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

# POST /api/claim/healthie/v1

`POST /api/claim/healthie/v1`

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
    - `name` string, required — Provider name
    - `npi` string, required — National Provider Identifier
    - `tax_id` string, required — Provider tax ID
    - `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.net/cairhealth/apis/cair-health-apis.md) · [All operations](https://skmtc.net/cairhealth/apis/cair-health-apis/llms.txt) · [OpenAPI document](https://skmtc-service-staging.skmtc.workers.dev/v1/apis/cairhealth/cair-health-apis/revisions/dfc60069747b/schema)
