API Reference

Create a claim

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

Claims Information

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

number

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

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

date
required

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

date

If the patient was admitted, date admission started.

date

If the patient was admitted, date of discharge.

diagnoses
object
required

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

string

Pre-authorization code for the claim.

items
array of objects
required

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

items*
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.

string

Required for insurer / HMO integrations

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

boolean
Defaults to false

Insurer / HMO integrations only.

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

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
string

Optional information for the claim
The name of the specialist who performed the service.

Responses

400

Bad Request

401

Unauthenticated

403

Forbidden

404

not found

Updated over 2 years ago

Language
Credentials
Bearer
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Response 
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application/json
Updated over 2 years ago