Claims
View claim
This endpoint returns a single insurance claim by its NexHealth id. Use the include parameter to embed related resources: patient, provider, guarantor, charges and/or charge_payouts. Note: when no claim with the given id exists, or it belongs to a location your token cannot access, this endpoint currently responds with HTTP 500 rather than a 404.
get/claims/{id}
Path parameters
idinteger required
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
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": 10022,
"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": "Amy.Ramos@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": 105,
"foreign_id": "100437",
"foreign_id_type": "--DataSource-",
"bio": {
"city": "New York",
"state": "NY",
"gender": "Female",
"zip_code": "20814",
"new_patient": false,
"non_patient": true,
"phone_number": "5163042196",
"date_of_birth": "1964-05-03",
"address_line_1": "",
"address_line_2": "",
"street_address": "",
"cell_phone_number": "",
"home_phone_number": "",
"work_phone_number": ""
},
"last_sync_time": "2024-04-12T10:30:00Z",
"guarantor_id": 472,
"billing_type": "Standard Billing - finance charges",
"chart_id": "017407",
"preferred_language": "es",
"provider_id": 23
},
"provider": {
"id": 415,
"email": "Amy.Ramos@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": 105,
"foreign_id": "100437",
"foreign_id_type": "--DataSource-",
"bio": {
"city": "New York",
"state": "NY",
"gender": "Female",
"zip_code": "20814",
"new_patient": false,
"non_patient": true,
"phone_number": "5163042196",
"date_of_birth": "1964-05-03",
"address_line_1": "",
"address_line_2": "",
"street_address": "",
"cell_phone_number": "",
"home_phone_number": "",
"work_phone_number": ""
},
"last_sync_time": "2024-04-12T10:30:00Z",
"display_name": "John Smith",
"npi": "1912507500",
"tin": "078051120",
"state_license": "R219935",
"specialty_code": "363L00000X"
},
"guarantor": {
"id": 415,
"email": "Amy.Ramos@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": 105,
"foreign_id": "100437",
"foreign_id_type": "--DataSource-",
"bio": {
"city": "New York",
"state": "NY",
"gender": "Female",
"zip_code": "20814",
"new_patient": false,
"non_patient": true,
"phone_number": "5163042196",
"date_of_birth": "1964-05-03",
"address_line_1": "",
"address_line_2": "",
"street_address": "",
"cell_phone_number": "",
"home_phone_number": "",
"work_phone_number": ""
},
"last_sync_time": "2024-04-12T10:30:00Z"
},
"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
}