---
title: "POST /api/claim/healthie/v1"
method: POST
path: "/api/claim/healthie/v1"
---

# POST /api/claim/healthie/v1

`POST /api/claim/healthie/v1`

## Request

- Base URL: `https://forecaster.cairhealth.com`
- URL: `https://forecaster.cairhealth.com/api/claim/healthie/v1`
- Auth: HTTP bearer

Creates a claim from a Healthie CMS 1500 file. This schema is based on the Healthie CMS 1500 schema that can be found [here](https://docs.gethealthie.com/reference/2024-06-01/objects/cms1500).

## Query parameters

- `attachmentId` string

## Request body

- object
  - `id` string, required: Unique identifier for the CMS 1500 form
  - `date_of_service` string, required: Date when the service was provided
  - `total_charge` string, required: Total charge amount for the claim
  - `patient` object, required: Information about the patient
    - `id` string: Patient identifier
    - `first_name` string: Patient's first name
    - `last_name` string: Patient's last name
    - `name` string: Patient's full name
    - `gender` string: Patient's gender
    - `dob` string: Patient's date of birth
    - `location` object: Patient's address information
      - `city` string: City
      - `country` string: Country
      - `line1` string: Address line 1
      - `line2` string: Address line 2
      - `name` string: Location name
      - `state` string: State
      - `to_oneline` string: Single line address representation
      - `zip` string: ZIP/Postal code
    - `policies` object[]: Patient's insurance policies
      - `id` string: Policy identifier
      - `num` string: Policy number
      - `group_num` string: Insurance group number
      - `name` string: Policy name
      - `holder_first` string: Policy holder's first name
      - `holder_last` string: Policy holder's last name
      - `holder_relationship` string: Relationship between patient and policy holder
      - `prior_authorization` string: Prior authorization reference number; stored on the FHIR Claim as insurance[].preAuthRef
      - `insurance_plan` object: Insurance plan details
        - `payer_name` string, required: Name of the insurance payer
        - `payer_id` string, required: Identifier for the insurance payer
        - `name_and_id` string: Combined name and ID of the insurance plan
  - `billing_provider` object, required: Information about the billing provider. Resolved to an Organization or, for individual (Type 1 NPI) providers, a Practitioner with a matching NPI and EIN.
    - `name` string, required: Provider name
    - `npi` string, required: National Provider Identifier
    - `tax_id` string, required: Provider tax ID (EIN). Used with the NPI to resolve the billing provider
    - `location` object, required: Provider's address information
      - `city` string: City
      - `country` string: Country
      - `line1` string: Address line 1
      - `line2` string: Address line 2
      - `name` string: Location name
      - `state` string: State
      - `to_oneline` string: Single line address representation
      - `zip` string: ZIP/Postal code
  - `rendering_provider` object, required: Information about the rendering provider
    - `id` string: Provider identifier
    - `first_name` string: Provider's first name
    - `last_name` string: Provider's last name
    - `name` string: Provider's full name
    - `npi` string, required: Provider's NPI
    - `gender` string: Provider's gender
    - `dob` string: Provider's date of birth
    - `location` object: Provider's address information
      - `city` string: City
      - `country` string: Country
      - `line1` string: Address line 1
      - `line2` string: Address line 2
      - `name` string: Location name
      - `state` string: State
      - `to_oneline` string: Single line address representation
      - `zip` string: ZIP/Postal code
  - `service_location` object: Location of the service
    - `place_of_service` object: Place of service details
      - `code` string: Code of the place of service
      - `name` string: Name of the place of service
      - `code_name` string: Code name of the place of service
  - `cpt_codes_cms1500s` object[], required: CPT codes associated with the claim
    - `fee` string: Billed amount for this service
    - `units` string: Number of units for this service
    - `mod1` string: Modifier 1
    - `mod2` string: Modifier 2
    - `mod3` string: Modifier 3
    - `mod4` string: Modifier 4
    - `cpt_code` object, required
      - `code` string, required: CPT code value
  - `icd_codes_cms1500s` object[], required: ICD diagnosis codes associated with the claim
    - `icd_code` object, required
      - `code` string, required: ICD code value

## Response `200`

Claim created successfully

- OperationOutcome: A FHIR standard response format for operations
  - `resourceType` 'OperationOutcome', required: Type of resource
  - `id` string: Logical id of this artifact
  - `issue` object[], required: A list of issues with the operation
    - `severity` 'fatal' | 'error' | 'warning' | 'information', required: Severity of the issue
    - `code` 'invalid' | 'structure' | 'required' | 'value' | 'invariant' | 'security' | 'login' | 'unknown' | 'expired' | 'forbidden' | 'suppressed' | 'processing' | 'not-supported' | 'duplicate' | 'multiple-matches' | 'not-found' | 'deleted' | 'too-long' | 'code-invalid' | 'extension' | 'too-costly' | 'business-rule' | 'conflict' | 'transient' | 'lock-error' | 'no-store' | 'exception' | 'timeout' | 'incomplete' | 'throttled' | 'informational', required: Error or warning code
    - `diagnostics` string: Additional diagnostic information about the issue
    - `details` object
      - `text` string: Text description of the issue
      - `coding` object[]: Coding of the issue
    - `location` string[]: Locations in the resource where the issue occurred
    - `expression` string[]: FHIRPath of element(s) causing the issue

## Other responses

- `400`: Invalid request body or validation error
- `401`: Unauthorized access or invalid organization ID

---

[API](https://skmtc.dev/cairhealth/apis/cair-health-apis.md) - [All operations](https://skmtc.dev/cairhealth/apis/cair-health-apis/llms.txt) - [OpenAPI document](https://skmtc.dev/cairhealth/apis/cair-health-apis/revisions/b32380ccde9a?raw)