Claims

View claim (beta)

🚧 Beta

Send Nex-Api-Version: v3.1.0 to use this endpoint. It is still changing, and access is limited to approved partner institutions. Contact NexHealth before you build on it.

Changed from v3.0.0: Adds response fields data.guarantor.address, data.guarantor.address.city, data.guarantor.address.line_1, data.guarantor.address.line_2 (+38 more); removes response fields data.guarantor.bio, data.guarantor.last_sync_time, data.patient.bio, data.patient.last_sync_time (+2 more).

This endpoint returns a single claim by its NexHealth ID, with optional sideloading of patient, provider, guarantor, charges, and charge_payouts.

get/claims/{id}

Request

Base URL
https://nexhealth.info
URL
https://nexhealth.info/claims/{id}
Auth
API key in header Authorization

Path parameters

idinteger required

NexHealth ID of the claim

Query parameters

subdomainstring required

Used to scope the request to the specified institution

include[]string[]

Resources to be included in the response

Headers

Nex-Api-Versionstring required

The NexHealth API version

Response

Successful

codeboolean

Indicates the success or failure of the request

descriptionstring

Additional context on the request to help with debugging.

errorstring[]

Any errors that occur during the execution of the request.

countinteger

Number of total objects, in case of collection.

Example response

{
  "description": "Description",
  "error": [
    "Error message"
  ],
  "data": {
    "id": 10,
    "location_id": 1,
    "patient_id": 1002,
    "provider_id": 101,
    "guarantor_id": 1001,
    "status": "sent",
    "received_at": "2024-06-10T15:16:57.000Z",
    "sent_at": "2024-06-03T11:23:12.000Z",
    "note": "Claim was sent to the insurance company",
    "primary_insurance_plan_id": 10021,
    "secondary_insurance_plan_id": 10021,
    "date_of_service": "2024-06-03",
    "totals": {
      "amount_billed_to_insurance": {
        "amount": "62.00",
        "currency": "USD"
      },
      "estimated_insurance_payment": {
        "amount": "62.00",
        "currency": "USD"
      },
      "insurance_payment": {
        "amount": "62.00",
        "currency": "USD"
      },
      "write_off": {
        "amount": "62.00",
        "currency": "USD"
      }
    },
    "updated_at": "2020-06-05T20:16:57.007Z",
    "deleted_at": "2022-01-01T00:00:00Z",
    "patient": {
      "id": 415,
      "email": "anthony.smith@nexhealth.com",
      "first_name": "John",
      "middle_name": "Anthony",
      "last_name": "Smith",
      "name": "John Smith",
      "created_at": "2020-06-05T20:16:57.007Z",
      "updated_at": "2020-06-05T20:16:57.007Z",
      "institution_id": 1,
      "foreign_id": "532e7f8c",
      "foreign_id_type": "--DataSource-",
      "cell_phone_number": "5163042196",
      "preferred_phone_number": "5163042196",
      "billing_type": "Standard Billing - finance charges",
      "chart_id": "017407",
      "preferred_language": "es",
      "gender": "Female",
      "non_patient": true,
      "date_of_birth": "1964-05-03",
      "address": {
        "line_1": "333 Bush Street",
        "line_2": "Apt 4B",
        "postal_code": "20814",
        "city": "New York",
        "region": "NY"
      }
    },
    "provider": {
      "id": 415,
      "email": "anthony.smith@nexhealth.com",
      "first_name": "John",
      "middle_name": "Anthony",
      "last_name": "Smith",
      "name": "John Smith",
      "created_at": "2020-06-05T20:16:57.007Z",
      "updated_at": "2020-06-05T20:16:57.007Z",
      "institution_id": 1,
      "foreign_id": "532e7f8c",
      "foreign_id_type": "--DataSource-",
      "phone_number": "5163042196",
      "display_name": "John Smith",
      "npi": "1912507500",
      "tin": "078051120",
      "state_license": "R219935",
      "specialty_code": "363L00000X"
    },
    "guarantor": {
      "id": 415,
      "email": "anthony.smith@nexhealth.com",
      "first_name": "John",
      "middle_name": "Anthony",
      "last_name": "Smith",
      "name": "John Smith",
      "created_at": "2020-06-05T20:16:57.007Z",
      "updated_at": "2020-06-05T20:16:57.007Z",
      "institution_id": 1,
      "foreign_id": "532e7f8c",
      "foreign_id_type": "--DataSource-",
      "cell_phone_number": "5163042196",
      "preferred_phone_number": "5163042196",
      "billing_type": "Standard Billing - finance charges",
      "chart_id": "017407",
      "preferred_language": "es",
      "gender": "Female",
      "non_patient": true,
      "date_of_birth": "1964-05-03",
      "address": {
        "line_1": "333 Bush Street",
        "line_2": "Apt 4B",
        "postal_code": "20814",
        "city": "New York",
        "region": "NY"
      }
    },
    "charge_payouts": [
      {
        "amount_billed_to_insurance": {
          "amount": "62.00",
          "currency": "USD"
        },
        "estimated_insurance_payment": {
          "amount": "62.00",
          "currency": "USD"
        },
        "insurance_payment": {
          "amount": "62.00",
          "currency": "USD"
        },
        "write_off": {
          "amount": "62.00",
          "currency": "USD"
        },
        "allowed_amount": {
          "amount": "62.00",
          "currency": "USD"
        },
        "fee_schedule_procedure_code": {
          "procedure_code_id": "ab123456-11aa-99ff-a111-d1ee12345678",
          "fee": {
            "amount": "62.00",
            "currency": "USD"
          },
          "code": "D0120",
          "id": 113,
          "location_id": 10,
          "fee_schedule_id": 1234,
          "updated_at": "2020-06-05T20:16:57.007Z"
        },
        "charge_id": 1234
      }
    ],
    "charges": [
      {
        "id": 113,
        "foreign_id": "1234-5678",
        "location_id": 10,
        "patient_id": 3,
        "guarantor_id": 5,
        "provider_id": 15,
        "procedure_id": 34,
        "procedure_code": "D0120",
        "updated_at": "2024-09-05T20:31:17.007Z",
        "description": "This is a description",
        "fee": {
          "amount": "62.00",
          "currency": "USD"
        },
        "charged_at": "2024-10-05"
      }
    ]
  },
  "count": 2
}

Changes

No recorded changes to this operation across all 1 revision of this API.