v4

latestOpenAPI 3.1.0raw.githubusercontent.com2025-10-10282656.2 KB

Claims

Review a claim (predictions, no funding)

post/v1/claims/reviews

Headers

Idempotency-Keystring

Provide a unique key per request to enable safe retries

Request body

facilitystring

Location/facility identifier

claim_identifierstring required

Unique claim ID

chart_identifierstring required

Patient chart ID

date_of_entrystring date

date_of_servicestring date required

date_of_submissionstring date

servicer_npistring required

billing_npistring required

patient_primary_payor_textstring

patient_primary_payor_idstring required

Thrivory payer ID

patient_primary_payor_plan_textstring

icd10_codesstring[]

cpt_billing_codesstring

Prefer service_lines[].cpt

cpt_billing_modifierstring

Prefer service_lines[].modifier

cpt_billing_textstring

submitted_amountnumber required

balance_payornumber

balance_patientnumber

payments_payornumber

payments_patientnumber

payments_totalnumber

settlement_datestring date

payment_account_locationstring

Last four digits or token reference

denial_codestring

denial_code_textstring

Response

Review results

authorization_idstring required

Short‑lived authorization handle used to create an adjudication

denial_predictedboolean required

expected_payment_datestring date

confidencenumber

Model confidence

idstring

Review ID