---
title: "View claim (beta)"
method: GET
path: "/claims/{id}"
tags: ["Claims"]
---

# View claim (beta)

`GET /claims/{id}`

## Request

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

> 🚧 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`.

## Path parameters

- `id` integer, required

## Query parameters

- `subdomain` string, required
- `include[]` string[]

## Headers

- `Nex-Api-Version` string, required

## Response `200`

Successful

- APIV31EntitiesLedgerInsuranceClaimResponse: API_V31_Entities_Ledger_Insurance_Claim_Response model
  - `code` boolean: Indicates the success or failure of the request
  - `description` string: Additional context on the request to help with debugging.
  - `error` string[]: Any errors that occur during the execution of the request.
  - `data` APIV31EntitiesLedgerInsuranceClaim
    - `id` integer: Claim ID
    - `location_id` integer: Location ID
    - `patient_id` integer: Patient ID
    - `provider_id` integer: Provider ID
    - `guarantor_id` integer: User ID of the patient's responsible party
    - `status` 'draft' | 'sent' | 'received' | 'canceled': Claim status
    - `received_at` string, date-time: Date and time in UTC when the claim was received from insurance
    - `sent_at` string, date-time: Date and time in UTC when the claim was sent to insurance
    - `note` string: Claim notes
    - `primary_insurance_plan_id` integer: ID of the primary insurance provider this claim was or will be sent to
    - `secondary_insurance_plan_id` integer: ID of the secondary insurance provider this claim was or will be sent to
    - `date_of_service` string, date: The date in UTC when the procedures included in the claim occured
    - `totals` APIV31EntitiesLedgerChargeClaimTotals
      - `amount_billed_to_insurance` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `estimated_insurance_payment` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `insurance_payment` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `write_off` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
    - `updated_at` string, date-time: Claim update date in UTC
    - `deleted_at` string, date-time: The UTC date and time the claim was deleted
    - `patient` APIV31EntitiesPatientBasic
      - `id` integer: User ID
      - `email` string: User email
      - `first_name` string: First name
      - `middle_name` string: Middle name
      - `last_name` string: Last name
      - `name` string: Full name
      - `created_at` string, date-time: User creation date in UTC
      - `updated_at` string, date-time: User last update date in UTC
      - `institution_id` integer: The institution this user belongs to
      - `foreign_id` string: Identifier NexHealth uses to uniquely match this record to its counterpart in the integrated EHR. How it is derived differs between EHRs and may change; treat it as an opaque string and do not parse it.
      - `foreign_id_type` string: Foreign ID type is a unique string identifier for the integrated system
      - `inactive` boolean: Is the user inactivated?
      - `home_phone_number` string: Home phone number
      - `work_phone_number` string: Work phone number
      - `work_phone_extension` string: Work phone extension
      - `cell_phone_number` string: Cell phone number. When the integrated system reports the patient's main number as an untyped primary number instead of a typed cell number — which is how most systems report it back after a write — this field falls back to that primary number. The fallback is usually the cell number, but the integrated system does not guarantee the primary number is a cell number.
      - `preferred_phone_number` string: The best-known phone number for reaching the patient: the first available of the integrated system's untyped primary number, cell phone number, home phone number, and work phone number. Read-only — write one of the typed phone number fields to change it.
      - `guarantor_id` integer: User ID of this patient's responsible party
      - `billing_type` string: Used by practices in some integrated systems to categorize and filter patients when creating reports, requesting payments, and performing other related office tasks. Some integrated systems call this an account type rather than a billing type
      - `chart_id` string: User-facing ID for referencing patient data, used in some integrated systems. Depending on the system, the chart ID supplements or replaces the foreign_id as the ID visible to EHR users
      - `preferred_language` string: Patient's preferred language as an ISO 639-1 code, if specified in the integrated system
      - `provider_id` integer: User ID of this patient's primary provider
      - `gender` string: Gender from biographical data
      - `new_patient` boolean: Whether the patient is new
      - `non_patient` boolean: Whether this is a non-patient user record
      - `date_of_birth` string: Date of birth in YYYY-MM-DD format
      - `premedication` string: Premedication notes
      - `address` APIV2EntitiesPatientAddress
        - `line_1` string, nullable: Address line 1
        - `line_2` string, nullable: Address line 2
        - `postal_code` string, nullable: Zip code
        - `city` string, nullable: City
        - `region` string, nullable: State
    - `provider` APIV31EntitiesProvider
      - `id` integer: User ID
      - `email` string: User email
      - `first_name` string: First name
      - `middle_name` string: Middle name
      - `last_name` string: Last name
      - `name` string: Full name
      - `created_at` string, date-time: User creation date in UTC
      - `updated_at` string, date-time: User last update date in UTC
      - `institution_id` integer: The institution this user belongs to
      - `foreign_id` string: Identifier NexHealth uses to uniquely match this record to its counterpart in the integrated EHR. How it is derived differs between EHRs and may change; treat it as an opaque string and do not parse it.
      - `foreign_id_type` string: Foreign ID type is a unique string identifier for the integrated system
      - `inactive` boolean: Is the user inactivated?
      - `phone_number` string: Primary phone number
      - `cell_phone_number` string: Cell phone number
      - `home_phone_number` string: Home phone number
      - `work_phone_number` string: Work phone number
      - `work_phone_extension` string: Work phone extension
      - `display_name` string: Display name
      - `npi` string: National Provider Identifier as registered in NPPES. May be null if the practice did not enter it into the integrated system.
      - `tin` string: Taxpayer Identification Number (SSN or ITIN). May be null if the practice did not enter it into the integrated system.
      - `state_license` string: State license number. May be null if the practice did not enter it into the integrated system.
      - `specialty_code` string: Specialty code corresponding to the provider's state license and NPI. May be null if the practice did not enter it into the integrated system.
    - `guarantor` APIV31EntitiesPatientBasic
      - `id` integer: User ID
      - `email` string: User email
      - `first_name` string: First name
      - `middle_name` string: Middle name
      - `last_name` string: Last name
      - `name` string: Full name
      - `created_at` string, date-time: User creation date in UTC
      - `updated_at` string, date-time: User last update date in UTC
      - `institution_id` integer: The institution this user belongs to
      - `foreign_id` string: Identifier NexHealth uses to uniquely match this record to its counterpart in the integrated EHR. How it is derived differs between EHRs and may change; treat it as an opaque string and do not parse it.
      - `foreign_id_type` string: Foreign ID type is a unique string identifier for the integrated system
      - `inactive` boolean: Is the user inactivated?
      - `home_phone_number` string: Home phone number
      - `work_phone_number` string: Work phone number
      - `work_phone_extension` string: Work phone extension
      - `cell_phone_number` string: Cell phone number. When the integrated system reports the patient's main number as an untyped primary number instead of a typed cell number — which is how most systems report it back after a write — this field falls back to that primary number. The fallback is usually the cell number, but the integrated system does not guarantee the primary number is a cell number.
      - `preferred_phone_number` string: The best-known phone number for reaching the patient: the first available of the integrated system's untyped primary number, cell phone number, home phone number, and work phone number. Read-only — write one of the typed phone number fields to change it.
      - `guarantor_id` integer: User ID of this patient's responsible party
      - `billing_type` string: Used by practices in some integrated systems to categorize and filter patients when creating reports, requesting payments, and performing other related office tasks. Some integrated systems call this an account type rather than a billing type
      - `chart_id` string: User-facing ID for referencing patient data, used in some integrated systems. Depending on the system, the chart ID supplements or replaces the foreign_id as the ID visible to EHR users
      - `preferred_language` string: Patient's preferred language as an ISO 639-1 code, if specified in the integrated system
      - `provider_id` integer: User ID of this patient's primary provider
      - `gender` string: Gender from biographical data
      - `new_patient` boolean: Whether the patient is new
      - `non_patient` boolean: Whether this is a non-patient user record
      - `date_of_birth` string: Date of birth in YYYY-MM-DD format
      - `premedication` string: Premedication notes
      - `address` APIV2EntitiesPatientAddress
        - `line_1` string, nullable: Address line 1
        - `line_2` string, nullable: Address line 2
        - `postal_code` string, nullable: Zip code
        - `city` string, nullable: City
        - `region` string, nullable: State
    - `charge_payouts` APIV31EntitiesLedgerChargePayout[]: Billing details for each charge associated with this claim
      - `amount_billed_to_insurance` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `estimated_insurance_payment` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `insurance_payment` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `write_off` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `allowed_amount` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `fee_schedule_procedure_code` APIV31EntitiesFeeScheduleProcedureCode
        - `procedure_code_id` string, nullable: The uuid of the procedure code associated with the fee schedule
        - `fee` APIV2EntitiesPrice
          - `amount` string: The currency value, in whole units (e.g. dollars)
          - `currency` string: The ISO currency code
        - `code` string, nullable: The code of the procedure associated with the fee schedule
        - `id` integer: Fee Schedule Procedure Resource ID
        - `location_id` integer, nullable: The location ID of the fee schedule
        - `fee_schedule_id` integer, nullable: The ID of the fee schedule associated with the fee schedule procedure
        - `updated_at` string, date-time: Fee Schedule Procedure update date in UTC
      - `charge_id` integer: The ID of the charge associated with this payout
    - `charges` APIV31EntitiesLedgerChargeBasic[]: Charges associated with this claim
      - `id` integer: Resource ID
      - `foreign_id` string: Identifier NexHealth uses to uniquely match this record to its counterpart in the integrated EHR. How it is derived differs between EHRs and may change; treat it as an opaque string and do not parse it.
      - `location_id` integer: The ID of the location that this item is for
      - `patient_id` integer: The ID of the patient that this item is for
      - `guarantor_id` integer: The ID of the guarantor that this item is for
      - `provider_id` integer: The ID of the provider that this item is for
      - `procedure_id` integer: The ID of the procedure associated with this charge
      - `procedure_code` string: The procedure code associated with this charge
      - `updated_at` string, date-time: Last updated time for item in UTC
      - `description` string: A description of the charge
      - `fee` APIV2EntitiesPrice
        - `amount` string: The currency value, in whole units (e.g. dollars)
        - `currency` string: The ISO currency code
      - `charged_at` string, date: The UTC date charge was made
  - `count` integer: Number of total objects, in case of collection.

## Other responses

- `400`: Bad Request
- `401`: Unauthorized
- `403`: Forbidden
- `404`: Not Found
- `500`: Internal Server Error

---

[API](https://skmtc.dev/nexhealth/apis/nexhealth-api-v3-1-0-beta.md) - [All operations](https://skmtc.dev/nexhealth/apis/nexhealth-api-v3-1-0-beta/llms.txt) - [OpenAPI document](https://skmtc.dev/nexhealth/apis/nexhealth-api-v3-1-0-beta/revisions/93cb4af790a5?raw)