Create a claim

post https://api.claims.curacel.co/api/v1/claims

Body Params

Claims Information

hmo_code

string

Required only for Provider / EMR integrations

The human friendly unique code of the Insurer who should receive this claim.

See insurer list endpoint for available Insurers

hmo_id

number

The ID of the Insurer who should receive this claim. Used when hmo_code is not supplied

provider_code

string

Required for Insurer / HMO integrations only.
This is the unique code/ID with which you(The Insurer) identify the provider within your database.
NB: This code must be attached to the provider on your curacel account.

enrollee

object

required

Specifies the Enrollee / Patient for whom this claim is created

encounter_date

date

required

The date of the patient’s visit to the provider.

admission_date

date

If the patient was admitted, date admission started.

discharge_date

date

If the patient was admitted, date of discharge.

diagnoses

object

required

The collection of diagnoses that should be attached to this claim.

pa_code

string

Pre-authorization code for the claim.

items

array of objects

required

Collection of all the line items that make up the claim.

items*

is_draft

boolean

Defaults to true

Applies only to Provider / EMR integrations
Always false for HMO / Insurer integrations

Determines whether the claim should be created as a draft (true) or submitted to the HMO immediately (false) after successful creation.
Creating as a draft would make it possible to review and edit the claim on the curacel platform before final submission to the HMO.

ref

string

Required for insurer / HMO integrations

Unique identifier for the claim as is on the source system. E.g it’s ID

auto_vet

boolean

Defaults to false

Insurer / HMO integrations only.

When true, the claim would be passed through the Curacel auto-vetting engine after successful creation.

create_missing_tariffs

boolean

Defaults to false

Insurer / HMO integrations only.

When true, new tariffs would be automatically created for items that have no match. They would be created under the account of the provider to which the claim belongs.

attachments

array of integers

An optional array of IDs of previously/already created attachments.
Supplied Attachments must be owned by caller's organization.

attachments

Responses

400

Bad Request

401

Unauthenticated

403

Forbidden

404

not found

Language

Credentials

Bearer

API KEY from your account dashboard

URL


xxxxxxxxxx
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curl --request POST \
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     --url https://api.claims.curacel.co/api/v1/claims \
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     --header 'accept: application/json' \
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     --header 'content-type: application/json' \
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     --data '
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{
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  "enrollee": {
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    "is_floating": false,
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    "create_if_not_found": false
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  },
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  "is_draft": true,
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  "auto_vet": false,
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  "create_missing_tariffs": false
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}
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'

Click Try It! to start a request and see the response here! Or choose an example:

application/json

200Success