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API Schema Example

Suggest edit Updated on April 26, 2021

The following table shows example of

  1. Request: A request with the correct structure and mandatory fields Submitted.
  2. Response: A response with the Case ID and ICN in it.
  3. A Response where no Claims were found.
Request:Response: - Not FoundResponse: - Results Found

{

"claimsInquiry":

{

"reasonForInquiry": "ERA",

"inquiryTypeSelect": "Other",

"claimsInquiryNotes": "Inquiry notes",

"groupNumber": "",

"exchangeIndicator": "",

"attachmentURL": "www.google.com",

"icnList":

[

{

"ID": "2019164P0000000200"

}

],

"claimHeader":

{

"billingProvider":

{

"nationalProviderIdentifier": "",

"taxIdentificationNumber": "",

"lastName": "",

"address":

[

{

"addressLine1": "",

"addressLine2": "",

"city": "",

"state": "",

"postalCode": ""

}

]

},

"subscriber":

{

"ID": "",

"firstName": "",

"lastName": ""

},

"patient":

{

"ID": "",

"firstName": "",

"lastName": ""

},

"claimType": "",

"claimStatus": "",

"serviceFromDate": "",

"serviceEndDate": "",

"renderingProvider":

{

"ID": ""

},

"planID": "",

"totalChargeAmount": "",

"paidAmount": "",

"contractInformation":

{

"ID": ""

},

"submittedDate": ""

}

}

}

{

"pxObjClass": "PegaHC-API",

"claimsInquiry":

{

"pxObjClass": "PegaHC-Int-ClaimsInquiry",

"statusCode": "200",

"statusDesc": "NoClaimsFound"

}

}

{

"pxObjClass": "PegaHC-API",

"claimsInquiry":

{

"claimInquiryID": "CI-207",

"pxObjClass": "PegaHC-Int-ClaimsInquiry",

"status": "Pending-Review",

"statusCode": "200",

"statusDesc": "Success",

"icnList":

[

{

"ID": "2019165P0000004700",

"pxObjClass": "Embed-PegaHC-Stringlist",

"Status": "ResultsFound"

}

]

}

}
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