combined coinsurance/deductible service-line report as a CSV download payload with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns service-line rows for denied services matching the supplied search, with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the denied service-line report as a CSV download payload with PHI obfuscated.

Request Body schema:
objectId
string or null
customerAccountNumber
Array of strings or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
clientControlNumbers
Array of strings or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
actualAllowedLte
number or null <double>
actualAllowedGte
number or null <double>
hasDeductible
boolean
hasCoins
boolean
notClaimStatuses
Array of strings or null
claimStatuses
Array of strings or null
customAdjustmentClaimStatusId
integer <int32>
customAdjustmentServiceLineStatusId
integer <int32>
claimPaymentWorkStatus
boolean or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_AdjustmentSearchViewModel)

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "customerAccountNumber": [
    ],
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "clientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "actualAllowedLte": 0.1,
  • "actualAllowedGte": 0.1,
  • "hasDeductible": true,
  • "hasCoins": true,
  • "notClaimStatuses": [
    ],
  • "claimStatuses": [
    ],
  • "customAdjustmentClaimStatusId": 0,
  • "customAdjustmentServiceLineStatusId": 0,
  • "claimPaymentWorkStatus": true,
  • "adjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Saves a customer-defined adjustment-reason status mapping used to categorise ERA adjustments.

Request Body schema:
customAdjustmentReasonId
integer <int64>
statusName
string or null
eraObjectId
string or null
accountNumber
string or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_CustomAdjustmentCodeViewModel)

Responses

Request samples

Content type
{
  • "customAdjustmentReasonId": 0,
  • "statusName": "string",
  • "eraObjectId": "string",
  • "accountNumber": "string",
  • "customAdjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Deletes an existing customer-defined adjustment-reason status mapping.

Request Body schema:
customAdjustmentReasonId
integer <int64>
statusName
string or null
eraObjectId
string or null
accountNumber
string or null
Array of objects or null (ClaimRevModels_EraQuickReportModels_CustomAdjustmentCodeViewModel)

Responses

Request samples

Content type
{
  • "customAdjustmentReasonId": 0,
  • "statusName": "string",
  • "eraObjectId": "string",
  • "accountNumber": "string",
  • "customAdjustmentCodes": [
    ]
}

Response samples

Content type
No sample

Returns the customer-defined adjustment-reason status mappings applicable to the given ERA object.

query Parameters
eraObjectId
string

Responses

Response samples

Content type
No sample

Returns per-payer aggregated counts of claim-payment info rows matching the supplied search.

Request Body schema:
accountNumbers
Array of strings or null
payerNumber
string or null
showUnmatched
boolean or null
patientFirstName
string or null
patientLastName
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
payerControlNumber
string or null
patientControlNumber
string or null
exactMatch
boolean
checkNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
checkDateStart
string or null <date-time>
checkDateEnd
string or null <date-time>

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "payerNumber": "string",
  • "showUnmatched": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "payerControlNumber": "string",
  • "patientControlNumber": "string",
  • "exactMatch": true,
  • "checkNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "checkDateStart": "2019-08-24T14:15:22Z",
  • "checkDateEnd": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Returns the claim-payment advice info rows matching the supplied search.

Request Body schema:
accountNumbers
Array of strings or null
payerNumber
string or null
showUnmatched
boolean or null
patientFirstName
string or null
patientLastName
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
payerControlNumber
string or null
patientControlNumber
string or null
exactMatch
boolean
checkNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
checkDateStart
string or null <date-time>
checkDateEnd
string or null <date-time>

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "payerNumber": "string",
  • "showUnmatched": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "payerControlNumber": "string",
  • "patientControlNumber": "string",
  • "exactMatch": true,
  • "checkNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "checkDateStart": "2019-08-24T14:15:22Z",
  • "checkDateEnd": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Toggles the "is worked" flag on a single claim payment row for the caller's default account.

Request Body schema:
payerPaymentAdviceId
string or null
singleClaimPaymentId
string or null
customerAccountNumber
string or null
asg
string or null
trn02CheckNumber
string or null
patientLastName
string or null
patientFirstName
string or null
clientControlNumber
string or null
payerControlNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
billedAmount
number or null <double>
payedAmount
number or null <double>
isWorked
boolean or null

Responses

Request samples

Content type
{
  • "payerPaymentAdviceId": "string",
  • "singleClaimPaymentId": "string",
  • "customerAccountNumber": "string",
  • "asg": "string",
  • "trn02CheckNumber": "string",
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "clientControlNumber": "string",
  • "payerControlNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "billedAmount": 0.1,
  • "payedAmount": 0.1,
  • "isWorked": true
}

Response samples

Content type
No sample

GoodFaithEstimate

Initializes a Good Faith Estimate session for the current user's account, returning the data needed to begin building an estimate.

Request Body schema:
eligibilityId
string or null
edi271
string or null
object (ClaimRevModels_GoodFaithEstimate_GfePatientInfo)
object (ClaimRevModels_GoodFaithEstimate_GfeProviderInfo)
enhancedMode
boolean

Responses

Request samples

Content type
{
  • "eligibilityId": "string",
  • "edi271": "string",
  • "patient": {
    },
  • "provider": {
    },
  • "enhancedMode": true
}

Generates a Good Faith Estimate for the supplied request. Returns 400 when the engine reports validation errors on the generated result.

Request Body schema:
estimateId
string or null
object (ClaimRevModels_GoodFaithEstimate_GfeBenefitOverrides)
Array of objects or null (ClaimRevModels_GoodFaithEstimate_GfeServiceLineInput)
disclaimerText
string or null

Responses

Request samples

Content type
{
  • "estimateId": "string",
  • "answers": {
    },
  • "serviceLines": [
    ],
  • "disclaimerText": "string"
}

Retrieves a previously generated Good Faith Estimate by id. Returns 404 if no estimate is found for the current account.

path Parameters
estimateId
required
string

Responses

Renders a previously generated Good Faith Estimate as a downloadable PDF file. Returns 404 if the estimate does not exist for the current account.

path Parameters
estimateId
required
string

Responses

Returns a paged history of Good Faith Estimates for the current account, optionally filtered by patient last name and date of birth.

query Parameters
patientLastName
string
patientDob
string <date-time>
skip
integer <int32>
Default: 0
limit
integer <int32>
Default: 25

Responses

Healthie

Returns the Healthie integration configuration for the current account.

Responses

Response samples

Content type
No sample

Saves the Healthie integration configuration for the current account.

Request Body schema:
gatewayName
string or null
gatewayKey
string or null
overrideClaimFilingIndicator
boolean
overrideInsuranceTypeCode
boolean
useActualDurationFromAppointment
boolean
fixMissingPointers
boolean
saveAdditionalTextOnPosting
boolean
sendClaimRevClaimToHealthie
boolean or null
autoCreateClaimFromEncounterOnImport
boolean or null
rolloverAppointmentOnImport
boolean or null
eligibilityDefaultAppointmentTypes
Array of strings or null

Responses

Request samples

Content type
{
  • "gatewayName": "string",
  • "gatewayKey": "string",
  • "overrideClaimFilingIndicator": true,
  • "overrideInsuranceTypeCode": true,
  • "useActualDurationFromAppointment": true,
  • "fixMissingPointers": true,
  • "saveAdditionalTextOnPosting": true,
  • "sendClaimRevClaimToHealthie": true,
  • "autoCreateClaimFromEncounterOnImport": true,
  • "rolloverAppointmentOnImport": true,
  • "eligibilityDefaultAppointmentTypes": [
    ]
}

Response samples

Content type
No sample

Searches Healthie HCFA claims for the current account and returns a paged result with PHI obfuscated.

Request Body schema:
status
string or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "status": "string",
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Imports a batch of selected Healthie claims into ClaimRev for processing.

Request Body schema:
Array
healthieClaimId
string or null
patientFirstName
string or null
patientLastName
string or null
createDate
string or null <date-time>
payer
string or null
payerId
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
healthieStatus
string or null
procedureCodes
Array of strings or null
isInRcm
boolean
chartNoteId
string or null
chartLocked
boolean
diagnosisCodeList
string or null

Responses

Request samples

Content type
[
  • {
    }
]

Response samples

Content type
No sample

Runs an import dry-run for a single Healthie claim, primarily for debugging integration issues.

Request Body schema:
healthieClaimId
string or null
patientFirstName
string or null
patientLastName
string or null
createDate
string or null <date-time>
payer
string or null
payerId
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
healthieStatus
string or null
procedureCodes
Array of strings or null
isInRcm
boolean
chartNoteId
string or null
chartLocked
boolean
diagnosisCodeList
string or null

Responses

Request samples

Content type
{
  • "healthieClaimId": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "createDate": "2019-08-24T14:15:22Z",
  • "payer": "string",
  • "payerId": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "healthieStatus": "string",
  • "procedureCodes": [
    ],
  • "isInRcm": true,
  • "chartNoteId": "string",
  • "chartLocked": true,
  • "diagnosisCodeList": "string"
}

Response samples

Content type
No sample

Imports a single selected Healthie claim into ClaimRev.

Request Body schema:
healthieClaimId
string or null
patientFirstName
string or null
patientLastName
string or null
createDate
string or null <date-time>
payer
string or null
payerId
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
healthieStatus
string or null
procedureCodes
Array of strings or null
isInRcm
boolean
chartNoteId
string or null
chartLocked
boolean
diagnosisCodeList
string or null

Responses

Request samples

Content type
{
  • "healthieClaimId": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "createDate": "2019-08-24T14:15:22Z",
  • "payer": "string",
  • "payerId": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "healthieStatus": "string",
  • "procedureCodes": [
    ],
  • "isInRcm": true,
  • "chartNoteId": "string",
  • "chartLocked": true,
  • "diagnosisCodeList": "string"
}

Response samples

Content type
No sample

Returns the raw GraphQL response body for a Healthie claim, used for debugging integration issues.

query Parameters
healthieClaimId
string

Responses

Response samples

Content type
No sample

Returns the raw GraphQL response body for a Healthie appointment, used for debugging integration issues.

query Parameters
healthieAppointmentId
string

Responses

Response samples

Content type
No sample

Searches Healthie appointments that are candidates for running eligibility checks and returns a paged, PHI-obfuscated result.

Request Body schema:
startDate
string <date-time>
endDate
string <date-time>
patientId
string or null
providerId
string or null
appointmentTypes
Array of strings or null
noteLocked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "patientId": "string",
  • "providerId": "string",
  • "appointmentTypes": [
    ],
  • "noteLocked": true,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Searches Healthie appointments that are candidates for being imported into ClaimRev and returns a paged, PHI-obfuscated result.

Request Body schema:
startDate
string <date-time>
endDate
string <date-time>
patientId
string or null
providerId
string or null
appointmentTypes
Array of strings or null
noteLocked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "patientId": "string",
  • "providerId": "string",
  • "appointmentTypes": [
    ],
  • "noteLocked": true,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Returns the list of appointment types configured in Healthie for the current account.

Responses

Response samples

Content type
No sample

Returns the list of Healthie providers configured for the current account with PHI obfuscated.

Responses

Response samples

Content type
No sample

Imports all providers from Healthie into ClaimRev for the current account and returns whether the operation succeeded.

Responses

Response samples

Content type
No sample

Imports all facilities from Healthie into ClaimRev for the current account and returns whether the operation succeeded.

Responses

Response samples

Content type
No sample

Runs an eligibility check for the patient associated with the supplied Healthie appointment and returns the updated appointment record.

Request Body schema:
appointmentId
string or null
appointmentStart
string or null <date-time>
patientLastName
string or null
patientFirstName
string or null
providerFirstName
string or null
providerLastName
string or null
patientDob
string or null <date-time>
gender
string or null
patientId
string or null
appointmentType
string or null
actualDuration
string or null
chartNoteLocked
boolean
Array of objects or null (ClaimRev_Rcm_Integrations_Healthie_Models_EligibilityStatusViewModel)

Responses

Request samples

Content type
{
  • "appointmentId": "string",
  • "appointmentStart": "2019-08-24T14:15:22Z",
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "providerFirstName": "string",
  • "providerLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "gender": "string",
  • "patientId": "string",
  • "appointmentType": "string",
  • "actualDuration": "string",
  • "chartNoteLocked": true,
  • "eligibilityStatuses": [
    ]
}

Response samples

Content type
No sample

Adds the payers referenced on a Healthie appointment to the ClaimRev payer list and returns the updated appointment record.

Request Body schema:
appointmentId
string or null
appointmentStart
string or null <date-time>
patientLastName
string or null
patientFirstName
string or null
providerFirstName
string or null
providerLastName
string or null
patientDob
string or null <date-time>
gender
string or null
patientId
string or null
appointmentType
string or null
actualDuration
string or null
chartNoteLocked
boolean
Array of objects or null (ClaimRev_Rcm_Integrations_Healthie_Models_EligibilityStatusViewModel)

Responses

Request samples

Content type
{
  • "appointmentId": "string",
  • "appointmentStart": "2019-08-24T14:15:22Z",
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "providerFirstName": "string",
  • "providerLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "gender": "string",
  • "patientId": "string",
  • "appointmentType": "string",
  • "actualDuration": "string",
  • "chartNoteLocked": true,
  • "eligibilityStatuses": [
    ]
}

Response samples

Content type
No sample

Executes an arbitrary GraphQL request against Healthie and returns the raw response, used for debugging integration issues.

Request Body schema:
query
string or null
object or null

Responses

Request samples

Content type
{
  • "query": "string",
  • "variables": {
    }
}

Response samples

Content type
No sample

Searches for ERA payment advices awaiting posting in Healthie for the current account and returns a paged, PHI-obfuscated result.

Request Body schema:
accountNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
isWorked
boolean or null
patientFirstName
string or null
patientLastName
string or null
payerNumber
string or null
patientControlNumber
string or null
checkNumber
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
object (ClaimRevModels_PagingSearchViewModel)
hasFoundRcmClaim
boolean or null
paymentStatusId
integer or null <int32>
isProcessing
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "isWorked": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "payerNumber": "string",
  • "patientControlNumber": "string",
  • "checkNumber": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "pagingSearch": {
    },
  • "hasFoundRcmClaim": true,
  • "paymentStatusId": 0,
  • "isProcessing": true
}

Response samples

Content type
No sample

Posts a single ERA payment advice to Healthie against the matching HCFA claim.

Request Body schema:
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
healthieClaimId
string or null
isClaimFound
boolean
healthieStatus
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "accountNumber": "string",
  • "receivedDate": "2019-08-24T14:15:22Z",
  • "payerName": "string",
  • "payerNumber": "string",
  • "paymentAdviceStatusId": 0,
  • "paymentInfo": {
    },
  • "checkInformation": {
    },
  • "eraClassification": "string",
  • "healthieClaimId": "string",
  • "isClaimFound": true,
  • "healthieStatus": "string"
}

Response samples

Content type
No sample

Posts every payment advice matching the supplied search criteria to Healthie and returns whether the batch started successfully.

Request Body schema:
accountNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
isWorked
boolean or null
patientFirstName
string or null
patientLastName
string or null
payerNumber
string or null
patientControlNumber
string or null
checkNumber
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
object (ClaimRevModels_PagingSearchViewModel)
hasFoundRcmClaim
boolean or null
paymentStatusId
integer or null <int32>
isProcessing
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "isWorked": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "payerNumber": "string",
  • "patientControlNumber": "string",
  • "checkNumber": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "pagingSearch": {
    },
  • "hasFoundRcmClaim": true,
  • "paymentStatusId": 0,
  • "isProcessing": true
}

Response samples

Content type
No sample

Posts the supplied list of ERA payment advices to Healthie and returns a per-advice response.

Request Body schema:
Array
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
healthieClaimId
string or null
isClaimFound
boolean
healthieStatus
string or null

Responses

Request samples

Content type
[
  • {
    }
]

Response samples

Content type
No sample

Updates the IsWorked flag on a Healthie claim payment advice record.

Request Body schema:
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
healthieClaimId
string or null
isClaimFound
boolean
healthieStatus
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "accountNumber": "string",
  • "receivedDate": "2019-08-24T14:15:22Z",
  • "payerName": "string",
  • "payerNumber": "string",
  • "paymentAdviceStatusId": 0,
  • "paymentInfo": {
    },
  • "checkInformation": {
    },
  • "eraClassification": "string",
  • "healthieClaimId": "string",
  • "isClaimFound": true,
  • "healthieStatus": "string"
}

Response samples

Content type
No sample

Imports a Healthie patient record into ClaimRev for the current account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Imports a Healthie appointment into ClaimRev as an encounter for the current account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Saves the SOAP note to HCFA field mapping configuration used when importing appointments from Healthie.

Request Body schema:
formName
string or null
Array of objects or null (ClaimRev_Rcm_Integrations_Healthie_Models_Mapping)

Responses

Request samples

Content type
{
  • "formName": "string",
  • "mappings": [
    ]
}

Response samples

Content type
No sample

Searches Healthie for CPT codes matching the supplied keyword.

query Parameters
keyword
string

Responses

Response samples

Content type
No sample

Imports CPT codes matching the supplied keyword from Healthie into ClaimRev for the current account.

query Parameters
keyword
string

Responses

Response samples

Content type
No sample

Searches Healthie for ICD diagnosis codes matching the supplied keyword.

query Parameters
keyword
string

Responses

Response samples

Content type
No sample

Imports ICD codes matching the supplied keyword from Healthie into ClaimRev for the current account.

query Parameters
keyword
string

Responses

Response samples

Content type
No sample

Re-syncs encounter dates across all imported Healthie appointments for the current account, used as a maintenance utility.

query Parameters
keyword
string

Responses

Response samples

Content type
No sample

Re-syncs the encounter date for a single imported Healthie appointment identified by encounter id.

query Parameters
encounterId
integer <int64>

Responses

Response samples

Content type
No sample

Repairs Healthie ERA entries whose matching HCFA claim is missing, using the supplied search criteria.

Request Body schema:
accountNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
isWorked
boolean or null
patientFirstName
string or null
patientLastName
string or null
payerNumber
string or null
patientControlNumber
string or null
checkNumber
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
object (ClaimRevModels_PagingSearchViewModel)
hasFoundRcmClaim
boolean or null
paymentStatusId
integer or null <int32>
isProcessing
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "isWorked": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "payerNumber": "string",
  • "patientControlNumber": "string",
  • "checkNumber": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "pagingSearch": {
    },
  • "hasFoundRcmClaim": true,
  • "paymentStatusId": 0,
  • "isProcessing": true
}

Response samples

Content type
No sample

Repairs a single Healthie ERA entry whose matching HCFA claim is missing.

Request Body schema:
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
healthieClaimId
string or null
isClaimFound
boolean
healthieStatus
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "accountNumber": "string",
  • "receivedDate": "2019-08-24T14:15:22Z",
  • "payerName": "string",
  • "payerNumber": "string",
  • "paymentAdviceStatusId": 0,
  • "paymentInfo": {
    },
  • "checkInformation": {
    },
  • "eraClassification": "string",
  • "healthieClaimId": "string",
  • "isClaimFound": true,
  • "healthieStatus": "string"
}

Response samples

Content type
No sample

Returns a paged reconciliation report comparing Healthie appointments against imported ClaimRev encounters.

Request Body schema:
startDate
string <date-time>
endDate
string <date-time>
patientId
string or null
providerId
string or null
appointmentTypes
Array of strings or null
noteLocked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "patientId": "string",
  • "providerId": "string",
  • "appointmentTypes": [
    ],
  • "noteLocked": true,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Repairs a single Healthie ERA entry identified by the claim control number when its matching HCFA claim is missing.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

InputFile

Post your Edi File to this End Point.

Request Body schema:
accountNumber
string or null
ediFileContent
string or null
base64EdiFileContent
string or null
fileName
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "ediFileContent": "string",
  • "base64EdiFileContent": "string",
  • "fileName": "string"
}

Response samples

Content type
No sample

Returns the list of customer input files matching the search criteria for the caller's account with PHI obfuscated.

Request Body schema:
accountNumber
string or null
receiveStartDate
string or null <date-time>
receiveEndDate
string or null <date-time>
fileStatusId
integer or null <int32>
acknowledgementStatusId
integer or null <int32>
uploadUser
string or null
fileId
string or null
claimAcknowledgementStatusId
integer or null <int32>
fileName
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "receiveStartDate": "2019-08-24T14:15:22Z",
  • "receiveEndDate": "2019-08-24T14:15:22Z",
  • "fileStatusId": 0,
  • "acknowledgementStatusId": 0,
  • "uploadUser": "string",
  • "fileId": "string",
  • "claimAcknowledgementStatusId": 0,
  • "fileName": "string"
}

Response samples

Content type
No sample

Loads a customer input file by id for online viewing, searching across the caller's accessible accounts and obfuscating PHI.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Re-processes a previously uploaded input file (including duplicates) for the caller's account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Mips

Returns the MIPS performance dashboard for the account and performance year. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
performanceYear
integer <int32>
providerNpi
string

Responses

Response samples

Content type
No sample

Returns the MIPS gap analysis report for the account and performance year with PHI obfuscated. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
performanceYear
integer <int32>
providerNpi
string

Responses

Response samples

Content type
No sample

Returns the MIPS provider scorecard for the account and performance year with PHI obfuscated. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
performanceYear
integer <int32>
providerNpi
string

Responses

Response samples

Content type
No sample

Returns the MIPS capture rate report for the account and performance year. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
startDate
string <date-time>
endDate
string <date-time>
performanceYear
integer <int32>
providerNpi
string

Responses

Response samples

Content type
No sample

Returns the current MIPS measure configuration for the account and performance year. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
performanceYear
integer <int32>

Responses

Response samples

Content type
No sample

Enables or disables a MIPS measure for the account. Returns 400 if MipsMeasureId or the resolved AccountNumber is missing.

Request Body schema:
accountNumber
string or null
mipsMeasureId
integer <int32>
isActive
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "mipsMeasureId": 0,
  • "isActive": true
}

Response samples

Content type
No sample

Exports the current MIPS measure configuration as a CSV download. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
performanceYear
integer <int32>

Responses

Response samples

Content type
No sample

Imports a MIPS measure configuration CSV and returns an import summary. Returns 400 if AccountNumber, PerformanceYear, or the CSV file is missing.

query Parameters
accountNumber
string
performanceYear
integer <int32>
Request Body schema: multipart/form-data
file
string <binary>

Responses

Response samples

Content type
No sample

Returns the MIPS gap alerts associated with a claim. Returns 400 if AccountNumber or ClaimId is missing.

path Parameters
claimId
required
string
query Parameters
accountNumber
string

Responses

Response samples

Content type
No sample

Confirms a MIPS gap alert, recording the confirming user and source IP address. Returns 400 if AccountNumber or AlertId is missing.

path Parameters
alertId
required
string
query Parameters
accountNumber
string
Request Body schema:
qualityCode
string or null
isForTracking
boolean

Responses

Request samples

Content type
{
  • "qualityCode": "string",
  • "isForTracking": true
}

Response samples

Content type
No sample

Dismisses a MIPS gap alert, recording the dismissing user and source IP address. Returns 400 if AccountNumber or AlertId is missing.

path Parameters
alertId
required
string
query Parameters
accountNumber
string
Request Body schema:
reason
string or null

Responses

Request samples

Content type
{
  • "reason": "string"
}

Response samples

Content type
No sample

Returns a paged MIPS gap review queue for the account and performance year with PHI obfuscated. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
performanceYear
integer <int32>
page
integer <int32>
Default: 1
pageSize
integer <int32>
Default: 25

Responses

Response samples

Content type
No sample

Returns the MIPS measure flags for a patient within the account. Returns 400 if AccountNumber or PatientAccountNumber is missing.

path Parameters
patientAccountNumber
required
string
query Parameters
accountNumber
string

Responses

Response samples

Content type
No sample

Returns the gap confirmation history for a claim (by TCN) with PHI obfuscated. Returns 400 if AccountNumber or ClaimTcn is missing.

path Parameters
claimTcn
required
string
query Parameters
accountNumber
string

Responses

Response samples

Content type
No sample

Exports a MIPS quality summary as a CSV download. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
performanceYear
integer <int32>
providerNpi
string

Responses

Response samples

Content type
No sample

Exports MIPS claim-level detail as a CSV download. Returns 400 if AccountNumber or PerformanceYear is missing.

query Parameters
accountNumber
string
performanceYear
integer <int32>
providerNpi
string

Responses

Response samples

Content type
No sample

Generates and downloads a QRDA III XML submission for the specified NPI and performance year. Returns 400 if AccountNumber, NPI, or PerformanceYear is missing.

query Parameters
accountNumber
string
npi
string
performanceYear
integer <int32>

Responses

Response samples

Content type
No sample

Generates and downloads a QPP JSON submission for the specified NPI and performance year. Returns 400 if AccountNumber, NPI, or PerformanceYear is missing.

query Parameters
accountNumber
string
npi
string
performanceYear
integer <int32>

Responses

Response samples

Content type
No sample

NcciEdits

Uploads and stores Medicare NCCI PTP (Procedure-to-Procedure) edit files. Requires form fields for effective start date, file type, version, revision, and data start row.

Responses

Response samples

Content type
No sample

Uploads and stores a Medicare NCCI MUE (Medically Unlikely Edits) file. Requires form fields for effective start date, file type, and data start row.

Responses

Response samples

Content type
No sample

Uploads and stores a Medicare NCCI Add-On edit file. Requires form fields for effective start date, data start row, version, and revision.

Responses

Response samples

Content type
No sample

Returns the list of uploaded Medicare NCCI PTP files matching the supplied optional filters.

query Parameters
medicareNcciEditPtpFileId
integer <int32>
ncciPtpEditTypeId
integer <int32>
effectiveStartDate
string <date-time>
effectiveEndDate
string <date-time>
fileVersion
integer <int32>
fileRevision
integer <int32>

Responses

Response samples

Content type
No sample

Returns the list of uploaded Medicare NCCI MUE files matching the supplied optional filters.

query Parameters
ncciPtpEditTypeId
integer <int32>
effectiveStartDate
string <date-time>
effectiveEndDate
string <date-time>

Responses

Response samples

Content type
No sample

Returns the list of uploaded Medicare NCCI Add-On files matching the supplied optional filters.

query Parameters
effectiveStartDate
string <date-time>
effectiveEndDate
string <date-time>
fileVersion
integer <int32>
fileRevision
integer <int32>

Responses

Response samples

Content type
No sample

Evaluates a set of procedure code pairs against Medicare NCCI PTP edits and returns any edits found.

Request Body schema:
dateOfService
string or null <date-time>
ncciPtpEditTypeId
integer <int32>
fileVersion
integer or null <int32>
fileRevision
integer or null <int32>
codes
Array of strings or null
showDeleted
boolean

Responses

Request samples

Content type
{
  • "dateOfService": "2019-08-24T14:15:22Z",
  • "ncciPtpEditTypeId": 0,
  • "fileVersion": 0,
  • "fileRevision": 0,
  • "codes": [
    ],
  • "showDeleted": true
}

Response samples

Content type
No sample

Evaluates a set of procedure code unit checks against Medicare NCCI MUE edits and returns any edits found.

Request Body schema:
Array of objects or null (ClaimRev_Business_NcciEdits_Models_NcciMueEditLookupCheck)
ncciEditTypeId
integer <int32>
ignoreUnits
boolean

Responses

Request samples

Content type
{
  • "mueEditLookupChecks": [
    ],
  • "ncciEditTypeId": 0,
  • "ignoreUnits": true
}

Response samples

Content type
No sample

Evaluates primary/add-on procedure code relationships against Medicare NCCI Add-On edits and returns any edits found.

Request Body schema:
dateOfService
string or null <date-time>
fileVersion
integer or null <int32>
fileRevision
integer or null <int32>
editTypeId
integer <int32>
primaryCode
string or null

Responses

Request samples

Content type
{
  • "dateOfService": "2019-08-24T14:15:22Z",
  • "fileVersion": 0,
  • "fileRevision": 0,
  • "editTypeId": 0,
  • "primaryCode": "string"
}

Response samples

Content type
No sample

Loads and processes a previously uploaded Medicare NCCI PTP file by its storage id supplied in the form body.

Responses

Response samples

Content type
No sample

Loads and processes a previously uploaded Medicare NCCI MUE file by its storage id supplied in the form body.

Responses

Response samples

Content type
No sample

Loads and processes a previously uploaded Medicare NCCI Add-On file by its storage id supplied in the form body.

Responses

Response samples

Content type
No sample

Downloads the current quarter's NCCI files from CMS and loads them, returning a summary of the refresh.

Responses

Response samples

Content type
No sample

Deletes all NCCI edit files loaded for the specified year/quarter. Form body must include a numeric year and a quarter in the range 1-4.

Responses

Response samples

Content type
No sample

NotificationMgmt

Returns the count of unread portal notifications for the current user's default account.

Responses

Response samples

Content type
No sample

Returns the current user's portal notifications, optionally filtered by read status.

query Parameters
isReadFilter
boolean

Responses

Response samples

Content type
No sample

Marks a portal notification as read or unread for the current user.

Request Body schema:
portalNotificationId
integer <int64>
isRead
boolean

Responses

Request samples

Content type
{
  • "portalNotificationId": 0,
  • "isRead": true
}

Marks a portal notification as deleted or restored for the current user.

Request Body schema:
portalNotificationId
integer <int64>
isDeleted
boolean

Responses

Request samples

Content type
{
  • "portalNotificationId": 0,
  • "isDeleted": true
}

Creates a portal notification. Returns 401 Unauthorized when the user lacks permission to use the requested notification type, to broadcast globally, or to target an account other than their own.

Request Body schema:
accountNumber
string or null
messageBodyText
string or null
messageBodyHtml
string or null
messageTitle
string or null
Array of objects or null (ClaimRev_Business_Notification_Models_NotificationRecipient)
notificationType
string or null
object or null
expirationDate
string or null <date-time>
listedUsersOnly
boolean
isGlobal
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "messageBodyText": "string",
  • "messageBodyHtml": "string",
  • "messageTitle": "string",
  • "recipients": [
    ],
  • "notificationType": "string",
  • "templateValues": {
    },
  • "expirationDate": "2019-08-24T14:15:22Z",
  • "listedUsersOnly": true,
  • "isGlobal": true
}

Response samples

Content type
No sample

Returns the list of available notification type list items, scoped by the user's ClaimRev-only permission.

Responses

Response samples

Content type
No sample

Health check that verifies connectivity to the downstream notification webservice.

Responses

Response samples

Content type
No sample

PayerInputFile

Returns claim-level payer acceptance records connected to a single claim transaction and patient control number.

query Parameters
singleClaimTransactionObjectId
string
patientControlNumber
string

Responses

Response samples

Content type
No sample

PayerList

Returns payers matching the supplied search criteria for the public payer directory.

Request Body schema:
payerTypeIds
Array of integers or null <int32> [ items <int32 > ]
transactionTypeIds
Array of integers or null <int32> [ items <int32 > ]
payerName
string or null
payerNumber
string or null
payerState
string or null

Responses

Request samples

Content type
{
  • "payerTypeIds": [
    ],
  • "transactionTypeIds": [
    ],
  • "payerName": "string",
  • "payerNumber": "string",
  • "payerState": "string"
}

Response samples

Content type
No sample

Exports payers matching the supplied search criteria as an Excel (.xlsx) spreadsheet download.

Request Body schema:
payerTypeIds
Array of integers or null <int32> [ items <int32 > ]
transactionTypeIds
Array of integers or null <int32> [ items <int32 > ]
payerName
string or null
payerNumber
string or null
payerState
string or null

Responses

Request samples

Content type
{
  • "payerTypeIds": [
    ],
  • "transactionTypeIds": [
    ],
  • "payerName": "string",
  • "payerNumber": "string",
  • "payerState": "string"
}

Response samples

Content type
No sample

PaymentAdvice

Gets a payment advice (ERA) by id, optionally scoped to a specific claim control number, with PHI obfuscated per user scope. Returns 404 when the advice does not exist or does not belong to the caller's account.

query Parameters
adviceId
string
claimControlNumber
string

Responses

Response samples

Content type
No sample

Gets a single-claim payment advice by id with PHI obfuscated per user scope. Returns 404 when the advice does not exist or does not belong to the caller's account.

query Parameters
adviceId
string

Responses

Response samples

Content type
No sample

Gets the raw ClaimPaymentAdvice associated with an outbound client file. Returns null when the caller has the hide-PHI scope.

query Parameters
id
string

Responses

Response samples

Content type
No sample

Searches payment advice headers using the supplied filter criteria; returns an empty list when the body is null.

Request Body schema:
accountNumber
string or null
checkDateStart
string or null <date-time>
checkDateEnd
string or null <date-time>
checkNumber
string or null
payerNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
paidAmountStart
string or null
paidAmountEnd
string or null
hasPaidAmount
boolean
patientIdentifier
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "checkDateStart": "2019-08-24T14:15:22Z",
  • "checkDateEnd": "2019-08-24T14:15:22Z",
  • "checkNumber": "string",
  • "payerNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "paidAmountStart": "string",
  • "paidAmountEnd": "string",
  • "hasPaidAmount": true,
  • "patientIdentifier": "string"
}

Response samples

Content type
No sample

Searches claim-level payment info aggregations with paging; results have PHI obfuscated per user scope.

Request Body schema:
accountNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
isWorked
boolean or null
patientFirstName
string or null
patientLastName
string or null
payerNumber
string or null
patientControlNumber
string or null
checkNumber
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
object (ClaimRevModels_PagingSearchViewModel)
hasFoundRcmClaim
boolean or null
paymentStatusId
integer or null <int32>
isProcessing
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "isWorked": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "payerNumber": "string",
  • "patientControlNumber": "string",
  • "checkNumber": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "pagingSearch": {
    },
  • "hasFoundRcmClaim": true,
  • "paymentStatusId": 0,
  • "isProcessing": true
}

Response samples

Content type
No sample

Manually links a specific payment-info line within an advice to a specific claim.

Request Body schema:
paymentAdviceId
string or null
paymentInfoId
string or null
claimId
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "paymentInfoId": "string",
  • "claimId": "string"
}

Response samples

Content type
No sample

Toggles the "is worked" flag on a single claim-payment aggregation for the caller's account.

Request Body schema:
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "accountNumber": "string",
  • "receivedDate": "2019-08-24T14:15:22Z",
  • "payerName": "string",
  • "payerNumber": "string",
  • "paymentAdviceStatusId": 0,
  • "paymentInfo": {
    },
  • "checkInformation": {
    },
  • "eraClassification": "string"
}

Response samples

Content type
No sample

Creates a new (typically secondary) claim derived from an existing matched claim + ERA context. Returns 204 when the derived claim could not be produced.

Request Body schema:
paymentAdviceId
string or null
paymentInfoId
string or null
matchedClaimId
string or null
payerId
integer <int32>
payerName
string or null
payerIdentifier
string or null
subscriberLastName
string or null
subscriberFirstName
string or null
subscriberMiddleName
string or null
subscriberSuffix
string or null
subscriberPrimaryIdent
string or null
subscriberAddress1
string or null
subscriberAddress2
string or null
subscriberCity
string or null
subscriberState
string or null
subscriberZip
string or null
subscriberBirthDay
string or null
subscriberGender
string or null
relationshipCode
string or null
policyNumber
string or null
groupName
string or null
insuranceTypeCode
string or null
claimFilingIndicator
string or null
providerSignatureOnFile
string or null
payerResponsibility
string or null
modifyControlNumber
boolean
newControlNumber
string or null
Array of objects or null (ClaimRevModels_ViewModels_ClaimModels_ServiceLineMatchOverride)

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "paymentInfoId": "string",
  • "matchedClaimId": "string",
  • "payerId": 0,
  • "payerName": "string",
  • "payerIdentifier": "string",
  • "subscriberLastName": "string",
  • "subscriberFirstName": "string",
  • "subscriberMiddleName": "string",
  • "subscriberSuffix": "string",
  • "subscriberPrimaryIdent": "string",
  • "subscriberAddress1": "string",
  • "subscriberAddress2": "string",
  • "subscriberCity": "string",
  • "subscriberState": "string",
  • "subscriberZip": "string",
  • "subscriberBirthDay": "string",
  • "subscriberGender": "string",
  • "relationshipCode": "string",
  • "policyNumber": "string",
  • "groupName": "string",
  • "insuranceTypeCode": "string",
  • "claimFilingIndicator": "string",
  • "providerSignatureOnFile": "string",
  • "payerResponsibility": "string",
  • "modifyControlNumber": true,
  • "newControlNumber": "string",
  • "serviceLineMatches": [
    ]
}

Response samples

Content type
No sample

Performs a fuzzy claim search used by the manual-match UI to find candidate claims for a given payment.

Request Body schema:
controlNumber
string or null
fuzzyMatch
boolean
patientLastName
string or null
patientFirstName
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
payerNumber
string or null
referenceDate
string or null <date-time>
withinDays
integer <int32>

Responses

Request samples

Content type
{
  • "controlNumber": "string",
  • "fuzzyMatch": true,
  • "patientLastName": "string",
  • "patientFirstName": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "payerNumber": "string",
  • "referenceDate": "2019-08-24T14:15:22Z",
  • "withinDays": 0
}

Response samples

Content type
No sample

Corrects the control number on a payment-info line so it can match to the intended claim.

Request Body schema:
paymentAdviceId
string or null
paymentInfoId
string or null
correctedControlNumber
string or null
correctedClaimControlNumber
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "paymentInfoId": "string",
  • "correctedControlNumber": "string",
  • "correctedClaimControlNumber": "string"
}

Response samples

Content type
No sample

RealTimeReports

Runs the service-line reconcile report for the requested claim search. Returns a System.Collections.Generic.List`1 of ClaimRevModels.ArBoost.ReportViewModel.PatientServiceLineViewModel or an ClaimRevModels.OutboundClientFileViewModel CSV export when `CsvOutput` is set.

Request Body schema:
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
accountNumber
string or null
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
patientControlNumber
string or null
payerControlNumber
string or null
renderingProviderNpi
string or null
claimStatusId
integer or null <int32>
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
csvOutput
boolean

Responses

Request samples

Content type
{
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "accountNumber": "string",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "patientControlNumber": "string",
  • "payerControlNumber": "string",
  • "renderingProviderNpi": "string",
  • "claimStatusId": 0,
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "csvOutput": true
}

Response samples

Content type
No sample

Returns aggregated claim totals across the requested accounts and month range, with optional grouping by provider, payer, or account. Returns 500 if the aggregation fails.

Request Body schema:
accountNumbers
Array of strings or null
startMonth
string or null <date-time>
endMonth
string or null <date-time>
groupByProvider
boolean
groupByPayer
boolean
groupByAccount
boolean
includeChildAccounts
boolean

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "startMonth": "2019-08-24T14:15:22Z",
  • "endMonth": "2019-08-24T14:15:22Z",
  • "groupByProvider": true,
  • "groupByPayer": true,
  • "groupByAccount": true,
  • "includeChildAccounts": true
}

Response samples

Content type
No sample

Returns aggregated claim totals as a downloadable CSV ClaimRevModels.OutboundClientFileViewModel. Returns 500 if the aggregation fails.

Request Body schema:
accountNumbers
Array of strings or null
startMonth
string or null <date-time>
endMonth
string or null <date-time>
groupByProvider
boolean
groupByPayer
boolean
groupByAccount
boolean
includeChildAccounts
boolean

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "startMonth": "2019-08-24T14:15:22Z",
  • "endMonth": "2019-08-24T14:15:22Z",
  • "groupByProvider": true,
  • "groupByPayer": true,
  • "groupByAccount": true,
  • "includeChildAccounts": true
}

Response samples

Content type
No sample

Returns counts of ERA adjustment reason codes grouped by code, obfuscating PHI before returning.

Request Body schema:
accountNumber
string or null
serviceLineStartDate
string or null <date-time>
serviceLineEndDate
string or null <date-time>
checkDate
string or null <date-time>
checkNumber
string or null
payerNumber
string or null
groupByPayer
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "serviceLineStartDate": "2019-08-24T14:15:22Z",
  • "serviceLineEndDate": "2019-08-24T14:15:22Z",
  • "checkDate": "2019-08-24T14:15:22Z",
  • "checkNumber": "string",
  • "payerNumber": "string",
  • "groupByPayer": true
}

Response samples

Content type
No sample

Returns service-line level detail behind an adjustment reason code group, obfuscating PHI before returning.

Request Body schema:
accountNumber
string or null
adjustmentReasonCode
string or null
payerPaymentAdviceObjectId
string or null
claimObjectId
string or null
patientMemberId
string or null
procedureCode
string or null
modifier
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
checkDate
string or null <date-time>
checkNumber
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "adjustmentReasonCode": "string",
  • "payerPaymentAdviceObjectId": "string",
  • "claimObjectId": "string",
  • "patientMemberId": "string",
  • "procedureCode": "string",
  • "modifier": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "checkDate": "2019-08-24T14:15:22Z",
  • "checkNumber": "string"
}

Response samples

Content type
No sample

Exports the adjustment reason code group detail report as a downloadable CSV file.

Request Body schema:
accountNumber
string or null
adjustmentReasonCode
string or null
payerPaymentAdviceObjectId
string or null
claimObjectId
string or null
patientMemberId
string or null
procedureCode
string or null
modifier
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
checkDate
string or null <date-time>
checkNumber
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "adjustmentReasonCode": "string",
  • "payerPaymentAdviceObjectId": "string",
  • "claimObjectId": "string",
  • "patientMemberId": "string",
  • "procedureCode": "string",
  • "modifier": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "checkDate": "2019-08-24T14:15:22Z",
  • "checkNumber": "string"
}

Response samples

Content type
No sample

Returns the reconciliation summary header for the user's default account.

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns the claim summary grouped by provider for the user's default account.

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns the acceptance and error summary header for the user's default account.

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns chart-ready data for the acceptance and error summary (used to render dashboard charts).

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns the most frequent ClaimRev-generated and payer-generated claim errors for the user's default account.

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns claim counts broken down by day of the week for the user's default account.

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns an aging summary of claims that have been sent but are still awaiting an ERA response.

Responses

Response samples

Content type
No sample

Returns dashboard-level claim status counts for the user's default account matching the supplied search.

Request Body schema:
objectId
string or null
accountNumbers
Array of strings or null
accountNumber
string or null
statusIds
Array of integers or null <int32> [ items <int32 > ]
claimStatusGroup
string or null
excludeStatusIds
Array of integers or null <int32> [ items <int32 > ]
claimAcceptanceStatusId
integer or null <int32>
fileAcceptanceId
integer or null <int32>
claimTypeIds
Array of integers or null <int32> [ items <int32 > ]
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
sharpRevenuePatientId
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientBirthDate
string or null <date-time>
payerPaidAmtStart
number or null <double>
payerPaidAmtEnd
number or null <double>
payerNumber
string or null
payerName
string or null
traceNumber
string or null
traceNumbers
Array of strings or null
workflowId
integer or null <int64>
workflowStatusIds
Array of integers or null <int64> [ items <int64 > ]
workflowEmails
Array of strings or null
inputFileObjectId
string or null
paymentAdviceObjectId
string or null
patientControlNumber
string or null
patientControlNumbers
Array of strings or null
payerControlNumber
string or null
payerControlNumbers
Array of strings or null
paymentAdviceStatusIds
Array of integers or null <int32> [ items <int32 > ]
errorMessage
string or null
dateAggregate
string or null
dayCount
integer <int32>
dayAgeStart
integer or null <int32>
dayAgeEnd
integer or null <int32>
billingProviderNpi
string or null
groupByField
string or null
isWorked
boolean or null
object (ClaimRevModels_PagingSearchViewModel)
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
distinctClaimObjectId
string or null
professionalRcmClaimId
string or null
Array of objects or null (ClaimRevModels_SortingViewModel)
notes
string or null
eraClassifications
Array of strings or null
submittedByEmail
string or null
fuzzyControlNumber
string or null
normalizedControlNumberPattern
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumbers": [
    ],
  • "accountNumber": "string",
  • "statusIds": [
    ],
  • "claimStatusGroup": "string",
  • "excludeStatusIds": [
    ],
  • "claimAcceptanceStatusId": 0,
  • "fileAcceptanceId": 0,
  • "claimTypeIds": [
    ],
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "sharpRevenuePatientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientBirthDate": "2019-08-24T14:15:22Z",
  • "payerPaidAmtStart": 0.1,
  • "payerPaidAmtEnd": 0.1,
  • "payerNumber": "string",
  • "payerName": "string",
  • "traceNumber": "string",
  • "traceNumbers": [
    ],
  • "workflowId": 0,
  • "workflowStatusIds": [
    ],
  • "workflowEmails": [
    ],
  • "inputFileObjectId": "string",
  • "paymentAdviceObjectId": "string",
  • "patientControlNumber": "string",
  • "patientControlNumbers": [
    ],
  • "payerControlNumber": "string",
  • "payerControlNumbers": [
    ],
  • "paymentAdviceStatusIds": [
    ],
  • "errorMessage": "string",
  • "dateAggregate": "string",
  • "dayCount": 0,
  • "dayAgeStart": 0,
  • "dayAgeEnd": 0,
  • "billingProviderNpi": "string",
  • "groupByField": "string",
  • "isWorked": true,
  • "pagingSearch": {
    },
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "distinctClaimObjectId": "string",
  • "professionalRcmClaimId": "string",
  • "sorting": [
    ],
  • "notes": "string",
  • "eraClassifications": [
    ],
  • "submittedByEmail": "string",
  • "fuzzyControlNumber": "string",
  • "normalizedControlNumberPattern": "string"
}

Response samples

Content type
No sample

Returns a combined transaction report across the requested accounts and date range, optionally including child accounts. Returns 500 if the aggregation fails.

Request Body schema:
accountNumbers
Array of strings or null
startMonth
string or null <date-time>
endMonth
string or null <date-time>
groupByProvider
boolean
groupByPayer
boolean
groupByAccount
boolean
includeChildAccounts
boolean

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "startMonth": "2019-08-24T14:15:22Z",
  • "endMonth": "2019-08-24T14:15:22Z",
  • "groupByProvider": true,
  • "groupByPayer": true,
  • "groupByAccount": true,
  • "includeChildAccounts": true
}

Response samples

Content type
No sample

Returns the combined transaction report as a downloadable CSV file. Returns 500 if the aggregation fails.

Request Body schema:
accountNumbers
Array of strings or null
startMonth
string or null <date-time>
endMonth
string or null <date-time>
groupByProvider
boolean
groupByPayer
boolean
groupByAccount
boolean
includeChildAccounts
boolean

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "startMonth": "2019-08-24T14:15:22Z",
  • "endMonth": "2019-08-24T14:15:22Z",
  • "groupByProvider": true,
  • "groupByPayer": true,
  • "groupByAccount": true,
  • "includeChildAccounts": true
}

Response samples

Content type
No sample

Returns a paged ERA claims reconciliation and collection-efficiency report, obfuscating PHI before returning.

Request Body schema:
accountNumber
string or null
serviceLineStartDate
string or null <date-time>
serviceLineEndDate
string or null <date-time>
checkDate
string or null <date-time>
checkNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
percentCollectedStart
integer or null <int32>
percentCollectedEnd
integer or null <int32>
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "serviceLineStartDate": "2019-08-24T14:15:22Z",
  • "serviceLineEndDate": "2019-08-24T14:15:22Z",
  • "checkDate": "2019-08-24T14:15:22Z",
  • "checkNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "percentCollectedStart": 0,
  • "percentCollectedEnd": 0,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Returns the billable transaction counts used for invoicing, either grouped per account or aggregated across all requested accounts.

Request Body schema:
accountNumbers
Array of strings or null
startMonth
string or null <date-time>
endMonth
string or null <date-time>
groupByAccount
boolean
includeChildAccounts
boolean

Responses

Request samples

Content type
{
  • "accountNumbers": [
    ],
  • "startMonth": "2019-08-24T14:15:22Z",
  • "endMonth": "2019-08-24T14:15:22Z",
  • "groupByAccount": true,
  • "includeChildAccounts": true
}

Response samples

Content type
No sample

Exports the ERA claims reconciliation and collection-efficiency report as a downloadable CSV file.

Request Body schema:
accountNumber
string or null
serviceLineStartDate
string or null <date-time>
serviceLineEndDate
string or null <date-time>
checkDate
string or null <date-time>
checkNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
percentCollectedStart
integer or null <int32>
percentCollectedEnd
integer or null <int32>
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "serviceLineStartDate": "2019-08-24T14:15:22Z",
  • "serviceLineEndDate": "2019-08-24T14:15:22Z",
  • "checkDate": "2019-08-24T14:15:22Z",
  • "checkNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "percentCollectedStart": 0,
  • "percentCollectedEnd": 0,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Returns biller notes created in the specified date range (default: last 90 days) for the user's default account.

query Parameters
dateStart
string <date-time>
dateEnd
string <date-time>

Responses

Response samples

Content type
No sample

Returns claim queue counts as pie-chart data for the user's default account.

query Parameters
dateStart
string <date-time>
dateEnd
string <date-time>

Responses

Response samples

Content type
No sample

Returns claim submission efficacy pie-chart data for the user's default account.

query Parameters
dateStart
string <date-time>
dateEnd
string <date-time>

Responses

Response samples

Content type
No sample

Returns a paged procedure-integrity dashboard grouped by month and payer. Defaults to the past 30 days when no dates are supplied.

query Parameters
dateStart
string <date-time>
dateEnd
string <date-time>
onlyWithChanges
boolean
search
string
page
integer <int32>
limit
integer <int32>

Responses

Response samples

Content type
No sample

Returns paged procedure-integrity line-level detail for a specific ERA.

Request Body schema:
accountNumber
string or null
eraIds
Array of strings or null
page
integer <int32>
limit
integer <int32>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "eraIds": [
    ],
  • "page": 0,
  • "limit": 0
}

Response samples

Content type
No sample

RepricingManagement

Downloads any new repricing input files from the sender's bucket. Returns false on exception.

query Parameters
senderId
string

Responses

Response samples

Content type
No sample

Polls the payer's SFTP gateway for new report files and imports them. Returns false on exception.

query Parameters
payerId
integer <int64>

Responses

Response samples

Content type
No sample

Returns the number of files waiting on the payer's SFTP gateway, or -1 on exception.

query Parameters
payerId
integer <int64>

Responses

Response samples

Content type
No sample

Parses repricing input files that are in a Ready state. Returns false on exception.

query Parameters
senderId
string

Responses

Response samples

Content type
No sample

Merges repriced claims into outbound payer files and sends them. Returns false on exception.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Sends queued outbound files for the specified payer. Returns false on exception.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Searches repricing claims for the user's default account and returns a paged result.

Request Body schema:
objectId
string or null
accountNumber
string or null
receivedStartDate
string or null <date-time>
receivedEndDate
string or null <date-time>
claimStatusId
Array of integers or null <int32> (ClaimRevModels_Enums_RepricerClaimStatus) [ items <int32 > ]
Enum: "Ready" "PatientMatch" "PatientMatchFailed" "ValidationCheck" "Reprice" "ManualReprice" "Audit" "AuthorizationHold" "ReadyToSend" "MergedToPayer" "SentToPayer" "Error" "Reprocess" "TagClaim" "Void" "ReportOnly" "Embeddings" "SendToClearingHouse" "SendToNivonyx" "UndoClaim" "AutoReprice" "Duplicate" "SendToExternalRepricer" "ManualSendToExternalRepricer"
clientGroupNumber
string or null
clientGroupName
string or null
benefitCode
string or null
isTribal
string or null
memberId
integer or null <int64>
memberFirstName
string or null
memberLastName
string or null
payerControlNumber
string or null
repricingControlNumber
string or null
object (ClaimRevModels_PagingSearchViewModel)
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
queueId
integer or null <int64>
textSearch
string or null
textSearchIsVector
boolean
textSearchVectorMinScore
number or null <double>
textSearchVectorLimit
integer or null <int32>
billingTaxId
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumber": "string",
  • "receivedStartDate": "2019-08-24T14:15:22Z",
  • "receivedEndDate": "2019-08-24T14:15:22Z",
  • "claimStatusId": [
    ],
  • "clientGroupNumber": "string",
  • "clientGroupName": "string",
  • "benefitCode": "string",
  • "isTribal": "string",
  • "memberId": 0,
  • "memberFirstName": "string",
  • "memberLastName": "string",
  • "payerControlNumber": "string",
  • "repricingControlNumber": "string",
  • "pagingSearch": {
    },
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "queueId": 0,
  • "textSearch": "string",
  • "textSearchIsVector": true,
  • "textSearchVectorMinScore": 0.1,
  • "textSearchVectorLimit": 0,
  • "billingTaxId": "string"
}

Response samples

Content type
No sample

Searches repricing claims and returns the result as a downloadable CSV file.

Request Body schema:
objectId
string or null
accountNumber
string or null
receivedStartDate
string or null <date-time>
receivedEndDate
string or null <date-time>
claimStatusId
Array of integers or null <int32> (ClaimRevModels_Enums_RepricerClaimStatus) [ items <int32 > ]
Enum: "Ready" "PatientMatch" "PatientMatchFailed" "ValidationCheck" "Reprice" "ManualReprice" "Audit" "AuthorizationHold" "ReadyToSend" "MergedToPayer" "SentToPayer" "Error" "Reprocess" "TagClaim" "Void" "ReportOnly" "Embeddings" "SendToClearingHouse" "SendToNivonyx" "UndoClaim" "AutoReprice" "Duplicate" "SendToExternalRepricer" "ManualSendToExternalRepricer"
clientGroupNumber
string or null
clientGroupName
string or null
benefitCode
string or null
isTribal
string or null
memberId
integer or null <int64>
memberFirstName
string or null
memberLastName
string or null
payerControlNumber
string or null
repricingControlNumber
string or null
object (ClaimRevModels_PagingSearchViewModel)
tagIds
Array of integers or null <int64> [ items <int64 > ]
excludeTagIds
Array of integers or null <int64> [ items <int64 > ]
queueId
integer or null <int64>
textSearch
string or null
textSearchIsVector
boolean
textSearchVectorMinScore
number or null <double>
textSearchVectorLimit
integer or null <int32>
billingTaxId
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumber": "string",
  • "receivedStartDate": "2019-08-24T14:15:22Z",
  • "receivedEndDate": "2019-08-24T14:15:22Z",
  • "claimStatusId": [
    ],
  • "clientGroupNumber": "string",
  • "clientGroupName": "string",
  • "benefitCode": "string",
  • "isTribal": "string",
  • "memberId": 0,
  • "memberFirstName": "string",
  • "memberLastName": "string",
  • "payerControlNumber": "string",
  • "repricingControlNumber": "string",
  • "pagingSearch": {
    },
  • "tagIds": [
    ],
  • "excludeTagIds": [
    ],
  • "queueId": 0,
  • "textSearch": "string",
  • "textSearchIsVector": true,
  • "textSearchVectorMinScore": 0.1,
  • "textSearchVectorLimit": 0,
  • "billingTaxId": "string"
}

Response samples

Content type
No sample

Refreshes cached claim data (member/policy lookups) for a claim by object id.

query Parameters
objectId
string

Responses

Response samples

Content type
No sample

Updates a repricing claim to the requested status.

query Parameters
objectId
string
statusId
integer <int32>

Responses

Response samples

Content type
No sample

Reprocesses the given repricing claim through the pricing pipeline.

query Parameters
objectId
string

Responses

Response samples

Content type
No sample

Undoes a repricing decision on a claim, returning it to an unprocessed state.

query Parameters
objectId
string

Responses

Response samples

Content type
No sample

Saves repricing decisions for a claim without changing the send state.

Request Body schema:
claimObjectId
string or null
transactionNumber
string or null
patientClaimControlNumber
string or null
subscriberIsPatient
boolean
object (ClaimRevModels_Repricing_RepricingInfo)
object (ClaimRevModels_Repricing_RepricingInfo)
Array of objects or null (ClaimRev_Repricing_Models_ServiceLineRepriceViewModel)
payerControlNumber
string or null
claimRevControlNumber
string or null
otherControlNumber
string or null
claimStatus
string or null
claimType
string or null
product
string or null
group
string or null
planId
string or null
planName
string or null
effectiveStartDate
string or null <date-time>
effectiveEndDate
string or null <date-time>
oic
string or null
memberId
string or null
memberPrimaryKey
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientDob
string or null <date-time>
patientTribal
string or null
patientPrcEligible
string or null
payerNumber
string or null
payerName
string or null
billingProviderNpi
string or null
billingProviderTaxId
string or null
billingProviderFirstName
string or null
billingProviderLastName
string or null
billingProviderAddress
string or null
billingProviderCity
string or null
billingProviderState
string or null
billingProviderZip
string or null
claimAmount
number or null <double>
networkSource
string or null
intermediateControlNumber
string or null
diagnosisRelatedGroup
string or null
Array of objects or null (ClaimRev_Repricing_Models_DiagnosisCodeView)
otherInsurances
Array of strings or null
billType
string or null
object (ClaimRevModels_ClaimNote)
caseId
string or null

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "transactionNumber": "string",
  • "patientClaimControlNumber": "string",
  • "subscriberIsPatient": true,
  • "repricing": {
    },
  • "previousRepricing": {
    },
  • "services": [
    ],
  • "payerControlNumber": "string",
  • "claimRevControlNumber": "string",
  • "otherControlNumber": "string",
  • "claimStatus": "string",
  • "claimType": "string",
  • "product": "string",
  • "group": "string",
  • "planId": "string",
  • "planName": "string",
  • "effectiveStartDate": "2019-08-24T14:15:22Z",
  • "effectiveEndDate": "2019-08-24T14:15:22Z",
  • "oic": "string",
  • "memberId": "string",
  • "memberPrimaryKey": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "patientTribal": "string",
  • "patientPrcEligible": "string",
  • "payerNumber": "string",
  • "payerName": "string",
  • "billingProviderNpi": "string",
  • "billingProviderTaxId": "string",
  • "billingProviderFirstName": "string",
  • "billingProviderLastName": "string",
  • "billingProviderAddress": "string",
  • "billingProviderCity": "string",
  • "billingProviderState": "string",
  • "billingProviderZip": "string",
  • "claimAmount": 0.1,
  • "networkSource": "string",
  • "intermediateControlNumber": "string",
  • "diagnosisRelatedGroup": "string",
  • "diagnosisCodes": [
    ],
  • "otherInsurances": [
    ],
  • "billType": "string",
  • "markToSendNote": {
    },
  • "caseId": "string"
}

Response samples

Content type
No sample

Saves repricing decisions for a claim and marks it as ready to send.

Request Body schema:
claimObjectId
string or null
transactionNumber
string or null
patientClaimControlNumber
string or null
subscriberIsPatient
boolean
object (ClaimRevModels_Repricing_RepricingInfo)
object (ClaimRevModels_Repricing_RepricingInfo)
Array of objects or null (ClaimRev_Repricing_Models_ServiceLineRepriceViewModel)
payerControlNumber
string or null
claimRevControlNumber
string or null
otherControlNumber
string or null
claimStatus
string or null
claimType
string or null
product
string or null
group
string or null
planId
string or null
planName
string or null
effectiveStartDate
string or null <date-time>
effectiveEndDate
string or null <date-time>
oic
string or null
memberId
string or null
memberPrimaryKey
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientDob
string or null <date-time>
patientTribal
string or null
patientPrcEligible
string or null
payerNumber
string or null
payerName
string or null
billingProviderNpi
string or null
billingProviderTaxId
string or null
billingProviderFirstName
string or null
billingProviderLastName
string or null
billingProviderAddress
string or null
billingProviderCity
string or null
billingProviderState
string or null
billingProviderZip
string or null
claimAmount
number or null <double>
networkSource
string or null
intermediateControlNumber
string or null
diagnosisRelatedGroup
string or null
Array of objects or null (ClaimRev_Repricing_Models_DiagnosisCodeView)
otherInsurances
Array of strings or null
billType
string or null
object (ClaimRevModels_ClaimNote)
caseId
string or null

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "transactionNumber": "string",
  • "patientClaimControlNumber": "string",
  • "subscriberIsPatient": true,
  • "repricing": {
    },
  • "previousRepricing": {
    },
  • "services": [
    ],
  • "payerControlNumber": "string",
  • "claimRevControlNumber": "string",
  • "otherControlNumber": "string",
  • "claimStatus": "string",
  • "claimType": "string",
  • "product": "string",
  • "group": "string",
  • "planId": "string",
  • "planName": "string",
  • "effectiveStartDate": "2019-08-24T14:15:22Z",
  • "effectiveEndDate": "2019-08-24T14:15:22Z",
  • "oic": "string",
  • "memberId": "string",
  • "memberPrimaryKey": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "patientTribal": "string",
  • "patientPrcEligible": "string",
  • "payerNumber": "string",
  • "payerName": "string",
  • "billingProviderNpi": "string",
  • "billingProviderTaxId": "string",
  • "billingProviderFirstName": "string",
  • "billingProviderLastName": "string",
  • "billingProviderAddress": "string",
  • "billingProviderCity": "string",
  • "billingProviderState": "string",
  • "billingProviderZip": "string",
  • "claimAmount": 0.1,
  • "networkSource": "string",
  • "intermediateControlNumber": "string",
  • "diagnosisRelatedGroup": "string",
  • "diagnosisCodes": [
    ],
  • "otherInsurances": [
    ],
  • "billType": "string",
  • "markToSendNote": {
    },
  • "caseId": "string"
}

Response samples

Content type
No sample

Flags a claim as a duplicate and updates its status accordingly.

Request Body schema:
claimObjectId
string or null
transactionNumber
string or null
patientClaimControlNumber
string or null
subscriberIsPatient
boolean
object (ClaimRevModels_Repricing_RepricingInfo)
object (ClaimRevModels_Repricing_RepricingInfo)
Array of objects or null (ClaimRev_Repricing_Models_ServiceLineRepriceViewModel)
payerControlNumber
string or null
claimRevControlNumber
string or null
otherControlNumber
string or null
claimStatus
string or null
claimType
string or null
product
string or null
group
string or null
planId
string or null
planName
string or null
effectiveStartDate
string or null <date-time>
effectiveEndDate
string or null <date-time>
oic
string or null
memberId
string or null
memberPrimaryKey
integer or null <int64>
patientFirstName
string or null
patientLastName
string or null
patientDob
string or null <date-time>
patientTribal
string or null
patientPrcEligible
string or null
payerNumber
string or null
payerName
string or null
billingProviderNpi
string or null
billingProviderTaxId
string or null
billingProviderFirstName
string or null
billingProviderLastName
string or null
billingProviderAddress
string or null
billingProviderCity
string or null
billingProviderState
string or null
billingProviderZip
string or null
claimAmount
number or null <double>
networkSource
string or null
intermediateControlNumber
string or null
diagnosisRelatedGroup
string or null
Array of objects or null (ClaimRev_Repricing_Models_DiagnosisCodeView)
otherInsurances
Array of strings or null
billType
string or null
object (ClaimRevModels_ClaimNote)
caseId
string or null

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "transactionNumber": "string",
  • "patientClaimControlNumber": "string",
  • "subscriberIsPatient": true,
  • "repricing": {
    },
  • "previousRepricing": {
    },
  • "services": [
    ],
  • "payerControlNumber": "string",
  • "claimRevControlNumber": "string",
  • "otherControlNumber": "string",
  • "claimStatus": "string",
  • "claimType": "string",
  • "product": "string",
  • "group": "string",
  • "planId": "string",
  • "planName": "string",
  • "effectiveStartDate": "2019-08-24T14:15:22Z",
  • "effectiveEndDate": "2019-08-24T14:15:22Z",
  • "oic": "string",
  • "memberId": "string",
  • "memberPrimaryKey": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "patientTribal": "string",
  • "patientPrcEligible": "string",
  • "payerNumber": "string",
  • "payerName": "string",
  • "billingProviderNpi": "string",
  • "billingProviderTaxId": "string",
  • "billingProviderFirstName": "string",
  • "billingProviderLastName": "string",
  • "billingProviderAddress": "string",
  • "billingProviderCity": "string",
  • "billingProviderState": "string",
  • "billingProviderZip": "string",
  • "claimAmount": 0.1,
  • "networkSource": "string",
  • "intermediateControlNumber": "string",
  • "diagnosisRelatedGroup": "string",
  • "diagnosisCodes": [
    ],
  • "otherInsurances": [
    ],
  • "billType": "string",
  • "markToSendNote": {
    },
  • "caseId": "string"
}

Response samples

Content type
No sample

Returns the repricing-decision view model for the given claim, refreshing cached data first.

query Parameters
claimObjectId
string

Responses

Response samples

Content type
No sample

Searches repricing members scoped to the user's default account.

Request Body schema:
accountNumber
string or null
memberNumber
string or null
subscriberNumber
string or null
firstName
string or null
lastName
string or null
state
string or null
city
string or null
isTribal
string or null
benefitCode
string or null
termed
string or null
clientGroupNumber
string or null
networkId
integer or null <int32>
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "memberNumber": "string",
  • "subscriberNumber": "string",
  • "firstName": "string",
  • "lastName": "string",
  • "state": "string",
  • "city": "string",
  • "isTribal": "string",
  • "benefitCode": "string",
  • "termed": "string",
  • "clientGroupNumber": "string",
  • "networkId": 0,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Exports a member search as a downloadable CSV file.

Request Body schema:
accountNumber
string or null
memberNumber
string or null
subscriberNumber
string or null
firstName
string or null
lastName
string or null
state
string or null
city
string or null
isTribal
string or null
benefitCode
string or null
termed
string or null
clientGroupNumber
string or null
networkId
integer or null <int32>
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "memberNumber": "string",
  • "subscriberNumber": "string",
  • "firstName": "string",
  • "lastName": "string",
  • "state": "string",
  • "city": "string",
  • "isTribal": "string",
  • "benefitCode": "string",
  • "termed": "string",
  • "clientGroupNumber": "string",
  • "networkId": 0,
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Adds or updates a repricing member and reprocesses claims linked to them.

Request Body schema:
memberId
integer or null <int64>
accountNumber
string or null
memberNumber
string or null
subscriberNumber
string or null
relationshipId
integer or null <int32>
ssn
string or null
firstName
string or null
middleName
string or null
lastName
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zip
string or null
dob
string or null <date-time>
genderId
integer or null <int32>
isTribal
boolean or null
createDate
string or null <date-time>
createUser
string or null
updateUser
string or null
lastUpdateDate
string or null <date-time>
tribalStatusDate
string or null <date-time>
isTribalOther
boolean or null
tribalStatusOtherDate
string or null <date-time>
isTribalDual
boolean or null
tribalStatusDualDate
string or null <date-time>
isPrc
boolean or null
prcStatusDate
string or null <date-time>
emailAddress
string or null
phoneNumber
string or null
isHandicapped
boolean or null
hireDate
string or null <date-time>
hoursPerWeek
integer or null <int32>
dataSoureNetworkId
integer or null <int32>

Responses

Request samples

Content type
{
  • "memberId": 0,
  • "accountNumber": "string",
  • "memberNumber": "string",
  • "subscriberNumber": "string",
  • "relationshipId": 0,
  • "ssn": "string",
  • "firstName": "string",
  • "middleName": "string",
  • "lastName": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zip": "string",
  • "dob": "2019-08-24T14:15:22Z",
  • "genderId": 0,
  • "isTribal": true,
  • "createDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "updateUser": "string",
  • "lastUpdateDate": "2019-08-24T14:15:22Z",
  • "tribalStatusDate": "2019-08-24T14:15:22Z",
  • "isTribalOther": true,
  • "tribalStatusOtherDate": "2019-08-24T14:15:22Z",
  • "isTribalDual": true,
  • "tribalStatusDualDate": "2019-08-24T14:15:22Z",
  • "isPrc": true,
  • "prcStatusDate": "2019-08-24T14:15:22Z",
  • "emailAddress": "string",
  • "phoneNumber": "string",
  • "isHandicapped": true,
  • "hireDate": "2019-08-24T14:15:22Z",
  • "hoursPerWeek": 0,
  • "dataSoureNetworkId": 0
}

Response samples

Content type
No sample

Returns the repricing member with the given id scoped to the user's default account.

query Parameters
memberId
integer <int64>

Responses

Response samples

Content type
No sample

Returns the list of available benefits for dropdown selection.

Responses

Response samples

Content type
No sample

Searches insurance policies for the user's default account.

Request Body schema:
accountNumber
string or null
subscriberNumber
string or null
coverageStartDate
string or null <date-time>
coverageEndDate
string or null <date-time>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "subscriberNumber": "string",
  • "coverageStartDate": "2019-08-24T14:15:22Z",
  • "coverageEndDate": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Adds or updates an insurance policy and returns its id.

Request Body schema:
subscriberNumber
string or null
accountNumber
string or null
insurancePolicyId
integer <int64>
planInformationId
integer <int32>
subscriberId
integer or null <int64>
coverageStartDate
string <date-time>
coverageEndDate
string or null <date-time>
clientGroupId
integer or null <int32>
datasourceNetworkId
integer or null <int32>
coverageTypeId
integer or null <int32>
isCobra
boolean
productTypeId
integer or null <int32>
benefitPlanCode
string or null

Responses

Request samples

Content type
{
  • "subscriberNumber": "string",
  • "accountNumber": "string",
  • "insurancePolicyId": 0,
  • "planInformationId": 0,
  • "subscriberId": 0,
  • "coverageStartDate": "2019-08-24T14:15:22Z",
  • "coverageEndDate": "2019-08-24T14:15:22Z",
  • "clientGroupId": 0,
  • "datasourceNetworkId": 0,
  • "coverageTypeId": 0,
  • "isCobra": true,
  • "productTypeId": 0,
  • "benefitPlanCode": "string"
}

Response samples

Content type
No sample

Returns the editor view model for an insurance policy.

query Parameters
insurancePolicyId
integer <int64>

Responses

Response samples

Content type
No sample

Searches other-coverage records for the user's default account.

Request Body schema:
memberNumber
string or null
accountNumber
string or null

Responses

Request samples

Content type
{
  • "memberNumber": "string",
  • "accountNumber": "string"
}

Response samples

Content type
No sample

Soft-deletes an other-coverage record by id.

Request Body schema:
otherCoverageId
integer <int64>
memberId
integer <int64>
insuranceResponsibilityName
string or null
payerName
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
isDeleted
boolean

Responses

Request samples

Content type
{
  • "otherCoverageId": 0,
  • "memberId": 0,
  • "insuranceResponsibilityName": "string",
  • "payerName": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "isDeleted": true
}

Response samples

Content type
No sample

Returns the editor view model for an other-coverage record.

query Parameters
otherCoverageId
integer <int64>

Responses

Response samples

Content type
No sample

Adds or updates an other-coverage record and returns its id.

Request Body schema:
accountNumber
string or null
otherCoverageId
integer <int64>
memberNumber
string or null
insuranceResponsibilityId
integer or null <int32>
payerName
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
comments
string or null
isDeleted
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "otherCoverageId": 0,
  • "memberNumber": "string",
  • "insuranceResponsibilityId": 0,
  • "payerName": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "comments": "string",
  • "isDeleted": true
}

Response samples

Content type
No sample

Searches plan information for the repricing editor.

Request Body schema:
planInformationId
integer or null <int32>
clientGroupId
integer or null <int32>
benefitPlanId
integer or null <int32>
planTypeId
integer or null <int32>
productTypeId
integer or null <int32>
planName
string or null
planDescription
string or null

Responses

Request samples

Content type
{
  • "planInformationId": 0,
  • "clientGroupId": 0,
  • "benefitPlanId": 0,
  • "planTypeId": 0,
  • "productTypeId": 0,
  • "planName": "string",
  • "planDescription": "string"
}

Response samples

Content type
No sample

Returns the coverage-type dropdown list.

Responses

Response samples

Content type
No sample

Returns the client-group dropdown list.

Responses

Response samples

Content type
No sample

Returns the client-group-number dropdown list.

Responses

Response samples

Content type
No sample

Returns the data-source-network dropdown list.

Responses

Response samples

Content type
No sample

Returns the insurance-responsibility dropdown list.

Responses

Response samples

Content type
No sample

Returns the product-type dropdown list.

Responses

Response samples

Content type
No sample

Returns the list of repricing claim statuses for UI filters.

Responses

Response samples

Content type
No sample

Returns a repricing payer by id.

query Parameters
payerId
integer <int64>

Responses

Response samples

Content type
No sample

Adds or updates a repricing payer and returns its id.

Request Body schema:
payerId
integer or null <int64>
submitterId
string or null
payerName
string or null
supportContactName
string or null
supportContactPhone
string or null
supportContactEmail
string or null
sendProtocolId
integer or null <int32>
sendConfigJson
string or null
notes
string or null
passwordExpireDate
string or null <date-time>
dataSourceNetworkId
integer or null <int32>
createAdjudicationCase
boolean

Responses

Request samples

Content type
{
  • "payerId": 0,
  • "submitterId": "string",
  • "payerName": "string",
  • "supportContactName": "string",
  • "supportContactPhone": "string",
  • "supportContactEmail": "string",
  • "sendProtocolId": 0,
  • "sendConfigJson": "string",
  • "notes": "string",
  • "passwordExpireDate": "2019-08-24T14:15:22Z",
  • "dataSourceNetworkId": 0,
  • "createAdjudicationCase": true
}

Response samples

Content type
No sample

Searches repricing payers.

Request Body schema:
payerId
integer or null <int64>
payerName
string or null

Responses

Request samples

Content type
{
  • "payerId": 0,
  • "payerName": "string"
}

Response samples

Content type
No sample

Returns the send-protocol dropdown list for payer configuration.

Responses

Response samples

Content type
No sample

Returns claim counts grouped by benefit plan for the user's default account.

Responses

Response samples

Content type
No sample

Returns the detail rows behind a benefit-plan/status group-count bucket.

query Parameters
benefitPlanCode
string
statusId
integer <int32>

Responses

Response samples

Content type
No sample

Re-tags claims for queue assignment across the user's default account.

Responses

Response samples

Content type
No sample

Runs the JSC/JST authorization-hold report for the user's default account.

Responses

Response samples

Content type
No sample

Exports the JSC/JST authorization-hold report as a downloadable CSV file.

Responses

Response samples

Content type
No sample

Returns counts per claim queue for the user's default account.

Responses

Response samples

Content type
No sample

Returns the detail rows for a specific claim queue.

query Parameters
claimQueueId
integer <int64>

Responses

Response samples

Content type
No sample

Moves a claim to a different queue (requires the repricing:change-queue policy).

query Parameters
claimObjectId
string
queueId
integer <int64>

Responses

Response samples

Content type
No sample

Runs the client-group eligibility report for the specified client group.

query Parameters
clientGroup
string

Responses

Response samples

Content type
No sample

Exports the client-group eligibility report as a downloadable CSV file.

query Parameters
clientGroup
string

Responses

Response samples

Content type
No sample

Runs the repricing-processed report across the user's default account using the supplied filters.

query Parameters
benefitPlanCode
string
receivedStartDateTime
string <date-time>
receivedEndDateTime
string <date-time>
sentStartDateTime
string <date-time>
sentEndDateTime
string <date-time>
serviceStartDateTime
string <date-time>
serviceEndDateTime
string <date-time>
EdiType
integer <int32> (ClaimRevModels_Enums_TransactionType)
Enum: "ProfessionalClaims" "InstitutionalClaims" "DentalClaims" "ImplementAck" "ClaimAcceptance277" "AdditionalInformation275" "PaymentAdvice835" "EligibilityRequest270" "ClaimStatusRequest276" "ClaimStatusResponse277" "ZollEligibilityRequest270" "RealTimeClaimStatusCheck" "AdditionalInformationRequest277"

Responses

Response samples

Content type
No sample

Exports the repricing-processed report as a downloadable CSV file.

query Parameters
benefitPlanCode
string
receivedStartDateTime
string <date-time>
receivedEndDateTime
string <date-time>
sentStartDateTime
string <date-time>
sentEndDateTime
string <date-time>
serviceStartDateTime
string <date-time>
serviceEndDateTime
string <date-time>
EdiType
integer <int32> (ClaimRevModels_Enums_TransactionType)
Enum: "ProfessionalClaims" "InstitutionalClaims" "DentalClaims" "ImplementAck" "ClaimAcceptance277" "AdditionalInformation275" "PaymentAdvice835" "EligibilityRequest270" "ClaimStatusRequest276" "ClaimStatusResponse277" "ZollEligibilityRequest270" "RealTimeClaimStatusCheck" "AdditionalInformationRequest277"

Responses

Response samples

Content type
No sample

Sends the specified repriced claim to the clearinghouse.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Sends the specified claim to the Nivonyx external repricer.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Adds a note to a repricing claim.

Request Body schema:
claimObjectId
string or null
noteText
string or null

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "noteText": "string"
}

Response samples

Content type
No sample

Returns notes attached to a repricing claim; returns 404 when the claim is not found.

query Parameters
objectId
string

Responses

Response samples

Content type
No sample

Searches repricing input files scoped to the user's default repricer account.

Request Body schema:
statusId
integer <int32> (ClaimRevModels_Enums_RepricerInputFileStatus)
Enum: "Ready" "Complete" "Error" "Duplicate" "Processing"
submitterId
string or null
fileName
string or null
receivedStartDate
string or null <date-time>
receivedEndDate
string or null <date-time>
rePricerAccountNumber
string or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "statusId": "Ready",
  • "submitterId": "string",
  • "fileName": "string",
  • "receivedStartDate": "2019-08-24T14:15:22Z",
  • "receivedEndDate": "2019-08-24T14:15:22Z",
  • "rePricerAccountNumber": "string",
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Updates the processing status of a repricing input file.

Request Body schema:
mongoId
string or null
statusId
integer <int32> (ClaimRevModels_Enums_RepricerInputFileStatus)
Enum: "Ready" "Complete" "Error" "Duplicate" "Processing"

Responses

Request samples

Content type
{
  • "mongoId": "string",
  • "statusId": "Ready"
}

Response samples

Content type
No sample

Queues a repricing input file for reprocessing.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Uploads a repricing input file (EDI or other supported format) for processing.

Request Body schema: multipart/form-data
file
string <binary>
submitterId
string
fileType
string
Default: "edi"

Responses

Response samples

Content type
No sample

Returns the text content of a repricing input file; returns 404 when missing or 500 on error.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Searches repricing outbound files scoped to the user's default account.

Request Body schema:
fileStatusId
integer <int32> (ClaimRevModels_Enums_FileStatus)
Enum: "Ready" "Sent" "InProcess" "Error" "AcceptedAtPayer" "FunctionalGroupError" "TransactionError" "Void"
submitterId
string or null
receiverId
string or null
fileName
string or null
createStartDate
string or null <date-time>
createEndDate
string or null <date-time>
accountNumber
string or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "fileStatusId": "Ready",
  • "submitterId": "string",
  • "receiverId": "string",
  • "fileName": "string",
  • "createStartDate": "2019-08-24T14:15:22Z",
  • "createEndDate": "2019-08-24T14:15:22Z",
  • "accountNumber": "string",
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Updates the processing status of a repricing outbound file.

Request Body schema:
mongoId
string or null
fileStatusId
integer <int32> (ClaimRevModels_Enums_FileStatus)
Enum: "Ready" "Sent" "InProcess" "Error" "AcceptedAtPayer" "FunctionalGroupError" "TransactionError" "Void"

Responses

Request samples

Content type
{
  • "mongoId": "string",
  • "fileStatusId": "Ready"
}

Response samples

Content type
No sample

Returns the text content of a repricing outbound file; returns 404 when missing or 500 on error.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Returns monthly outbound file counts for the user's default account.

Responses

Response samples

Content type
No sample

Returns the claim case linked to the given claim object id; 400 on invalid id, 404 if not found.

path Parameters
claimObjectId
required
string

Responses

Response samples

Content type
No sample

Updates the review outcome for a specific repricing attempt on a claim case; returns 400 or 404 when invalid.

Request Body schema:
caseId
string or null
attemptNumber
integer <int32>
reviewStatus
string or null
reviewedBy
string or null
reviewNotes
string or null

Responses

Request samples

Content type
{
  • "caseId": "string",
  • "attemptNumber": 0,
  • "reviewStatus": "string",
  • "reviewedBy": "string",
  • "reviewNotes": "string"
}

Response samples

Content type
No sample

Records the final disposition decision for a claim case; returns 400 or 404 when invalid.

Request Body schema:
caseId
string or null
status
string or null
approvedAmount
number or null <double>
selectedAttempt
integer or null <int32>
decisionBy
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "caseId": "string",
  • "status": "string",
  • "approvedAmount": 0.1,
  • "selectedAttempt": 0,
  • "decisionBy": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns external repricer preferences available to route a given submitter's claims to.

path Parameters
submitterId
required
string

Responses

Response samples

Content type
No sample

Sends a claim to the specified external repricer and returns the updated claim case; returns 400 or 404 when invalid.

Request Body schema:
claimObjectId
string or null
repricerId
integer <int64>

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "repricerId": 0
}

Response samples

Content type
No sample

Retries a specific repricing attempt for a claim; returns 400 or 404 when invalid.

Request Body schema:
claimObjectId
string or null
attemptNumber
integer <int32>

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "attemptNumber": 0
}

Response samples

Content type
No sample

Returns the seed data needed to create a patient from an existing claim; returns 404 when unavailable.

path Parameters
claimObjectId
required
string

Responses

Response samples

Content type
No sample

Returns the plan information configured for a given client group.

path Parameters
clientGroupId
required
integer <int32>

Responses

Response samples

Content type
No sample

Creates a repricing patient (member, policy, and optionally other coverage) from an existing claim.

Request Body schema:
claimObjectId
string or null
firstName
string or null
middleName
string or null
lastName
string or null
dob
string or null <date-time>
genderId
integer or null <int32>
memberNumber
string or null
subscriberNumber
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
relationshipId
integer or null <int32>
address1
string or null
address2
string or null
city
string or null
state
string or null
zip
string or null
clientGroupId
integer or null <int32>
productTypeId
integer or null <int32>
benefitPlanCode
string or null
planInformationId
integer or null <int32>
coverageTypeId
integer or null <int32>
coverageStartDate
string <date-time>
coverageEndDate
string or null <date-time>
isCobra
boolean

Responses

Request samples

Content type
{
  • "claimObjectId": "string",
  • "firstName": "string",
  • "middleName": "string",
  • "lastName": "string",
  • "dob": "2019-08-24T14:15:22Z",
  • "genderId": 0,
  • "memberNumber": "string",
  • "subscriberNumber": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "relationshipId": 0,
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zip": "string",
  • "clientGroupId": 0,
  • "productTypeId": 0,
  • "benefitPlanCode": "string",
  • "planInformationId": 0,
  • "coverageTypeId": 0,
  • "coverageStartDate": "2019-08-24T14:15:22Z",
  • "coverageEndDate": "2019-08-24T14:15:22Z",
  • "isCobra": true
}

Response samples

Content type
No sample

RuleManager

Returns an empty rule set template for the editor.

Responses

Response samples

Content type
No sample

Returns an empty rule-condition template for the editor.

Responses

Response samples

Content type
No sample

Returns an empty rule-segment template for the editor.

Responses

Response samples

Content type
No sample

Returns an empty rule value edit template for the editor.

Responses

Response samples

Content type
No sample

Returns all rule sets for the user's default account (shallow load).

Responses

Response samples

Content type
No sample

Returns a rule set by id, scoped to the accounts connected to the caller's email.

query Parameters
ruleSetId
integer <int64>

Responses

Response samples

Content type
No sample

Saves a rule set and returns its id, or 0 if the save produced no rule.

Request Body schema:
ruleSetId
integer <int64>
accountNumber
string or null
ruleName
string or null
ruleDesc
string or null
startDate
string <date-time>
endDate
string or null <date-time>
transactionTypeId
integer <int32>
Array of objects or null (ClaimRevModels_RuleModels_RuleSetConditionViewModel)
errorMessages
Array of strings or null
Array of objects or null (ClaimRevModels_RuleModels_RuleValueEditViewModel)
Array of objects or null (ClaimRevModels_RuleModels_RuleSegmentAddViewModel)

Responses

Request samples

Content type
{
  • "ruleSetId": 0,
  • "accountNumber": "string",
  • "ruleName": "string",
  • "ruleDesc": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "transactionTypeId": 0,
  • "conditions": [
    ],
  • "errorMessages": [
    ],
  • "ruleValueEdits": [
    ],
  • "addSegments": [
    ]
}

Response samples

Content type
No sample

Enables a feature module on the user's default account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Removes a feature module from the user's default account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Returns all feature modules available to add to the user's default account.

Responses

Response samples

Content type
No sample

Returns the feature modules currently enabled on the user's default account.

Responses

Response samples

Content type
No sample

Returns validation modules available to add to the user's default account.

Responses

Response samples

Content type
No sample

Returns validation modules currently selected on the user's default account.

Responses

Response samples

Content type
No sample

Returns payer-scoped validation modules selected on the user's default account.

Responses

Response samples

Content type
No sample

Enables a validation module on the user's default account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Removes a validation module from the user's default account.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Enables a validation module for a specific payer on the user's default account.

Request Body schema:
moduleName
string or null
payerId
integer <int32>
transactionTypeId
integer <int32>

Responses

Request samples

Content type
{
  • "moduleName": "string",
  • "payerId": 0,
  • "transactionTypeId": 0
}

Response samples

Content type
No sample

Removes a payer-scoped validation module from the user's default account.

Request Body schema:
moduleName
string or null
payerId
integer <int32>
transactionTypeId
integer <int32>

Responses

Request samples

Content type
{
  • "moduleName": "string",
  • "payerId": 0,
  • "transactionTypeId": 0
}

Response samples

Content type
No sample

Returns every validation module defined in the system.

Responses

Response samples

Content type
No sample

Returns the diagnosis rules configured for the user's default account (PHI obfuscated).

Responses

Response samples

Content type
No sample

Removes a diagnosis rule from the user's default account.

Request Body schema:
accountNumber
string or null
diagnosisCodeValue
string or null
serviceLineStartDate
string or null <date-time>
removeDiagnosis
boolean
diagnosisCodeReplaceValue
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null
payerNumber
string or null
replaceCodeWithSecondary
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "diagnosisCodeValue": "string",
  • "serviceLineStartDate": "2019-08-24T14:15:22Z",
  • "removeDiagnosis": true,
  • "diagnosisCodeReplaceValue": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string",
  • "payerNumber": "string",
  • "replaceCodeWithSecondary": true
}

Response samples

Content type
No sample

Adds or updates a diagnosis rule on the user's default account; returns false when the payload is null.

Request Body schema:
accountNumber
string or null
diagnosisCodeValue
string or null
serviceLineStartDate
string or null <date-time>
removeDiagnosis
boolean
diagnosisCodeReplaceValue
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null
payerNumber
string or null
replaceCodeWithSecondary
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "diagnosisCodeValue": "string",
  • "serviceLineStartDate": "2019-08-24T14:15:22Z",
  • "removeDiagnosis": true,
  • "diagnosisCodeReplaceValue": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string",
  • "payerNumber": "string",
  • "replaceCodeWithSecondary": true
}

Response samples

Content type
No sample

Returns the procedure-code description rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a procedure-code description rule.

Request Body schema:
procedureCodeDescriptionRuleId
integer <int64>
accountNumber
string or null
procedureCode
string or null
description
string or null
overrideModifiers
boolean
modifier1
string or null
modifier2
string or null
modifier3
string or null
modifier4
string or null
payerNumber
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "procedureCodeDescriptionRuleId": 0,
  • "accountNumber": "string",
  • "procedureCode": "string",
  • "description": "string",
  • "overrideModifiers": true,
  • "modifier1": "string",
  • "modifier2": "string",
  • "modifier3": "string",
  • "modifier4": "string",
  • "payerNumber": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a procedure-code description rule; returns false when the payload is null.

Request Body schema:
procedureCodeDescriptionRuleId
integer <int64>
accountNumber
string or null
procedureCode
string or null
description
string or null
overrideModifiers
boolean
modifier1
string or null
modifier2
string or null
modifier3
string or null
modifier4
string or null
payerNumber
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "procedureCodeDescriptionRuleId": 0,
  • "accountNumber": "string",
  • "procedureCode": "string",
  • "description": "string",
  • "overrideModifiers": true,
  • "modifier1": "string",
  • "modifier2": "string",
  • "modifier3": "string",
  • "modifier4": "string",
  • "payerNumber": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns rendering-provider swap rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a rendering-provider swap rule.

Request Body schema:
renderingProviderSwapRuleId
integer <int64>
accountNumber
string or null
originalNpi
string or null
replacementNpi
string or null
replacementLastName
string or null
replacementFirstName
string or null
replacementEntityType
string or null
replacementTaxonomyCode
string or null
payerNumber
string or null
subscriberState
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "renderingProviderSwapRuleId": 0,
  • "accountNumber": "string",
  • "originalNpi": "string",
  • "replacementNpi": "string",
  • "replacementLastName": "string",
  • "replacementFirstName": "string",
  • "replacementEntityType": "string",
  • "replacementTaxonomyCode": "string",
  • "payerNumber": "string",
  • "subscriberState": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a rendering-provider swap rule; returns false when the payload is null.

Request Body schema:
renderingProviderSwapRuleId
integer <int64>
accountNumber
string or null
originalNpi
string or null
replacementNpi
string or null
replacementLastName
string or null
replacementFirstName
string or null
replacementEntityType
string or null
replacementTaxonomyCode
string or null
payerNumber
string or null
subscriberState
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "renderingProviderSwapRuleId": 0,
  • "accountNumber": "string",
  • "originalNpi": "string",
  • "replacementNpi": "string",
  • "replacementLastName": "string",
  • "replacementFirstName": "string",
  • "replacementEntityType": "string",
  • "replacementTaxonomyCode": "string",
  • "payerNumber": "string",
  • "subscriberState": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns billing-provider override rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a billing-provider override rule.

Request Body schema:
billingProviderOverrideRuleId
integer <int64>
accountNumber
string or null
payerNumber
string or null
subscriberState
string or null
billingNpi
string or null
billingName
string or null
billingFirstName
string or null
billingEntityType
string or null
billingAddress1
string or null
billingAddress2
string or null
billingCity
string or null
billingState
string or null
billingZip
string or null
billingTaxId
string or null
renderingProviderNpi
string or null
cptCodes
string or null
placeOfService
string or null
transactionTypeId
integer or null <int32>
payToNpi
string or null
payToName
string or null
payToAddress1
string or null
payToCity
string or null
payToState
string or null
payToZip
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "billingProviderOverrideRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "subscriberState": "string",
  • "billingNpi": "string",
  • "billingName": "string",
  • "billingFirstName": "string",
  • "billingEntityType": "string",
  • "billingAddress1": "string",
  • "billingAddress2": "string",
  • "billingCity": "string",
  • "billingState": "string",
  • "billingZip": "string",
  • "billingTaxId": "string",
  • "renderingProviderNpi": "string",
  • "cptCodes": "string",
  • "placeOfService": "string",
  • "transactionTypeId": 0,
  • "payToNpi": "string",
  • "payToName": "string",
  • "payToAddress1": "string",
  • "payToCity": "string",
  • "payToState": "string",
  • "payToZip": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a billing-provider override rule; returns false when the payload is null.

Request Body schema:
billingProviderOverrideRuleId
integer <int64>
accountNumber
string or null
payerNumber
string or null
subscriberState
string or null
billingNpi
string or null
billingName
string or null
billingFirstName
string or null
billingEntityType
string or null
billingAddress1
string or null
billingAddress2
string or null
billingCity
string or null
billingState
string or null
billingZip
string or null
billingTaxId
string or null
renderingProviderNpi
string or null
cptCodes
string or null
placeOfService
string or null
transactionTypeId
integer or null <int32>
payToNpi
string or null
payToName
string or null
payToAddress1
string or null
payToCity
string or null
payToState
string or null
payToZip
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "billingProviderOverrideRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "subscriberState": "string",
  • "billingNpi": "string",
  • "billingName": "string",
  • "billingFirstName": "string",
  • "billingEntityType": "string",
  • "billingAddress1": "string",
  • "billingAddress2": "string",
  • "billingCity": "string",
  • "billingState": "string",
  • "billingZip": "string",
  • "billingTaxId": "string",
  • "renderingProviderNpi": "string",
  • "cptCodes": "string",
  • "placeOfService": "string",
  • "transactionTypeId": 0,
  • "payToNpi": "string",
  • "payToName": "string",
  • "payToAddress1": "string",
  • "payToCity": "string",
  • "payToState": "string",
  • "payToZip": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns subscriber-id override rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a subscriber-id override rule.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
matchPattern
string or null
replacementValue
string or null
stripDashes
boolean
stripSpaces
boolean
prefixToAdd
string or null
suffixToAdd
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "matchPattern": "string",
  • "replacementValue": "string",
  • "stripDashes": true,
  • "stripSpaces": true,
  • "prefixToAdd": "string",
  • "suffixToAdd": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a subscriber-id override rule; returns false when the payload is null.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
matchPattern
string or null
replacementValue
string or null
stripDashes
boolean
stripSpaces
boolean
prefixToAdd
string or null
suffixToAdd
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "matchPattern": "string",
  • "replacementValue": "string",
  • "stripDashes": true,
  • "stripSpaces": true,
  • "prefixToAdd": "string",
  • "suffixToAdd": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns service-facility override rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a service-facility override rule.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
facilityNpi
string or null
facilityName
string or null
facilityAddress1
string or null
facilityAddress2
string or null
facilityCity
string or null
facilityState
string or null
facilityZip
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "facilityNpi": "string",
  • "facilityName": "string",
  • "facilityAddress1": "string",
  • "facilityAddress2": "string",
  • "facilityCity": "string",
  • "facilityState": "string",
  • "facilityZip": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a service-facility override rule; returns false when the payload is null.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
facilityNpi
string or null
facilityName
string or null
facilityAddress1
string or null
facilityAddress2
string or null
facilityCity
string or null
facilityState
string or null
facilityZip
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "facilityNpi": "string",
  • "facilityName": "string",
  • "facilityAddress1": "string",
  • "facilityAddress2": "string",
  • "facilityCity": "string",
  • "facilityState": "string",
  • "facilityZip": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns referring-provider auto-add rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a referring-provider auto-add rule.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
cptCodes
string or null
referringNpi
string or null
referringLastName
string or null
referringFirstName
string or null
referringEntityType
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "cptCodes": "string",
  • "referringNpi": "string",
  • "referringLastName": "string",
  • "referringFirstName": "string",
  • "referringEntityType": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a referring-provider auto-add rule; returns false when the payload is null.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
cptCodes
string or null
referringNpi
string or null
referringLastName
string or null
referringFirstName
string or null
referringEntityType
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "cptCodes": "string",
  • "referringNpi": "string",
  • "referringLastName": "string",
  • "referringFirstName": "string",
  • "referringEntityType": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns place-of-service override rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a place-of-service override rule.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
cptCodes
string or null
originalPlaceOfService
string or null
newPlaceOfService
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "cptCodes": "string",
  • "originalPlaceOfService": "string",
  • "newPlaceOfService": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a place-of-service override rule; returns false when the payload is null.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
cptCodes
string or null
originalPlaceOfService
string or null
newPlaceOfService
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "cptCodes": "string",
  • "originalPlaceOfService": "string",
  • "newPlaceOfService": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns claim-note auto-add rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a claim-note auto-add rule.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
noteQualifier
string or null
noteText
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "noteQualifier": "string",
  • "noteText": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a claim-note auto-add rule; returns false when the payload is null.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
noteQualifier
string or null
noteText
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "noteQualifier": "string",
  • "noteText": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns taxonomy-code override rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a taxonomy-code override rule.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
providerNpi
string or null
newTaxonomyCode
string or null
overrideBillingTaxonomy
boolean
overrideRenderingTaxonomy
boolean
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "providerNpi": "string",
  • "newTaxonomyCode": "string",
  • "overrideBillingTaxonomy": true,
  • "overrideRenderingTaxonomy": true,
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a taxonomy-code override rule; returns false when the payload is null.

Request Body schema:
id
integer <int64>
accountNumber
string or null
payerNumber
string or null
providerNpi
string or null
newTaxonomyCode
string or null
overrideBillingTaxonomy
boolean
overrideRenderingTaxonomy
boolean
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "id": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "providerNpi": "string",
  • "newTaxonomyCode": "string",
  • "overrideBillingTaxonomy": true,
  • "overrideRenderingTaxonomy": true,
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns claim-filing-indicator override rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a claim-filing-indicator override rule.

Request Body schema:
claimFilingIndicatorOverrideRuleId
integer <int64>
accountNumber
string or null
payerNumber
string or null
originalFilingIndicator
string or null
newFilingIndicator
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "claimFilingIndicatorOverrideRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "originalFilingIndicator": "string",
  • "newFilingIndicator": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a claim-filing-indicator override rule; returns false when the payload is null.

Request Body schema:
claimFilingIndicatorOverrideRuleId
integer <int64>
accountNumber
string or null
payerNumber
string or null
originalFilingIndicator
string or null
newFilingIndicator
string or null
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "claimFilingIndicatorOverrideRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "originalFilingIndicator": "string",
  • "newFilingIndicator": "string",
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns modifier rules for the user's default account.

Responses

Response samples

Content type
No sample

Removes a modifier rule.

Request Body schema:
modifierRuleId
integer <int64>
accountNumber
string or null
payerNumber
string or null
cptCodes
string or null
actionType
integer <int32>
modifierValue
string or null
replacementModifier
string or null
modifierPosition
integer or null <int32>
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "modifierRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "cptCodes": "string",
  • "actionType": 0,
  • "modifierValue": "string",
  • "replacementModifier": "string",
  • "modifierPosition": 0,
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Adds or updates a modifier rule; returns false when the payload is null.

Request Body schema:
modifierRuleId
integer <int64>
accountNumber
string or null
payerNumber
string or null
cptCodes
string or null
actionType
integer <int32>
modifierValue
string or null
replacementModifier
string or null
modifierPosition
integer or null <int32>
processStartDate
string <date-time>
processEndDate
string or null <date-time>
createUser
string or null
notes
string or null

Responses

Request samples

Content type
{
  • "modifierRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "cptCodes": "string",
  • "actionType": 0,
  • "modifierValue": "string",
  • "replacementModifier": "string",
  • "modifierPosition": 0,
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "createUser": "string",
  • "notes": "string"
}

Response samples

Content type
No sample

Returns metadata definitions describing every rule module the engine supports.

Responses

Response samples

Content type
No sample

Returns diagnosis reorder rules for the user's default account.

Responses

Response samples

Content type
No sample

Adds or updates a diagnosis reorder rule; returns false when the payload is null.

Request Body schema:
diagnosisReorderRuleId
integer <int32>
accountNumber
string or null
payerNumber
string or null
orderedDiagnosisCodes
Array of strings or null
conflictAction
integer <int32>
Array of objects or null (ClaimRevModels_RuleModels_DiagnosisReorderPointerViewModel)
processStartDate
string <date-time>
processEndDate
string or null <date-time>
notes
string or null
createUser
string or null

Responses

Request samples

Content type
{
  • "diagnosisReorderRuleId": 0,
  • "accountNumber": "string",
  • "payerNumber": "string",
  • "orderedDiagnosisCodes": [
    ],
  • "conflictAction": 0,
  • "pointerOverrides": [
    ],
  • "processStartDate": "2019-08-24T14:15:22Z",
  • "processEndDate": "2019-08-24T14:15:22Z",
  • "notes": "string",
  • "createUser": "string"
}

Response samples

Content type
No sample

Removes a diagnosis reorder rule by id.

Request Body schema:
integer <int32>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

SavedSearches

/api/SavedSearches/v1

Responses

Response samples

Content type
No sample

/api/SavedSearches/v1

Request Body schema:
name
string or null
object (ClaimRevModels_ViewModels_ClaimModels_ClaimSearchModel)
object (ClaimRevModels_ViewModels_SavedSearches_DateModeViewModel)

Responses

Request samples

Content type
{
  • "name": "string",
  • "filter": {
    },
  • "dateMode": {
    }
}

Response samples

Content type
No sample

/api/SavedSearches/v1/global

Request Body schema:
name
string or null
object (ClaimRevModels_ViewModels_ClaimModels_ClaimSearchModel)
object (ClaimRevModels_ViewModels_SavedSearches_DateModeViewModel)

Responses

Request samples

Content type
{
  • "name": "string",
  • "filter": {
    },
  • "dateMode": {
    }
}

Response samples

Content type
No sample

/api/SavedSearches/v1/{id}

path Parameters
id
required
string
Request Body schema:
name
string or null
object (ClaimRevModels_ViewModels_ClaimModels_ClaimSearchModel)
object (ClaimRevModels_ViewModels_SavedSearches_DateModeViewModel)

Responses

Request samples

Content type
{
  • "name": "string",
  • "filter": {
    },
  • "dateMode": {
    }
}

Response samples

Content type
No sample

/api/SavedSearches/v1/{id}

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

/api/SavedSearches/v1/{id}/copy

path Parameters
id
required
string

Responses

Response samples

Content type
No sample

/api/SavedSearches/v1/{id}/account-default

path Parameters
id
required
string
Request Body schema:
canOverride
boolean

Responses

Request samples

Content type
{
  • "canOverride": true
}

Response samples

Content type
No sample

/api/SavedSearches/v1/account-default

Responses

Response samples

Content type
No sample

/api/SavedSearches/v1/{id}/touch

path Parameters
id
required
string

Responses

SharpRcm

Returns the practice for the user's default account with PHI obfuscated.

Responses

Response samples

Content type
No sample

Creates or updates the practice, returning the persisted record.

Request Body schema:
practiceId
integer <int64>
accountNumber
string or null
practiceName
string or null
employerNumber
string or null
claimContactName
string or null
claimContactPhone
string or null
claimContactEmail
string or null
timeZoneId
string or null

Responses

Request samples

Content type
{
  • "practiceId": 0,
  • "accountNumber": "string",
  • "practiceName": "string",
  • "employerNumber": "string",
  • "claimContactName": "string",
  • "claimContactPhone": "string",
  • "claimContactEmail": "string",
  • "timeZoneId": "string"
}

Response samples

Content type
No sample

Searches patients by name, gender, and/or date of birth.

query Parameters
firstName
string
middleName
string
lastName
string
gender
string
dob
string <date-time>

Responses

Response samples

Content type
No sample

Returns a patient by id with PHI obfuscated.

query Parameters
patientId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a patient record.

Request Body schema:
accountNumber
string or null
firstName
string or null
lastName
string or null
middleName
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
integratedSystemId
string or null
alternativePhoneNumber
string or null
patientAccountNumber
string or null
patientId
integer <int64>
practiceId
integer <int64>
genderKey
string or null
dateOfBirth
string <date-time>
deathDate
string or null <date-time>
ssn
string or null
mrn
string or null
releaseOfInformationCode
string or null
isPatientSignatureGenerated
boolean
employer
string or null
employerState
string or null
referringProviderId
integer or null <int64>
contactName
string or null
primaryPhoneNumber
string or null
emailAddress
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "firstName": "string",
  • "lastName": "string",
  • "middleName": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "integratedSystemId": "string",
  • "alternativePhoneNumber": "string",
  • "patientAccountNumber": "string",
  • "patientId": 0,
  • "practiceId": 0,
  • "genderKey": "string",
  • "dateOfBirth": "2019-08-24T14:15:22Z",
  • "deathDate": "2019-08-24T14:15:22Z",
  • "ssn": "string",
  • "mrn": "string",
  • "releaseOfInformationCode": "string",
  • "isPatientSignatureGenerated": true,
  • "employer": "string",
  • "employerState": "string",
  • "referringProviderId": 0,
  • "contactName": "string",
  • "primaryPhoneNumber": "string",
  • "emailAddress": "string"
}

Response samples

Content type
No sample

Searches payers by name and/or payer number.

query Parameters
payerName
string
payerNumber
string

Responses

Response samples

Content type
No sample

Returns a payer by id.

query Parameters
payerId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a payer.

Request Body schema:
accountNumber
string or null
payerId
integer <int64>
practiceId
integer <int64>
billingProviderId
integer or null <int64>
payerNumber
string or null
claimPayerNumber
string or null
eligibilityPayerNumber
string or null
payerName
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
billingProviderNpi
string or null
timelyFilingDays
integer or null <int32>
planParticipationCode
string or null
providerSignatureOnFile
boolean
integratedSystemId
string or null
claimFilingIndicatorCode
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerId": 0,
  • "practiceId": 0,
  • "billingProviderId": 0,
  • "payerNumber": "string",
  • "claimPayerNumber": "string",
  • "eligibilityPayerNumber": "string",
  • "payerName": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "billingProviderNpi": "string",
  • "timelyFilingDays": 0,
  • "planParticipationCode": "string",
  • "providerSignatureOnFile": true,
  • "integratedSystemId": "string",
  • "claimFilingIndicatorCode": "string"
}

Response samples

Content type
No sample

Searches providers by name, NPI, and role flags.

query Parameters
providerFirstName
string
providerLastName
string
npi
string
isRenderingProvider
boolean
isBillingProvider
boolean
isSupervisingProvider
boolean
isOrderingProvider
boolean
isReferringProvider
boolean

Responses

Response samples

Content type
No sample

Returns a provider by id with PHI obfuscated.

query Parameters
providerId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a provider.

Request Body schema:
accountNumber
string or null
firstName
string or null
lastName
string or null
middleName
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
integratedSystemId
string or null
contactName
string or null
primaryPhoneNumber
string or null
alternativePhoneNumber
string or null
emailAddress
string or null
npi
string or null
providerId
integer <int64>
supervisingProviderId
integer or null <int64>
practiceId
integer <int64>
facilityId
integer or null <int64>
isGroup
boolean
suffixName
string or null
taxonomyCode
string or null
isBillingProvider
boolean
isRenderingProvider
boolean
isSupervisingProvider
boolean
isOrderingProvider
boolean
isReferringProvider
boolean
ssn
string or null
ein
string or null
useSupervisingProvider
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "firstName": "string",
  • "lastName": "string",
  • "middleName": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "integratedSystemId": "string",
  • "contactName": "string",
  • "primaryPhoneNumber": "string",
  • "alternativePhoneNumber": "string",
  • "emailAddress": "string",
  • "npi": "string",
  • "providerId": 0,
  • "supervisingProviderId": 0,
  • "practiceId": 0,
  • "facilityId": 0,
  • "isGroup": true,
  • "suffixName": "string",
  • "taxonomyCode": "string",
  • "isBillingProvider": true,
  • "isRenderingProvider": true,
  • "isSupervisingProvider": true,
  • "isOrderingProvider": true,
  • "isReferringProvider": true,
  • "ssn": "string",
  • "ein": "string",
  • "useSupervisingProvider": true
}

Response samples

Content type
No sample

Returns all insurance records for a given patient.

query Parameters
patientId
integer <int64>

Responses

Response samples

Content type
No sample

Returns a specific patient insurance record.

query Parameters
patientInsuranceId
integer <int64>

Responses

Response samples

Content type
No sample

Deletes a patient insurance record.

Request Body schema:
accountNumber
string or null
patientInsuranceId
integer <int64>
patientId
integer <int64>
payerName
string or null
payerNumber
string or null
payerId
integer <int64>
isNonPerson
boolean
subscriberMemberId
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
subscriberMiddleName
string or null
subscriberDob
string or null <date-time>
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
payerResponsibilityCode
string or null
insuranceRelationshipCode
string or null
policyNumber
string or null
groupName
string or null
insuranceTypeCode
string or null
claimFilingIndicatorCode
string or null
benefitsAssignmentIndicator
string or null
policyStartDate
string <date-time>
policyEndDate
string or null <date-time>
latestEligibilityStatus
string or null
latestCheckDate
string or null <date-time>
revenueToolsObjectId
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientInsuranceId": 0,
  • "patientId": 0,
  • "payerName": "string",
  • "payerNumber": "string",
  • "payerId": 0,
  • "isNonPerson": true,
  • "subscriberMemberId": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "subscriberMiddleName": "string",
  • "subscriberDob": "2019-08-24T14:15:22Z",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "payerResponsibilityCode": "string",
  • "insuranceRelationshipCode": "string",
  • "policyNumber": "string",
  • "groupName": "string",
  • "insuranceTypeCode": "string",
  • "claimFilingIndicatorCode": "string",
  • "benefitsAssignmentIndicator": "string",
  • "policyStartDate": "2019-08-24T14:15:22Z",
  • "policyEndDate": "2019-08-24T14:15:22Z",
  • "latestEligibilityStatus": "string",
  • "latestCheckDate": "2019-08-24T14:15:22Z",
  • "revenueToolsObjectId": "string"
}

Response samples

Content type
No sample

Creates or updates a patient insurance record.

Request Body schema:
accountNumber
string or null
patientInsuranceId
integer <int64>
patientId
integer <int64>
payerName
string or null
payerNumber
string or null
payerId
integer <int64>
isNonPerson
boolean
subscriberMemberId
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
subscriberMiddleName
string or null
subscriberDob
string or null <date-time>
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
payerResponsibilityCode
string or null
insuranceRelationshipCode
string or null
policyNumber
string or null
groupName
string or null
insuranceTypeCode
string or null
claimFilingIndicatorCode
string or null
benefitsAssignmentIndicator
string or null
policyStartDate
string <date-time>
policyEndDate
string or null <date-time>
latestEligibilityStatus
string or null
latestCheckDate
string or null <date-time>
revenueToolsObjectId
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientInsuranceId": 0,
  • "patientId": 0,
  • "payerName": "string",
  • "payerNumber": "string",
  • "payerId": 0,
  • "isNonPerson": true,
  • "subscriberMemberId": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "subscriberMiddleName": "string",
  • "subscriberDob": "2019-08-24T14:15:22Z",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "payerResponsibilityCode": "string",
  • "insuranceRelationshipCode": "string",
  • "policyNumber": "string",
  • "groupName": "string",
  • "insuranceTypeCode": "string",
  • "claimFilingIndicatorCode": "string",
  • "benefitsAssignmentIndicator": "string",
  • "policyStartDate": "2019-08-24T14:15:22Z",
  • "policyEndDate": "2019-08-24T14:15:22Z",
  • "latestEligibilityStatus": "string",
  • "latestCheckDate": "2019-08-24T14:15:22Z",
  • "revenueToolsObjectId": "string"
}

Response samples

Content type
No sample

Runs a real-time eligibility check for the given patient insurance.

Request Body schema:
accountNumber
string or null
patientInsuranceId
integer <int64>
patientId
integer <int64>
payerName
string or null
payerNumber
string or null
payerId
integer <int64>
isNonPerson
boolean
subscriberMemberId
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
subscriberMiddleName
string or null
subscriberDob
string or null <date-time>
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
payerResponsibilityCode
string or null
insuranceRelationshipCode
string or null
policyNumber
string or null
groupName
string or null
insuranceTypeCode
string or null
claimFilingIndicatorCode
string or null
benefitsAssignmentIndicator
string or null
policyStartDate
string <date-time>
policyEndDate
string or null <date-time>
latestEligibilityStatus
string or null
latestCheckDate
string or null <date-time>
revenueToolsObjectId
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientInsuranceId": 0,
  • "patientId": 0,
  • "payerName": "string",
  • "payerNumber": "string",
  • "payerId": 0,
  • "isNonPerson": true,
  • "subscriberMemberId": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "subscriberMiddleName": "string",
  • "subscriberDob": "2019-08-24T14:15:22Z",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "payerResponsibilityCode": "string",
  • "insuranceRelationshipCode": "string",
  • "policyNumber": "string",
  • "groupName": "string",
  • "insuranceTypeCode": "string",
  • "claimFilingIndicatorCode": "string",
  • "benefitsAssignmentIndicator": "string",
  • "policyStartDate": "2019-08-24T14:15:22Z",
  • "policyEndDate": "2019-08-24T14:15:22Z",
  • "latestEligibilityStatus": "string",
  • "latestCheckDate": "2019-08-24T14:15:22Z",
  • "revenueToolsObjectId": "string"
}

Response samples

Content type
No sample

Returns the payer-responsibility dropdown list.

Responses

Response samples

Content type
No sample

Returns the claim-filing-indicator dropdown list.

Responses

Response samples

Content type
No sample

Returns the subscriber-relationship dropdown list.

Responses

Response samples

Content type
No sample

Returns the benefits-assignment dropdown list.

Responses

Response samples

Content type
No sample

Returns the plan-participation code dropdown list.

Responses

Response samples

Content type
No sample

Returns the insurance-type dropdown list.

Responses

Response samples

Content type
No sample

Returns the place-of-service dropdown list.

Responses

Response samples

Content type
No sample

Returns the claim-status dropdown list.

Responses

Response samples

Content type
No sample

Searches facilities by name and/or NPI.

query Parameters
name
string
npi
string

Responses

Response samples

Content type
No sample

Returns a facility by id.

query Parameters
facilityId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a facility.

Request Body schema:
facilityId
integer <int64>
practiceId
integer <int64>
accountNumber
string or null
facilityNpi
string or null
facilityName
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zipCode
string or null
stateLicenseNumber
string or null
commericalNumber
string or null
locationNumber
string or null
cliaNumber
string or null
integratedSystemId
string or null
placeOfServiceCode
string or null

Responses

Request samples

Content type
{
  • "facilityId": 0,
  • "practiceId": 0,
  • "accountNumber": "string",
  • "facilityNpi": "string",
  • "facilityName": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zipCode": "string",
  • "stateLicenseNumber": "string",
  • "commericalNumber": "string",
  • "locationNumber": "string",
  • "cliaNumber": "string",
  • "integratedSystemId": "string",
  • "placeOfServiceCode": "string"
}

Response samples

Content type
No sample

Searches RCM claims for the user's default account.

Request Body schema:
accountNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
claimStatusId
integer or null <int32>
patientFirstName
string or null
patientLastName
string or null
payerNumber
string or null
payerName
string or null
object (ClaimRevModels_PagingSearchViewModel)
patientId
integer or null <int64>
payerId
integer or null <int64>
mongoRecordObjectId
string or null
claimControlNumber
string or null
claimPaymentStatusId
integer or null <int32>
isAutoCreatedClaim
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "claimStatusId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "payerNumber": "string",
  • "payerName": "string",
  • "pagingSearch": {
    },
  • "patientId": 0,
  • "payerId": 0,
  • "mongoRecordObjectId": "string",
  • "claimControlNumber": "string",
  • "claimPaymentStatusId": 0,
  • "isAutoCreatedClaim": true
}

Response samples

Content type
No sample

Creates a claim from the quick-claim builder payload and returns a batch result.

Request Body schema:
accountNumber
string or null
object (ClaimRev_Rcm_Models_Provider)
object (ClaimRev_Rcm_Models_Patient)
object (ClaimRev_Rcm_Models_PatientInsurance)
claimControlNumber
string or null
placeOfServiceCode
string or null
frequencyCode
string or null
object (ClaimRev_Rcm_Models_DateViewModel)
object (ClaimRev_Rcm_Models_DateViewModel)
object (ClaimRev_Rcm_Models_DateViewModel)
isPregnant
boolean
Array of objects or null (ClaimRevModels_EditorViews_DiagnosisViewModel)
object (ClaimRev_Rcm_Models_Provider)
object (ClaimRev_Rcm_Models_Provider)
object (ClaimRev_Rcm_Models_Facility)
Array of objects or null (ClaimRev_Rcm_Models_CreateClaimServiceLineView)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "billingProvider": {
    },
  • "patient": {
    },
  • "payer": {
    },
  • "claimControlNumber": "string",
  • "placeOfServiceCode": "string",
  • "frequencyCode": "string",
  • "onsetDate": {
    },
  • "initialTreatmentDate": {
    },
  • "latestVisitDate": {
    },
  • "isPregnant": true,
  • "diagnosisCodes": [
    ],
  • "renderingProvider": {
    },
  • "referringProvider": {
    },
  • "serviceFacility": {
    },
  • "serviceLines": [
    ]
}

Response samples

Content type
No sample

Marks the selected claims for batch submission.

Request Body schema:
Array
claimId
integer <int64>
createDateTimeUtc
string <date-time>
payerName
string or null
payerNumber
string or null
patientFirstName
string or null
patientLastName
string or null
claimStatusId
integer <int32>
claimStatusName
string or null
accountNumber
string or null
integrationSystemName
string or null
integrationSystemId
integer or null <int32>
rcmClaimId
string or null
claimTotal
number or null <double>
paymentStatusId
integer or null <int32>
paymentStatusName
string or null
isAutoCreated
boolean
lastStatusMessage
string or null

Responses

Request samples

Content type
[
  • {
    }
]

Response samples

Content type
No sample

Sends any batched claims for the user's default account.

Responses

Response samples

Content type
No sample

Manually updates a claim's status (only Ready or Editing allowed); returns 400 otherwise.

Request Body schema:
claimId
integer <int64>
claimStatusId
integer <int32>

Responses

Request samples

Content type
{
  • "claimId": 0,
  • "claimStatusId": 0
}

Response samples

Content type
No sample

Deletes a claim by its integrated-system key; returns false on error.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Deletes a claim by claim id; returns false on error.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Deletes all claims linked to an encounter id; returns false on error.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Creates or updates a payer contract.

Request Body schema:
accountNumber
string or null
payerContractId
integer <int64>
payerId
integer <int64>
payerName
string or null
payerNumber
string or null
billingProviderId
integer <int64>
billingProviderFirstName
string or null
billingProviderLastName
string or null
state
string or null
startDate
string <date-time>
endDate
string or null <date-time>
timelyFilingDays
integer or null <int32>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerContractId": 0,
  • "payerId": 0,
  • "payerName": "string",
  • "payerNumber": "string",
  • "billingProviderId": 0,
  • "billingProviderFirstName": "string",
  • "billingProviderLastName": "string",
  • "state": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "timelyFilingDays": 0
}

Response samples

Content type
No sample

Deletes a payer contract.

Request Body schema:
accountNumber
string or null
payerContractId
integer <int64>
payerId
integer <int64>
payerName
string or null
payerNumber
string or null
billingProviderId
integer <int64>
billingProviderFirstName
string or null
billingProviderLastName
string or null
state
string or null
startDate
string <date-time>
endDate
string or null <date-time>
timelyFilingDays
integer or null <int32>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerContractId": 0,
  • "payerId": 0,
  • "payerName": "string",
  • "payerNumber": "string",
  • "billingProviderId": 0,
  • "billingProviderFirstName": "string",
  • "billingProviderLastName": "string",
  • "state": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "timelyFilingDays": 0
}

Response samples

Content type
No sample

Attaches a rendering provider to a payer contract.

Request Body schema:
accountNumber
string or null
payerContractId
integer <int64>
providerId
integer <int64>
useSupervisingProvider
boolean or null
supervisingProviderId
integer or null <int64>
renderingProviderFirstName
string or null
renderingProviderLastName
string or null
supervisingProviderFirstName
string or null
supervisingProviderLastName
string or null
isOverride
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerContractId": 0,
  • "providerId": 0,
  • "useSupervisingProvider": true,
  • "supervisingProviderId": 0,
  • "renderingProviderFirstName": "string",
  • "renderingProviderLastName": "string",
  • "supervisingProviderFirstName": "string",
  • "supervisingProviderLastName": "string",
  • "isOverride": true
}

Response samples

Content type
No sample

Detaches a rendering provider from a payer contract.

Request Body schema:
accountNumber
string or null
payerContractId
integer <int64>
providerId
integer <int64>
useSupervisingProvider
boolean or null
supervisingProviderId
integer or null <int64>
renderingProviderFirstName
string or null
renderingProviderLastName
string or null
supervisingProviderFirstName
string or null
supervisingProviderLastName
string or null
isOverride
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerContractId": 0,
  • "providerId": 0,
  • "useSupervisingProvider": true,
  • "supervisingProviderId": 0,
  • "renderingProviderFirstName": "string",
  • "renderingProviderLastName": "string",
  • "supervisingProviderFirstName": "string",
  • "supervisingProviderLastName": "string",
  • "isOverride": true
}

Response samples

Content type
No sample

Returns payer contracts matching the supplied filters.

query Parameters
payerNumber
string
payerName
string
contractState
string

Responses

Response samples

Content type
No sample

Returns a payer contract by id.

query Parameters
payerContractId
integer <int64>

Responses

Response samples

Content type
No sample

Returns the rendering providers attached to a payer contract.

query Parameters
payerContractId
integer <int64>

Responses

Response samples

Content type
No sample

Returns all telehealth rules for the user's default account.

Responses

Response samples

Content type
No sample

Returns a telehealth rule by id.

query Parameters
telehealthRuleId
integer <int32>

Responses

Response samples

Content type
No sample

Creates or updates a telehealth rule.

Request Body schema:
telehealthRuleId
integer <int32>
practiceId
integer <int64>
payerId
integer or null <int64>
payerName
string or null
placeOfServiceCode
string or null
placeOfServiceCodeDesc
string or null
modifier
string or null
replaceModifier
boolean

Responses

Request samples

Content type
{
  • "telehealthRuleId": 0,
  • "practiceId": 0,
  • "payerId": 0,
  • "payerName": "string",
  • "placeOfServiceCode": "string",
  • "placeOfServiceCodeDesc": "string",
  • "modifier": "string",
  • "replaceModifier": true
}

Response samples

Content type
No sample

Deletes a telehealth rule by id.

query Parameters
telehealthRuleId
integer <int32>

Responses

Response samples

Content type
No sample

Returns whether a data-change module is enabled for the practice.

query Parameters
moduleName
string

Responses

Response samples

Content type
No sample

Enables a data-change module for the practice.

query Parameters
moduleName
string

Responses

Response samples

Content type
No sample

Disables a data-change module for the practice.

query Parameters
moduleName
string

Responses

Response samples

Content type
No sample

Searches encounters for the user's default account.

Request Body schema:
accountNumber
string or null
encounterStartDate
string or null <date-time>
encounterEndDate
string or null <date-time>
patientId
integer or null <int64>
facilityId
integer or null <int64>
renderingProviderId
integer or null <int64>
object (ClaimRevModels_PagingSearchViewModel)
externalSystemId
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "encounterStartDate": "2019-08-24T14:15:22Z",
  • "encounterEndDate": "2019-08-24T14:15:22Z",
  • "patientId": 0,
  • "facilityId": 0,
  • "renderingProviderId": 0,
  • "pagingSearch": {
    },
  • "externalSystemId": "string"
}

Response samples

Content type
No sample

Returns an encounter by id.

query Parameters
encounterId
integer <int64>

Responses

Response samples

Content type
No sample

Returns the encounter-status dropdown list.

Responses

Response samples

Content type
No sample

Returns the encounter-type dropdown list for the user's account.

Responses

Response samples

Content type
No sample

Creates or updates an encounter.

Request Body schema:
encounterId
integer <int64>
accountNumber
string or null
patientId
integer <int64>
patientFirstName
string or null
patientLastName
string or null
practiceId
integer <int64>
facilityId
integer or null <int64>
facilityName
string or null
encounterDate
string <date-time>
externalSystemId
string or null
isClaimCreated
boolean
placeOfServiceCode
string or null
placeOfServiceName
string or null
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
encounterStatusName
string or null
encounterStatusId
integer <int32>
notesLocked
boolean
isCoded
boolean
durationMinutes
integer or null <int32>
object (ClaimRev_Rcm_Models_EncounterTypeViewModel)
encounterDateUtc
string or null <date-time>
encounterDateString
string or null
encounterTimeString
string or null

Responses

Request samples

Content type
{
  • "encounterId": 0,
  • "accountNumber": "string",
  • "patientId": 0,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "practiceId": 0,
  • "facilityId": 0,
  • "facilityName": "string",
  • "encounterDate": "2019-08-24T14:15:22Z",
  • "externalSystemId": "string",
  • "isClaimCreated": true,
  • "placeOfServiceCode": "string",
  • "placeOfServiceName": "string",
  • "renderingProvider": {
    },
  • "billingProvider": {
    },
  • "referringProvider": {
    },
  • "supervisingProvider": {
    },
  • "encounterStatusName": "string",
  • "encounterStatusId": 0,
  • "notesLocked": true,
  • "isCoded": true,
  • "durationMinutes": 0,
  • "encounterType": {
    },
  • "encounterDateUtc": "2019-08-24T14:15:22Z",
  • "encounterDateString": "string",
  • "encounterTimeString": "string"
}

Response samples

Content type
No sample

Returns diagnoses attached to an encounter.

query Parameters
encounterId
integer <int64>

Responses

Response samples

Content type
No sample

Saves a diagnosis on an encounter; returns 409 when the diagnosis is a duplicate.

Request Body schema:
encounterId
integer <int64>
diagnosisCode
string or null
diagnosisDescription
string or null
diagnosisOrder
integer <int32>

Responses

Request samples

Content type
{
  • "encounterId": 0,
  • "diagnosisCode": "string",
  • "diagnosisDescription": "string",
  • "diagnosisOrder": 0
}

Response samples

Content type
No sample

Deletes a diagnosis from an encounter.

Request Body schema:
encounterId
integer <int64>
diagnosisCode
string or null
diagnosisDescription
string or null
diagnosisOrder
integer <int32>

Responses

Request samples

Content type
{
  • "encounterId": 0,
  • "diagnosisCode": "string",
  • "diagnosisDescription": "string",
  • "diagnosisOrder": 0
}

Response samples

Content type
No sample

Returns procedures billed on an encounter.

query Parameters
encounterId
integer <int64>

Responses

Response samples

Content type
No sample

Saves a procedure on an encounter.

Request Body schema:
encounterProcedureId
integer <int64>
procedureCodeId
integer <int64>
encounterId
integer <int64>
cptCode
string or null
codeKey
string or null
cptMeasurementCode
string or null
quantity
number <double>
modifier1
string or null
modifier2
string or null
modifier3
string or null
modifier4
string or null
placeOfServiceCode
string or null
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
description
string or null
encounterDiagnosisCode1
string or null
encounterDiagnosisCode2
string or null
encounterDiagnosisCode3
string or null
encounterDiagnosisCode4
string or null
isEmergency
boolean
facilityId
integer or null <int64>

Responses

Request samples

Content type
{
  • "encounterProcedureId": 0,
  • "procedureCodeId": 0,
  • "encounterId": 0,
  • "cptCode": "string",
  • "codeKey": "string",
  • "cptMeasurementCode": "string",
  • "quantity": 0.1,
  • "modifier1": "string",
  • "modifier2": "string",
  • "modifier3": "string",
  • "modifier4": "string",
  • "placeOfServiceCode": "string",
  • "renderingProvider": {
    },
  • "primaryCareProvider": {
    },
  • "purchasedServiceProvider": {
    },
  • "supervisingProvider": {
    },
  • "orderingProvider": {
    },
  • "referringProvider": {
    },
  • "description": "string",
  • "encounterDiagnosisCode1": "string",
  • "encounterDiagnosisCode2": "string",
  • "encounterDiagnosisCode3": "string",
  • "encounterDiagnosisCode4": "string",
  • "isEmergency": true,
  • "facilityId": 0
}

Response samples

Content type
No sample

Deletes a procedure from an encounter.

Request Body schema:
encounterProcedureId
integer <int64>
procedureCodeId
integer <int64>
encounterId
integer <int64>
cptCode
string or null
codeKey
string or null
cptMeasurementCode
string or null
quantity
number <double>
modifier1
string or null
modifier2
string or null
modifier3
string or null
modifier4
string or null
placeOfServiceCode
string or null
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
object (ClaimRev_Rcm_Models_EncounterProvider)
description
string or null
encounterDiagnosisCode1
string or null
encounterDiagnosisCode2
string or null
encounterDiagnosisCode3
string or null
encounterDiagnosisCode4
string or null
isEmergency
boolean
facilityId
integer or null <int64>

Responses

Request samples

Content type
{
  • "encounterProcedureId": 0,
  • "procedureCodeId": 0,
  • "encounterId": 0,
  • "cptCode": "string",
  • "codeKey": "string",
  • "cptMeasurementCode": "string",
  • "quantity": 0.1,
  • "modifier1": "string",
  • "modifier2": "string",
  • "modifier3": "string",
  • "modifier4": "string",
  • "placeOfServiceCode": "string",
  • "renderingProvider": {
    },
  • "primaryCareProvider": {
    },
  • "purchasedServiceProvider": {
    },
  • "supervisingProvider": {
    },
  • "orderingProvider": {
    },
  • "referringProvider": {
    },
  • "description": "string",
  • "encounterDiagnosisCode1": "string",
  • "encounterDiagnosisCode2": "string",
  • "encounterDiagnosisCode3": "string",
  • "encounterDiagnosisCode4": "string",
  • "isEmergency": true,
  • "facilityId": 0
}

Response samples

Content type
No sample

Returns the SOAP-note type dropdown list.

Responses

Response samples

Content type
No sample

Returns the rendered SOAP note text for an encounter.

query Parameters
soapNoteTypeId
integer <int32>
encounterId
integer <int64>

Responses

Response samples

Content type
No sample

Searches procedure codes for the user's default account.

query Parameters
codeKey
string
code
string
codeName
string
description
string
isDeleted
boolean

Responses

Response samples

Content type
No sample

Returns a procedure code by id.

query Parameters
procedureCodeId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a procedure code and returns its id.

Request Body schema:
procedureCodeId
integer <int64>
accountNumber
string or null
codeTypeId
integer <int32>
codeName
string or null
cptCode
string or null
codeKey
string or null
feeAmount
number or null <double>
measurementCode
string or null
codeDescription
string or null
modifier1
string or null
modifier2
string or null
modifier3
string or null
modifier4
string or null
isDeleted
boolean
integratedSystemKey
string or null

Responses

Request samples

Content type
{
  • "procedureCodeId": 0,
  • "accountNumber": "string",
  • "codeTypeId": 0,
  • "codeName": "string",
  • "cptCode": "string",
  • "codeKey": "string",
  • "feeAmount": 0.1,
  • "measurementCode": "string",
  • "codeDescription": "string",
  • "modifier1": "string",
  • "modifier2": "string",
  • "modifier3": "string",
  • "modifier4": "string",
  • "isDeleted": true,
  • "integratedSystemKey": "string"
}

Response samples

Content type
No sample

Builds the EDI 837 for a claim, uploads it, and returns the control numbers and upload result.

Request Body schema:
Array of objects or null (ClaimRevModels_EditorViews_Professional_FullClaimEditorViewModel)
object (ClaimRev_Rcm_Models_IsaSegment)
submitterId
string or null
transactionControlNumber
string or null
groupControlNumber
string or null
bhtControlNumber
string or null
receiverName
string or null
accountNumber
string or null
submitterName
string or null
submitterContactName
string or null
submitterPhone
string or null

Responses

Request samples

Content type
{
  • "claims": [
    ],
  • "envelop": {
    },
  • "submitterId": "string",
  • "transactionControlNumber": "string",
  • "groupControlNumber": "string",
  • "bhtControlNumber": "string",
  • "receiverName": "string",
  • "accountNumber": "string",
  • "submitterName": "string",
  • "submitterContactName": "string",
  • "submitterPhone": "string"
}

Response samples

Content type
No sample

Creates an RCM claim from an existing encounter.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Loads the professional RCM claim editor view model for a claim.

query Parameters
rcmClaimId
string

Responses

Response samples

Content type
No sample

Saves edits made in the professional RCM claim editor.

Request Body schema:
rcmClaimObjectId
string or null
accountNumber
string or null
object (ClaimRevModels_EditorViews_Professional_FullClaimEditorViewModel)

Responses

Request samples

Content type
{
  • "rcmClaimObjectId": "string",
  • "accountNumber": "string",
  • "editClaim": {
    }
}

Response samples

Content type
No sample

Saves a fee/encounter/time-unit mapping and returns the persisted id.

Request Body schema:
feeEncounterTimeUnitMappingId
integer or null <int64>
accountNumber
string or null
procedureCodeId
integer <int64>
encounterTypeId
integer <int32>
payerId
integer or null <int64>
minimumMinutes
integer or null <int32>
maximumMinutes
integer or null <int32>
units
number or null <double>

Responses

Request samples

Content type
{
  • "feeEncounterTimeUnitMappingId": 0,
  • "accountNumber": "string",
  • "procedureCodeId": 0,
  • "encounterTypeId": 0,
  • "payerId": 0,
  • "minimumMinutes": 0,
  • "maximumMinutes": 0,
  • "units": 0.1
}

Response samples

Content type
No sample

Returns a fee/encounter/time-unit mapping by id.

query Parameters
feeEncounterTimeUnitMappingId
integer <int64>

Responses

Response samples

Content type
No sample

Searches fee/encounter/time-unit mappings by encounter type, payer, or procedure.

query Parameters
encounterTypeId
integer <int64>
payerId
integer <int64>
procedureCodeId
integer <int64>

Responses

Response samples

Content type
No sample

Deletes a fee/encounter/time-unit mapping.

Request Body schema:
feeEncounterTimeUnitMappingId
integer or null <int64>
accountNumber
string or null
procedureCodeId
integer <int64>
encounterTypeId
integer <int32>
payerId
integer or null <int64>
minimumMinutes
integer or null <int32>
maximumMinutes
integer or null <int32>
units
number or null <double>

Responses

Request samples

Content type
{
  • "feeEncounterTimeUnitMappingId": 0,
  • "accountNumber": "string",
  • "procedureCodeId": 0,
  • "encounterTypeId": 0,
  • "payerId": 0,
  • "minimumMinutes": 0,
  • "maximumMinutes": 0,
  • "units": 0.1
}

Response samples

Content type
No sample

Searches ERA payment advices aggregated for RCM posting.

Request Body schema:
accountNumber
string or null
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
isWorked
boolean or null
patientFirstName
string or null
patientLastName
string or null
payerNumber
string or null
patientControlNumber
string or null
checkNumber
string or null
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
queueIds
Array of integers or null <int64> [ items <int64 > ]
tagIds
Array of integers or null <int64> [ items <int64 > ]
object (ClaimRevModels_PagingSearchViewModel)
hasFoundRcmClaim
boolean or null
paymentStatusId
integer or null <int32>
isProcessing
boolean or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "isWorked": true,
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "payerNumber": "string",
  • "patientControlNumber": "string",
  • "checkNumber": "string",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "queueIds": [
    ],
  • "tagIds": [
    ],
  • "pagingSearch": {
    },
  • "hasFoundRcmClaim": true,
  • "paymentStatusId": 0,
  • "isProcessing": true
}

Response samples

Content type
No sample

Posts a single ERA payment advice into the patient ledger.

Request Body schema:
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
isClaimFound
boolean
claimRevRcmClaimId
integer or null <int64>
paymentStatusId
integer or null <int32>
paymentStatusDesc
string or null
integrationSystemKey
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "accountNumber": "string",
  • "receivedDate": "2019-08-24T14:15:22Z",
  • "payerName": "string",
  • "payerNumber": "string",
  • "paymentAdviceStatusId": 0,
  • "paymentInfo": {
    },
  • "checkInformation": {
    },
  • "eraClassification": "string",
  • "isClaimFound": true,
  • "claimRevRcmClaimId": 0,
  • "paymentStatusId": 0,
  • "paymentStatusDesc": "string",
  • "integrationSystemKey": "string"
}

Response samples

Content type
No sample

Posts multiple ERA payment advices in a single batch.

Request Body schema:
Array
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
isClaimFound
boolean
claimRevRcmClaimId
integer or null <int64>
paymentStatusId
integer or null <int32>
paymentStatusDesc
string or null
integrationSystemKey
string or null

Responses

Request samples

Content type
[
  • {
    }
]

Response samples

Content type
No sample

Flips the IsWorked flag on a claim payment advice.

Request Body schema:
paymentAdviceId
string or null
accountNumber
string or null
receivedDate
string <date-time>
payerName
string or null
payerNumber
string or null
paymentAdviceStatusId
integer <int32>
object (ClaimRevModels_ClaimRemittance835_ClaimPaymentInfo)
object (ClaimRevModels_ClaimRemittance835_FinancialInformation)
eraClassification
string or null
isClaimFound
boolean
claimRevRcmClaimId
integer or null <int64>
paymentStatusId
integer or null <int32>
paymentStatusDesc
string or null
integrationSystemKey
string or null

Responses

Request samples

Content type
{
  • "paymentAdviceId": "string",
  • "accountNumber": "string",
  • "receivedDate": "2019-08-24T14:15:22Z",
  • "payerName": "string",
  • "payerNumber": "string",
  • "paymentAdviceStatusId": 0,
  • "paymentInfo": {
    },
  • "checkInformation": {
    },
  • "eraClassification": "string",
  • "isClaimFound": true,
  • "claimRevRcmClaimId": 0,
  • "paymentStatusId": 0,
  • "paymentStatusDesc": "string",
  • "integrationSystemKey": "string"
}

Response samples

Content type
No sample

Returns payment information for a claim.

query Parameters
claimId
integer <int64>

Responses

Response samples

Content type
No sample

Returns the payment-status dropdown list.

Responses

Response samples

Content type
No sample

Returns patient payments filtered by patient and/or encounter.

query Parameters
patientId
integer <int64>
encounterId
integer <int64>

Responses

Response samples

Content type
No sample

Posts a patient payment.

Request Body schema:
patientPaymentId
integer or null <int64>
encounterId
integer or null <int64>
patientId
integer or null <int64>
amountPaid
number <double>
paymentDate
string <date-time>
paymentMethodId
integer or null <int32>
paymentTypeId
integer or null <int32>
paymentMethod
string or null
paymentType
string or null
appliedToClaim
boolean
createdUserEmail
string or null

Responses

Request samples

Content type
{
  • "patientPaymentId": 0,
  • "encounterId": 0,
  • "patientId": 0,
  • "amountPaid": 0.1,
  • "paymentDate": "2019-08-24T14:15:22Z",
  • "paymentMethodId": 0,
  • "paymentTypeId": 0,
  • "paymentMethod": "string",
  • "paymentType": "string",
  • "appliedToClaim": true,
  • "createdUserEmail": "string"
}

Response samples

Content type
No sample

Deletes (voids) a patient payment.

Request Body schema:
patientPaymentId
integer or null <int64>
encounterId
integer or null <int64>
patientId
integer or null <int64>
amountPaid
number <double>
paymentDate
string <date-time>
paymentMethodId
integer or null <int32>
paymentTypeId
integer or null <int32>
paymentMethod
string or null
paymentType
string or null
appliedToClaim
boolean
createdUserEmail
string or null

Responses

Request samples

Content type
{
  • "patientPaymentId": 0,
  • "encounterId": 0,
  • "patientId": 0,
  • "amountPaid": 0.1,
  • "paymentDate": "2019-08-24T14:15:22Z",
  • "paymentMethodId": 0,
  • "paymentTypeId": 0,
  • "paymentMethod": "string",
  • "paymentType": "string",
  • "appliedToClaim": true,
  • "createdUserEmail": "string"
}

Response samples

Content type
No sample

Returns the payment-method dropdown list.

Responses

Response samples

Content type
No sample

Returns the payment-type dropdown list.

Responses

Response samples

Content type
No sample

Saves a manual claim payment entry.

Request Body schema:
claimPaymentId
integer <int64>
claimId
integer <int64>
encounterId
integer or null <int64>
patientId
integer or null <int64>
paymentStatusId
integer <int32>
paidAmount
number or null <double>
patientResponsibility
number or null <double>
postedDateTimeUtc
string or null <date-time>
singleClaimPaymentId
string or null
claimControlNumber
string or null
checkDate
string or null <date-time>
checkNumber
string or null

Responses

Request samples

Content type
{
  • "claimPaymentId": 0,
  • "claimId": 0,
  • "encounterId": 0,
  • "patientId": 0,
  • "paymentStatusId": 0,
  • "paidAmount": 0.1,
  • "patientResponsibility": 0.1,
  • "postedDateTimeUtc": "2019-08-24T14:15:22Z",
  • "singleClaimPaymentId": "string",
  • "claimControlNumber": "string",
  • "checkDate": "2019-08-24T14:15:22Z",
  • "checkNumber": "string"
}

Response samples

Content type
No sample

Backfills missing EDI control numbers on claims for the user's default account.

Responses

Response samples

Content type
No sample

Returns the AR export rows filtered by date of service, patient, and providers.

query Parameters
dateOfServiceStart
string <date-time>
dateOfServiceEnd
string <date-time>
patientId
integer <int64>
renderingProviderId
integer <int64>
billingProviderId
integer <int64>

Responses

Response samples

Content type
No sample

Exports the AR report as a downloadable CSV file.

query Parameters
dateOfServiceStart
string <date-time>
dateOfServiceEnd
string <date-time>
patientId
integer <int64>
renderingProviderId
integer <int64>
billingProviderId
integer <int64>

Responses

Response samples

Content type
No sample

SharpRevenue

Runs a SharpRevenue eligibility request using an uploaded raw X12 string.

Request Body schema:
x12
string or null
accountNumber
string or null
products
Array of integers or null <int32> [ items <int32 > ]

Responses

Request samples

Content type
{
  • "x12": "string",
  • "accountNumber": "string",
  • "products": [
    ]
}

Response samples

Content type
No sample

Runs a SharpRevenue eligibility request from a structured request model.

Request Body schema:
accountNumber
string or null
practiceName
string or null
requestingSoftware
string or null
clientId
string or null
createDate
string or null <date-time>
uniqueTransactionNumber
string or null
originatingSystemId
string or null
serviceBeginDate
string <date-time>
serviceEndDate
string <date-time>
npi
string or null
pinCode
string or null
practiceState
string or null
subscriberId
string or null
patientFirstName
string or null
patientLastName
string or null
patientGender
string or null
patientSsn
string or null
patientState
string or null
Array of objects or null (ClaimRevModels_ArBoost_Request_SharpRevenuePayer)
patientAddress1
string or null
patientAddress2
string or null
patientCity
string or null
patientZip
string or null
patientEmployer
string or null
patientEmployerState
string or null
patientDob
string or null <date-time>
patientPhone
string or null
patientEmailAddress
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
subscriberDob
string or null <date-time>
subscriberAddress1
string or null
subscriberAddress2
string or null
subscriberCity
string or null
subscriberState
string or null
subscriberZip
string or null
serviceTypeCodes
Array of strings or null
productsToRun
Array of integers or null <int32> [ items <int32 > ]
includeCredit
boolean
Array of objects or null (ClaimRevModels_ArBoost_Request_SharpRevenuePreAuthorization)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "practiceName": "string",
  • "requestingSoftware": "string",
  • "clientId": "string",
  • "createDate": "2019-08-24T14:15:22Z",
  • "uniqueTransactionNumber": "string",
  • "originatingSystemId": "string",
  • "serviceBeginDate": "2019-08-24T14:15:22Z",
  • "serviceEndDate": "2019-08-24T14:15:22Z",
  • "npi": "string",
  • "pinCode": "string",
  • "practiceState": "string",
  • "subscriberId": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientGender": "string",
  • "patientSsn": "string",
  • "patientState": "string",
  • "payers": [
    ],
  • "patientAddress1": "string",
  • "patientAddress2": "string",
  • "patientCity": "string",
  • "patientZip": "string",
  • "patientEmployer": "string",
  • "patientEmployerState": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "patientPhone": "string",
  • "patientEmailAddress": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "subscriberDob": "2019-08-24T14:15:22Z",
  • "subscriberAddress1": "string",
  • "subscriberAddress2": "string",
  • "subscriberCity": "string",
  • "subscriberState": "string",
  • "subscriberZip": "string",
  • "serviceTypeCodes": [
    ],
  • "productsToRun": [
    ],
  • "includeCredit": true,
  • "preAuthorizations": [
    ]
}

Response samples

Content type
No sample

Queues a SharpRevenue request to execute as a background task and returns immediately.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Runs a bulk eligibility file already staged in SharpRevenue.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Runs a real-time 276/277 claim-status request.

Request Body schema:
accountNumber
string or null
practiceName
string or null
requestingSoftware
string or null
createDate
string or null <date-time>
originatingSystemId
string or null
object (ClaimRevModels_ArBoost_Request_SharpRevenueNpi)
object (ClaimRevModels_ArBoost_Request_SharpRevenueNpi)
object (ClaimRevModels_ArBoost_Request_SharpRevenueClaim)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "practiceName": "string",
  • "requestingSoftware": "string",
  • "createDate": "2019-08-24T14:15:22Z",
  • "originatingSystemId": "string",
  • "npi": {
    },
  • "submitterNpi": {
    },
  • "claim": {
    }
}

Response samples

Content type
No sample

Builds and runs a manual claim-status request from a revenue-tools view model; returns a fatal-error response on invalid input.

Request Body schema:
accountNumber
string or null
patientId
integer <int32>
visitNumber
string or null
createDate
string <date-time>
requestingSoftware
string or null
object (ClaimRev_Business_SharpRevenue_Models_ManualClaimStatusInfo)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientId": 0,
  • "visitNumber": "string",
  • "createDate": "2019-08-24T14:15:22Z",
  • "requestingSoftware": "string",
  • "claim": {
    }
}

Response samples

Content type
No sample

Runs a claim-status request using an existing claim object id; returns a fatal-error response on invalid input.

query Parameters
claimObjectId
string

Responses

Response samples

Content type
No sample

Searches stored claim-status checks; returns a fatal-error response on invalid input.

Request Body schema:
objectId
string or null
accountNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
patientId
integer or null <int32>

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "patientId": 0
}

Response samples

Content type
No sample

Returns the full result of a stored claim-status check.

query Parameters
sharpRevenueClaimStatusObjectId
string

Responses

Response samples

Content type
No sample

Polls the status of an in-flight SharpRevenue transaction.

Request Body schema:
accountNumber
string or null
uniqueTransactionNumber
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "uniqueTransactionNumber": "string"
}

Response samples

Content type
No sample

Creates a new revenue-tools visit and runs eligibility; returns a fatal-error response on invalid input.

Request Body schema:
accountNumber
string or null
patientId
integer <int32>
visitNumber
string or null
serviceBeginDate
string or null <date-time>
serviceEndDate
string or null <date-time>
subscriberNumber
string or null
groupNumber
string or null
medicalRecordNumber
string or null
productsToRun
Array of integers or null <int32> [ items <int32 > ]

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientId": 0,
  • "visitNumber": "string",
  • "serviceBeginDate": "2019-08-24T14:15:22Z",
  • "serviceEndDate": "2019-08-24T14:15:22Z",
  • "subscriberNumber": "string",
  • "groupNumber": "string",
  • "medicalRecordNumber": "string",
  • "productsToRun": [
    ]
}

Response samples

Content type
No sample

Returns the human-readable SharpRevenue output for a given originating system and ClaimRev id.

query Parameters
originatingSystemId
string
claimRevId
string

Responses

Response samples

Content type
No sample

Returns a visit and its readable eligibility output with PHI obfuscated.

query Parameters
visitId
integer <int64>

Responses

Response samples

Content type
No sample

Returns a batch real-time visit's readable output with PHI obfuscated.

query Parameters
sharpRevenueRtEligibilityObjectId
string

Responses

Response samples

Content type
No sample

Returns an eligibility visit's readable output with PHI obfuscated.

query Parameters
sharpRevenueRtEligibilityObjectId
string

Responses

Response samples

Content type
No sample

Searches eligibility benefits for matching patient/plan criteria.

Request Body schema:
accountNumber
string or null
sharpRevenueObjectId
string or null
serviceTypeCode
Array of strings or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "sharpRevenueObjectId": "string",
  • "serviceTypeCode": [
    ]
}

Response samples

Content type
No sample

Returns service-type codes available on a revenue-tools eligibility response.

query Parameters
revenueToolsObjectId
string

Responses

Response samples

Content type
No sample

Remaps a visit's eligibility output.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Remaps an RT eligibility record.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Re-runs an eligibility request using the original payload stored in mongo, creating a new record.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Returns the SharpRevenue practice for the user's default account.

Responses

Response samples

Content type
No sample

Returns products the practice has subscribed to.

Responses

Response samples

Content type
No sample

Returns products available to add to the practice.

Responses

Response samples

Content type
No sample

Saves changes to the SharpRevenue practice.

Request Body schema:
accountNumber
string or null
practiceName
string or null
groupName
string or null
groupNpi
string or null
practiceId
integer <int64>
pinCode
string or null
practiceState
string or null
serviceTypeCodes
string or null
eligibilityStaleDays
integer or null <int32>
address1
string or null
address2
string or null
city
string or null
state
string or null
zip
string or null
notificationEmailAddress
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "practiceName": "string",
  • "groupName": "string",
  • "groupNpi": "string",
  • "practiceId": 0,
  • "pinCode": "string",
  • "practiceState": "string",
  • "serviceTypeCodes": "string",
  • "eligibilityStaleDays": 0,
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zip": "string",
  • "notificationEmailAddress": "string"
}

Response samples

Content type
No sample

Returns a SharpRevenue patient by id with PHI obfuscated.

query Parameters
patientId
integer <int32>

Responses

Response samples

Content type
No sample

Searches SharpRevenue patients scoped to the user's default account.

Request Body schema:
patientId
integer or null <int64>
firstName
string or null
lastName
string or null
dateOfBirth
string or null <date-time>
clinicNpi
string or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "patientId": 0,
  • "firstName": "string",
  • "lastName": "string",
  • "dateOfBirth": "2019-08-24T14:15:22Z",
  • "clinicNpi": "string",
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Returns the latest eligibility status aggregations for a patient/gender/DOB combination.

query Parameters
patientFirst
string
patientLast
string
patientGender
string
patientDob
string <date-time>
eligibilityStatus
string

Responses

Response samples

Content type
No sample

Creates or updates a SharpRevenue patient.

Request Body schema:
patientId
integer or null <int64>
practiceName
string or null
accountNumber
string or null
originatingSystemId
string or null
lastEligibilityCheck
string or null <date-time>
firstName
string or null
lastName
string or null
middleName
string or null
suffix
string or null
dateOfBirth
string or null <date-time>
gender
string or null
ssn
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zip
string or null
employer
string or null
phoneNumber
string or null
emailAddress
string or null
subscriberNumber
string or null
subscriberFirstName
string or null
subscriberLastName
string or null
subscriberMiddleName
string or null
subscriberDateOfBirth
string or null <date-time>
subscriberGender
string or null
subscriberSsn
string or null
subscriberRelationship
string or null
subscriberEmployer
string or null
subscriberAddress1
string or null
subscriberAddress2
string or null
subscriberCity
string or null
subscriberState
string or null
subscriberZip
string or null
subscriberEmailAddress
string or null
Array of objects or null (ClaimRev_Business_SharpRevenue_Models_PatientPayerViewModel)
clinicNpi
string or null
clinicName
string or null

Responses

Request samples

Content type
{
  • "patientId": 0,
  • "practiceName": "string",
  • "accountNumber": "string",
  • "originatingSystemId": "string",
  • "lastEligibilityCheck": "2019-08-24T14:15:22Z",
  • "firstName": "string",
  • "lastName": "string",
  • "middleName": "string",
  • "suffix": "string",
  • "dateOfBirth": "2019-08-24T14:15:22Z",
  • "gender": "string",
  • "ssn": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zip": "string",
  • "employer": "string",
  • "phoneNumber": "string",
  • "emailAddress": "string",
  • "subscriberNumber": "string",
  • "subscriberFirstName": "string",
  • "subscriberLastName": "string",
  • "subscriberMiddleName": "string",
  • "subscriberDateOfBirth": "2019-08-24T14:15:22Z",
  • "subscriberGender": "string",
  • "subscriberSsn": "string",
  • "subscriberRelationship": "string",
  • "subscriberEmployer": "string",
  • "subscriberAddress1": "string",
  • "subscriberAddress2": "string",
  • "subscriberCity": "string",
  • "subscriberState": "string",
  • "subscriberZip": "string",
  • "subscriberEmailAddress": "string",
  • "payers": [
    ],
  • "clinicNpi": "string",
  • "clinicName": "string"
}

Response samples

Content type
No sample

Returns the master payer list filtered by search text.

query Parameters
searchText
string

Responses

Response samples

Content type
No sample

Uploads a bulk patient file for the caller's default customer; returns 403 when no customer is linked.

Responses

Response samples

Content type
No sample

Uploads a bulk eligibility file; returns 403 when no customer is linked.

Responses

Response samples

Content type
No sample

Uploads a bulk real-time eligibility file; returns 403 when no customer is linked.

Responses

Response samples

Content type
No sample

Uploads a bulk RT demographic verification / coverage discovery file; returns 403 when no customer is linked.

Responses

Response samples

Content type
No sample

Uploads a bulk demographic verification / coverage discovery file; returns 403 when no customer is linked.

Responses

Response samples

Content type
No sample

Searches stored bulk input files, obfuscating PHI before returning.

Request Body schema:
objectId
string or null
accountNumber
string or null
startDate
string or null <date-time>
endDate
string or null <date-time>
customerFileName
string or null
uploadUser
string or null
sendStatus
integer <int32> (ClaimRevModels_Enums_RevenueToolsBulkSendStatus)
Enum: "ReadyToSend" "Sent" "DoNotSend" "Error"
processStatus
integer <int32> (ClaimRevModels_Enums_RevenueToolsBulkFileStatus)
Enum: "Ready" "Complete" "WaitingForResults" "Error" "InProcess"
batchType
string or null

Responses

Request samples

Content type
{
  • "objectId": "string",
  • "accountNumber": "string",
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "customerFileName": "string",
  • "uploadUser": "string",
  • "sendStatus": "ReadyToSend",
  • "processStatus": "Ready",
  • "batchType": "string"
}

Response samples

Content type
No sample

Returns the original request payload for a bulk input file.

query Parameters
id
string

Responses

Response samples

Content type
No sample

Returns the results file for a bulk input file.

query Parameters
id
string

Responses

Response samples

Content type
No sample

Extracts patient data from a claim and adds or updates the matching SharpRevenue patient.

Request Body schema:
string

Responses

Request samples

Content type
"string"

Response samples

Content type
No sample

Adds or updates a deductible-monitoring configuration; returns 403 when no customer is linked.

Request Body schema:
deductibleMonitoringPatientId
integer <int64>
patientId
integer <int64>
serviceType
string or null
remainingAmount
number or null <double>
inNetwork
boolean
sendAfterAge
integer or null <int32>
startDate
string or null <date-time>
endDate
string or null <date-time>
payerNumber
string or null
coverageLevel
string or null

Responses

Request samples

Content type
{
  • "deductibleMonitoringPatientId": 0,
  • "patientId": 0,
  • "serviceType": "string",
  • "remainingAmount": 0.1,
  • "inNetwork": true,
  • "sendAfterAge": 0,
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "payerNumber": "string",
  • "coverageLevel": "string"
}

Response samples

Content type
No sample

Removes (via add/update) a deductible-monitoring entry; returns 403 when no customer is linked.

Request Body schema:
deductibleMonitoringPatientId
integer <int64>
patientId
integer <int64>
serviceType
string or null
remainingAmount
number or null <double>
inNetwork
boolean
sendAfterAge
integer or null <int32>
startDate
string or null <date-time>
endDate
string or null <date-time>
payerNumber
string or null
coverageLevel
string or null

Responses

Request samples

Content type
{
  • "deductibleMonitoringPatientId": 0,
  • "patientId": 0,
  • "serviceType": "string",
  • "remainingAmount": 0.1,
  • "inNetwork": true,
  • "sendAfterAge": 0,
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z",
  • "payerNumber": "string",
  • "coverageLevel": "string"
}

Response samples

Content type
No sample

Returns deductible-monitoring for a patient/payer; returns 403 when no customer is linked.

query Parameters
patientId
integer <int64>
payerNumber
string

Responses

Response samples

Content type
No sample

Searches ERAs associated with a patient for the dashboard.

Request Body schema:
accountNumber
string or null
patientId
integer <int64>
receivedDateStart
string or null <date-time>
receivedDateEnd
string or null <date-time>
serviceDateStart
string or null <date-time>
serviceDateEnd
string or null <date-time>
linkOnClaimControlNumber
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientId": 0,
  • "receivedDateStart": "2019-08-24T14:15:22Z",
  • "receivedDateEnd": "2019-08-24T14:15:22Z",
  • "serviceDateStart": "2019-08-24T14:15:22Z",
  • "serviceDateEnd": "2019-08-24T14:15:22Z",
  • "linkOnClaimControlNumber": true
}

Response samples

Content type
No sample

Searches visits for a patient.

Request Body schema:
accountNumber
string or null
patientId
integer <int64>
startDate
string or null <date-time>
endDate
string or null <date-time>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "patientId": 0,
  • "startDate": "2019-08-24T14:15:22Z",
  • "endDate": "2019-08-24T14:15:22Z"
}

Response samples

Content type
No sample

Returns a downloadable template for the revenue-tools eligibility bulk upload.

Responses

Response samples

Content type
No sample

Returns a downloadable template for the revenue-tools patient bulk upload.

Responses

Response samples

Content type
No sample

Searches clinics scoped to the user's default account.

Request Body schema:
accountNumber
string or null
clinicName
string or null
clinicNpi
string or null
clinicId
integer or null <int64>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "clinicName": "string",
  • "clinicNpi": "string",
  • "clinicId": 0
}

Response samples

Content type
No sample

Returns a clinic by id.

query Parameters
clinicId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a clinic.

Request Body schema:
clinicId
integer or null <int64>
practiceId
integer or null <int64>
accountNumber
string or null
clinicName
string or null
clinicNpi
string or null
clinicTaxId
string or null
address1
string or null
address2
string or null
city
string or null
state
string or null
zip
string or null
pinCode
string or null
enrollmentStatus
integer or null <int32>
notes
string or null

Responses

Request samples

Content type
{
  • "clinicId": 0,
  • "practiceId": 0,
  • "accountNumber": "string",
  • "clinicName": "string",
  • "clinicNpi": "string",
  • "clinicTaxId": "string",
  • "address1": "string",
  • "address2": "string",
  • "city": "string",
  • "state": "string",
  • "zip": "string",
  • "pinCode": "string",
  • "enrollmentStatus": 0,
  • "notes": "string"
}

Response samples

Content type
No sample

Searches patients within a real-time batch.

Request Body schema:
accountNumber
string or null
objectId
string or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "objectId": "string",
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Downloads real-time batch results as a JSON file.

Request Body schema:
accountNumber
string or null
objectId
string or null
object (ClaimRevModels_PagingSearchViewModel)

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "objectId": "string",
  • "pagingSearch": {
    }
}

Response samples

Content type
No sample

Searches the most recent eligibility check per patient; returns an empty list on invalid input.

Request Body schema:
createDateStart
string or null <date-time>
createDateEnd
string or null <date-time>
accountNumber
string or null
coverageStatus
string or null
payerName
string or null
sharpRevenuePayerNumber
string or null
claimProcessingPayerNumber
string or null
insuranceType
string or null
daysOldStart
integer or null <int32>
daysOldEnd
integer or null <int32>
payerType
string or null
patientFirstName
string or null
patientLastName
string or null
createUserEmail
string or null
visitNumber
string or null
transactionId
string or null
npi
string or null

Responses

Request samples

Content type
{
  • "createDateStart": "2019-08-24T14:15:22Z",
  • "createDateEnd": "2019-08-24T14:15:22Z",
  • "accountNumber": "string",
  • "coverageStatus": "string",
  • "payerName": "string",
  • "sharpRevenuePayerNumber": "string",
  • "claimProcessingPayerNumber": "string",
  • "insuranceType": "string",
  • "daysOldStart": 0,
  • "daysOldEnd": 0,
  • "payerType": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "createUserEmail": "string",
  • "visitNumber": "string",
  • "transactionId": "string",
  • "npi": "string"
}

Response samples

Content type
No sample

Exports the latest eligibility search results as a downloadable CSV file.

Request Body schema:
createDateStart
string or null <date-time>
createDateEnd
string or null <date-time>
accountNumber
string or null
coverageStatus
string or null
payerName
string or null
sharpRevenuePayerNumber
string or null
claimProcessingPayerNumber
string or null
insuranceType
string or null
daysOldStart
integer or null <int32>
daysOldEnd
integer or null <int32>
payerType
string or null
patientFirstName
string or null
patientLastName
string or null
createUserEmail
string or null
visitNumber
string or null
transactionId
string or null
npi
string or null

Responses

Request samples

Content type
{
  • "createDateStart": "2019-08-24T14:15:22Z",
  • "createDateEnd": "2019-08-24T14:15:22Z",
  • "accountNumber": "string",
  • "coverageStatus": "string",
  • "payerName": "string",
  • "sharpRevenuePayerNumber": "string",
  • "claimProcessingPayerNumber": "string",
  • "insuranceType": "string",
  • "daysOldStart": 0,
  • "daysOldEnd": 0,
  • "payerType": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "createUserEmail": "string",
  • "visitNumber": "string",
  • "transactionId": "string",
  • "npi": "string"
}

Response samples

Content type
No sample

Searches SharpRevenue transactions with PHI obfuscated.

Request Body schema:
createDateStart
string or null <date-time>
createDateEnd
string or null <date-time>
accountNumber
string or null
coverageStatus
string or null
payerName
string or null
sharpRevenuePayerNumber
string or null
claimProcessingPayerNumber
string or null
insuranceType
string or null
patientFirstName
string or null
patientLastName
string or null
patientDob
string or null <date-time>
subscriberId
string or null
createUserEmail
string or null
visitNumber
string or null
transactionId
string or null
npi
string or null
mrn
string or null
status
string or null
transactionType
string or null
page
integer or null <int32>
pageSize
integer or null <int32>

Responses

Request samples

Content type
{
  • "createDateStart": "2019-08-24T14:15:22Z",
  • "createDateEnd": "2019-08-24T14:15:22Z",
  • "accountNumber": "string",
  • "coverageStatus": "string",
  • "payerName": "string",
  • "sharpRevenuePayerNumber": "string",
  • "claimProcessingPayerNumber": "string",
  • "insuranceType": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "subscriberId": "string",
  • "createUserEmail": "string",
  • "visitNumber": "string",
  • "transactionId": "string",
  • "npi": "string",
  • "mrn": "string",
  • "status": "string",
  • "transactionType": "string",
  • "page": 0,
  • "pageSize": 0
}

Response samples

Content type
No sample

Exports SharpRevenue transaction search as a downloadable CSV file.

Request Body schema:
createDateStart
string or null <date-time>
createDateEnd
string or null <date-time>
accountNumber
string or null
coverageStatus
string or null
payerName
string or null
sharpRevenuePayerNumber
string or null
claimProcessingPayerNumber
string or null
insuranceType
string or null
patientFirstName
string or null
patientLastName
string or null
patientDob
string or null <date-time>
subscriberId
string or null
createUserEmail
string or null
visitNumber
string or null
transactionId
string or null
npi
string or null
mrn
string or null
status
string or null
transactionType
string or null
page
integer or null <int32>
pageSize
integer or null <int32>

Responses

Request samples

Content type
{
  • "createDateStart": "2019-08-24T14:15:22Z",
  • "createDateEnd": "2019-08-24T14:15:22Z",
  • "accountNumber": "string",
  • "coverageStatus": "string",
  • "payerName": "string",
  • "sharpRevenuePayerNumber": "string",
  • "claimProcessingPayerNumber": "string",
  • "insuranceType": "string",
  • "patientFirstName": "string",
  • "patientLastName": "string",
  • "patientDob": "2019-08-24T14:15:22Z",
  • "subscriberId": "string",
  • "createUserEmail": "string",
  • "visitNumber": "string",
  • "transactionId": "string",
  • "npi": "string",
  • "mrn": "string",
  • "status": "string",
  • "transactionType": "string",
  • "page": 0,
  • "pageSize": 0
}

Response samples

Content type
No sample

Streams an AI-assisted answer about a patient's eligibility as a Server-Sent Events response.

Request Body schema:
accountNumber
string or null
sharpRevenueObjectId
string or null
question
string or null
payerCode
string or null
model
string or null
webSearch
boolean

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "sharpRevenueObjectId": "string",
  • "question": "string",
  • "payerCode": "string",
  • "model": "string",
  • "webSearch": true
}

Response samples

Content type
No sample

Returns billable transaction counts across the user's accounts for the requested billing window.

query Parameters
billingStartDate
string <date-time>
billingEndDate
string <date-time>

Responses

Response samples

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No sample

Returns a payer-level transaction summary across the user's accounts for the requested window and product.

query Parameters
startDate
string <date-time>
endDate
string <date-time>
productId
integer <int32>

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Response samples

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No sample

SupportInfo

Returns ClaimRev support contact details (phone, support email, sales email) as an anonymous object.

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No sample

SystemStatus

Returns the current aggregated system status (service health, dependencies, etc.).

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No sample

UserPreferences

/api/UserPreferences/v1

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No sample

/api/UserPreferences/v1/landing-page

Request Body schema:
routeId
string or null

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Request samples

Content type
{
  • "routeId": "string"
}

Response samples

Content type
No sample

/api/UserPreferences/v1/default-search

Request Body schema:
savedSearchId
string or null

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Request samples

Content type
{
  • "savedSearchId": "string"
}

Response samples

Content type
No sample

/api/UserPreferences/v1/hide-classic-search-link

Request Body schema:
hide
boolean

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Request samples

Content type
{
  • "hide": true
}

Response samples

Content type
No sample

/api/UserPreferences/v1/effective-default-search

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No sample

UserProfile

Returns the client app configuration for the current user (menu, default account, feature flags, etc.).

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No sample

Sets the current user's default customer account to the supplied account number.

Request Body schema:
string

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Request samples

Content type
"string"

Response samples

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No sample

Returns the current user's currently selected default account number.

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No sample

Returns the list of customer accounts the current user's email is attached to.

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No sample

Workflow

Creates or updates a workflow tag for the caller's resolved account and returns the saved tag.

Request Body schema:
tagId
integer or null <int64>
accountNumber
string or null
tagName
string or null
tagDescription
string or null
tagColor
string or null
stopClaim
boolean

Responses

Request samples

Content type
{
  • "tagId": 0,
  • "accountNumber": "string",
  • "tagName": "string",
  • "tagDescription": "string",
  • "tagColor": "string",
  • "stopClaim": true
}

Response samples

Content type
No sample

Returns the workflow tags defined for the caller's default account.

Responses

Response samples

Content type
No sample

Returns a single workflow tag by id, scoped to the caller's default account.

query Parameters
tagId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a workflow queue and returns the saved queue.

Request Body schema:
claimQueueId
integer or null <int64>
accountNumber
string or null
queueName
string or null
queueDescription
string or null
queueColor
string or null
queueOrder
integer or null <int32>

Responses

Request samples

Content type
{
  • "claimQueueId": 0,
  • "accountNumber": "string",
  • "queueName": "string",
  • "queueDescription": "string",
  • "queueColor": "string",
  • "queueOrder": 0
}

Response samples

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No sample

Returns all workflow queues configured for the caller's default account.

Responses

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No sample

Returns a single workflow queue by id, scoped to the caller's default account.

query Parameters
queueId
integer <int64>

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No sample

Returns the tags already assigned to a queue along with those still available to add.

query Parameters
queueId
integer <int64>

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No sample

Returns payer acceptance rules for the account, optionally filtered to a specific tag.

query Parameters
tagId
integer <int64>

Responses

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No sample

Returns payer advice (remit) rules for the account, optionally filtered to a specific tag.

query Parameters
tagId
integer <int64>

Responses

Response samples

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No sample

Returns the add/edit view model (rule plus lookup data) for a payer advice tag rule.

query Parameters
paymentAdviceTagRuleId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a payer advice tag rule and returns the saved rule.

Request Body schema:
accountNumber
string or null
tagId
integer <int64>
groupCode
string or null
reasonCode
string or null
remarkCode
string or null
remarkQualifier
string or null
paymentAdviceTagRuleId
integer <int64>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "tagId": 0,
  • "groupCode": "string",
  • "reasonCode": "string",
  • "remarkCode": "string",
  • "remarkQualifier": "string",
  • "paymentAdviceTagRuleId": 0
}

Response samples

Content type
No sample

Returns the add/edit view model (rule plus lookup data) for a payer acceptance tag rule.

query Parameters
payerAcceptanceTagRuleId
integer <int64>

Responses

Response samples

Content type
No sample

Creates or updates a payer acceptance tag rule and returns the saved rule.

Request Body schema:
accountNumber
string or null
payerAcceptanceTagRuleId
integer or null <int64>
tagId
integer <int64>
statusCodeCategory
string or null
statusCode
string or null
identityCode
string or null
freeFormTextContains
string or null

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "payerAcceptanceTagRuleId": 0,
  • "tagId": 0,
  • "statusCodeCategory": "string",
  • "statusCode": "string",
  • "identityCode": "string",
  • "freeFormTextContains": "string"
}

Response samples

Content type
No sample

Adds a tag to a queue's include list. Returns true when the assignment succeeds.

Request Body schema:
accountNumber
string or null
tagId
integer or null <int64>
claimQueueId
integer or null <int64>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "tagId": 0,
  • "claimQueueId": 0
}

Response samples

Content type
No sample

Adds a tag to a queue's exclude list. Returns true when the assignment succeeds.

Request Body schema:
accountNumber
string or null
tagId
integer or null <int64>
claimQueueId
integer or null <int64>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "tagId": 0,
  • "claimQueueId": 0
}

Response samples

Content type
No sample

Removes a tag from a queue's include list. Returns true when the removal succeeds.

Request Body schema:
accountNumber
string or null
tagId
integer or null <int64>
claimQueueId
integer or null <int64>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "tagId": 0,
  • "claimQueueId": 0
}

Response samples

Content type
No sample

Removes a tag from a queue's exclude list. Returns true when the removal succeeds.

Request Body schema:
accountNumber
string or null
tagId
integer or null <int64>
claimQueueId
integer or null <int64>

Responses

Request samples

Content type
{
  • "accountNumber": "string",
  • "tagId": 0,
  • "claimQueueId": 0
}

Response samples

Content type
No sample

Deletes a payer acceptance tag rule by id within the caller's default account.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Deletes a payer advice tag rule by id within the caller's default account.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Deletes a tag by id within the caller's default account.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Deletes a queue by id within the caller's default account.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Persists a new queue ordering for the caller's default account.

Request Body schema:
Array
claimQueueId
integer or null <int64>
accountNumber
string or null
queueName
string or null
queueDescription
string or null
queueColor
string or null
queueOrder
integer or null <int32>

Responses

Request samples

Content type
[
  • {
    }
]

Response samples

Content type
No sample

Returns a single claim property tag rule by id (or a new/default rule when no id is supplied).

query Parameters
tagRuleId
integer <int64>

Responses

Response samples

Content type
No sample

Returns all claim property tag rules configured for the caller's default account.

Responses

Response samples

Content type
No sample

Creates or updates a claim property tag rule and returns the saved rule.

Request Body schema:
tagRuleId
integer or null <int64>
object (ClaimRev_Business_Workflow_ViewModels_TagViewModel)
tagId
integer <int64>
ruleName
string or null
ruleDescription
string or null
Array of objects or null (ClaimRev_Business_Workflow_ViewModels_CriterionViewModel)

Responses

Request samples

Content type
{
  • "tagRuleId": 0,
  • "tag": {
    },
  • "tagId": 0,
  • "ruleName": "string",
  • "ruleDescription": "string",
  • "criteriaList": [
    ]
}

Response samples

Content type
No sample

Deletes a claim property tag rule by id within the caller's default account.

Request Body schema:
integer <int64>

Responses

Request samples

Content type
0
0

Response samples

Content type
No sample

Returns the default set of criterion JSON paths that can be used when configuring tag rules.

Responses

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No sample

Returns the list of criterion comparison operators available for tag rules.

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No sample

Seeds the caller's default account with the standard set of default workflow queues.

Responses

Response samples

Content type
No sample