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v1

latestOpenAPI 3.1.0MIT2026-07-22172693.3 KB

Creates a professional claim from a CMS 1500 file. This schema is an augmentation of the Healthie CMS 1500 schema to support the full CMS-1500 claim format.

post/api/claim/professional/v1

Query parameters

attachmentIdstring

Optional ID of document references to associate with the claim. Can be specified multiple times. This id will be returned from the Create Claim Attachment endpoint.

primaryPcnstring

Optional primary PCN to associate with the claim. You should ONLY use this in cases of submitting a secondary or tertiary claim, or in some specific denial resubmission scenarios.

Request body

accept_assignmentboolean required

Whether the provider agrees to accept assignment

idstring required

Unique identifier for the CMS 1500 form

date_of_servicestring required

Date when the service was provided

total_chargestring required

Total charge amount for the claim

patient_paid_amountnumber

Amount paid by the patient

clia_numberstring

Clinical Laboratory Improvement Amendment (CLIA) number for CLIA-certified facilities performing CLIA-covered laboratory services.

Response

Claim created successfully

resourceType'OperationOutcome' required

Type of resource

idstring

Logical id of this artifact