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POST API Request Mapping

Suggest edit Updated on April 26, 2021

The following table shows the POST API Request Fields and Corresponding SCE Class and Property Mapping.

Request ParameterSCE ClassSCE PropertyProperty TypeAPI ClassApi PropertyData TypeIs Mandatory
Claims inquiry reason codePegaHC-CLM-Work-ClaimsinquiryReasonForInquiryTextPegaHC-API claimsInquiry.reasonForInquiryStringYes
PegaHC-CLM-Work-ClaimsinquiryReasonForInquiryOtherTextPegaHC-API claimsInquiry.reasonForInquiryOtherStringNo
Claims Inquiry typePegaHC-CLM-Work-ClaimsinquiryInquiryTypeSelectTextPegaHC-API claimsInquiry.inquiryTypeSelectStringYes
PegaHC-CLM-Work-ClaimsinquiryInquiryTypeSelectOtherTextPegaHC-API claimsInquiry.inquiryTypeSelectOtherStringNo
Inquiry NotesPegaHC-CLM-Work-ClaimsinquiryClaimsInquiryNotesTextPegaHC-API claimsInquiry.claimsInquiryNotesStringNo
ICN'sPegaHC-CLM-Work-ClaimsinquiryICNList().IDPagelistPegaHC-API claimsInquiry.icnList().IDStringConditional
BillingProviderNPIPegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.NationalProviderIdentifierTextPegaHC-API claimsInquiry.claimHeader.billingProvider.nationalProviderIdentifierStringConditional
BillingProviderTaxIDPegaHC-CLM-WorkBillingProviderNumberTextPegaHC-API claimsInquiry.claimHeader.billingProvider.taxIdentificationNumberStringConditional
BillingProviderLastNamePegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.pyLastNameTextPegaHC-API claimsInquiry.claimHeader.billingProvider.lastNameStringNo
BillingProviderAddressLine1PegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.PracticeAddress().AddressLine1TextPegaHC-API claimsInquiry.claimHeader.billingProvider.address().addressLine1StringNo
BillingProviderAddressLine2PegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.PracticeAddress().AddressLine2TextPegaHC-API claimsInquiry.claimHeader.billingProvider.address().addressLine2StringNo
BillingProviderCityPegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.PracticeAddress().CityTextPegaHC-API claimsInquiry.claimHeader.billingProvider.address().cityStringNo
BillingProviderStatePegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.PracticeAddress().StateTextPegaHC-API claimsInquiry.claimHeader.billingProvider.address().stateStringNo
BillingProviderZipPegaHC-CLM-Work-ClaimsinquiryClaim.BillingEntity.PracticeAddress().PostalCodeTextPegaHC-API claimsInquiry.claimHeader.billingProvider.address().postalCodeStringNo
SubscriberIDPegaHC-CLM-WorkSubscriberNumberTextPegaHC-API claimsInquiry.claimHeader.subscriber.IDStringConditional
SubscriberFirstNamePegaHC-CLM-Work-ClaimsinquiryClaim.Subscriber.pyFirstNameTextPegaHC-API claimsInquiry.claimHeader.subscriber.firstNameStringNo
SubscriberLastNamePegaHC-CLM-Work-ClaimsinquiryClaim.Subscriber.pyLastNameTextPegaHC-API claimsInquiry.claimHeader.subscriber.lastNameStringNo
PatientIDPegaHC-CLM-WorkPatientNumberTextPegaHC-API claimsInquiry.claimHeader.patient.IDStringConditional
PatientFirstNamePegaHC-CLM-Work-ClaimsinquiryClaim.Patient.pyFirstNameTextPegaHC-API claimsInquiry.claimHeader.patient.firstNameStringNo
PatientLastNamePegaHC-CLM-Work-ClaimsinquiryClaim.Patient.pyLastNameTextPegaHC-API claimsInquiry.claimHeader.patient.lastNameStringNo
Claim typePegaHC-CLM-Work-ClaimsinquiryClaim.ClaimTypeTextPegaHC-API claimsInquiry.claimHeader.claimTypeStringNo
Claim total charge amountPegaHC-CLM-Work-ClaimsinquiryClaim.TotalClaimChargeAmountDecimalPegaHC-API claimsInquiry.claimHeader.totalChargeAmountStringNo
Claim total paid amountPegaHC-CLM-Work-ClaimsinquiryClaim.TotalClaimPaidAmountDecimalPegaHC-API claimsInquiry.claimHeader.paidAmountStringNo
StatusPegaHC-CLM-Work-ClaimsinquiryClaim.ClaimStatusTextPegaHC-API claimsInquiry.claimHeader.claimStatusStringNo
ServiceDateFromPegaHC-CLM-Work-ClaimsinquiryClaim.ServiceFromDateDatePegaHC-API claimsInquiry.claimHeader.serviceFromDateStringNo
ServiceDateToPegaHC-CLM-Work-ClaimsinquiryClaim.ServiceToDateDatePegaHC-API claimsInquiry.claimHeader.serviceEndDateStringNo
Submission datePegaHC-CLM-Work-ClaimsinquiryClaim.SubmittedDateDatePegaHC-API claimsInquiry.claimHeader.submittedDateStringNo
Rendering provider NPIPegaHC-CLM-WorkRenderingProviderNumberTextPegaHC-API claimsInquiry.claimHeader.renderingProvider.IDStringNo
Plan IDPegaHC-CLM-Work-ClaimsinquiryClaim.Patient.PlanNameTextPegaHC-API claimsInquiry.claimHeader.planIDStringNo
Contract IDPegaHC-CLM-WorkContractIDTextPegaHC-API claimsInquiry.claimHeader.contractInformation.IDStringNo
Attachment URLWork-pyURLStringPegaHC-API claimsInquiry.attachmentURLStringNo
Group NumberPegaHC-CLM-WorkGroupNumberTextPegaHC-API claimsInquiry.groupNumberStringNo
Exchange IndicatorPegaHC-CLM-Work-ClaimsinquiryExchangeIndicatorTextPegaHC-API claimsInquiry.exchangeIndicatorStringNo

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