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Get Claim By Claim Number

Header Parameters

X-Request-Idstring

Optional correlation ID associated with the request, comprised of alphanumeric or hyphen characters up to 36 characters in length.

Authorizationstring

Query Parameters

person_idstring

The GUID of the person (participant).

Path Parameters

claim_numberstring Required

The Claim number, an alphanumeric string, e.g. 11BPEB1210513P0000101

Response

200
Object
Successfully retrieved claim information

Response Attributes

claim_numberstring Required

A unique identifier assigned to the claim.

claim_amountnumber Required

The total amount of the claim submitted.

claim_statusstring Required

The current processing status of the claim.

submission_datestring

The date the claim was submitted.

Nullable:
True
start_date_of_servicestring

The first date services were provided for the claim.

Nullable:
True
end_date_of_servicestring

The last date services were provided for the claim.

Nullable:
True
processed_datestring

The date the claim was processed.

Nullable:
True
provider_namestring

The name of the provider associated with the claim.

Nullable:
True
paid_amountnumber Required

The amount reimbursed for the claim.

submitted_amountnumber Required

The original amount submitted for reimbursement.

is_ptpboolean Required

Indicates whether the claim is part of a pay-the-provider process.

denial_reasonsarray

The reason or reasons the submitted claim was denied, if applicable.

Nullable:
True

Show child attributes

requests_for_more_informationarray

Requests for additional information related to the claim, if applicable.

Nullable:
True

Show child attributes

receipt_statusstring Required

The status of receipt submission for the claim.

denied_amountnumber Required

The total amount of the claim that was denied.

applied_copay_amountnumber Required

The portion of the claim amount applied to a copay.

applied_coinsurance_amountnumber Required

The portion of the claim amount applied to coinsurance.

applied_deductible_amountnumber Required

The portion of the claim amount applied to a deductible.

claim_sourcestring Required

The source of the claim submission.

scheduled_for_reimbursement_datestring

The date the claim is scheduled for reimbursement.

Nullable:
True
plan_year_namestring

The name of the plan year associated with the claim.

Nullable:
True
plan_year_start_datestring

The start date of the applicable plan year.

Nullable:
True
plan_namestring

The name of the plan associated with the claim.

Nullable:
True
final_filing_datestring

The final date on which the claim can be filed.

Nullable:
True
expense_idstring Required

The expense identifier associated with the claim.

receipt_status_dtstring

The date and time the receipt status was last updated.

Nullable:
True
400
Object
Bad Request

Response Attributes

typestring
Nullable:
True
titlestring
Nullable:
True
statusinteger
Nullable:
True
detailstring
Nullable:
True
instancestring
Nullable:
True
401
Object
Unauthorized

Response Attributes

typestring
Nullable:
True
titlestring
Nullable:
True
statusinteger
Nullable:
True
detailstring
Nullable:
True
instancestring
Nullable:
True
404
Object
Not Found

Response Attributes

typestring
Nullable:
True
titlestring
Nullable:
True
statusinteger
Nullable:
True
detailstring
Nullable:
True
instancestring
Nullable:
True
500
Object
Internal Server Error

Response Attributes

typestring
Nullable:
True
titlestring
Nullable:
True
statusinteger
Nullable:
True
detailstring
Nullable:
True
instancestring
Nullable:
True
default
Object
Unexpected error

Response Attributes

typestring
Nullable:
True
titlestring
Nullable:
True
statusinteger
Nullable:
True
detailstring
Nullable:
True
instancestring
Nullable:
True
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