Tross
ATHENA

Fetch claim

Fetch claim in Athena

POSThttps://api.ontross.com/api/integrations/athena/fetch-claim
Request Fields
input.org_id
integer
required
Org id
Example
25910
input.department_id
integer
required
Department id
Example
3
input.patient_id
integer
required
Patient id
Example
596
input.claim_id
string
required
Source identifiers remain strings.
Example
"1348"
auth_id
string
required
Saved connection to run this operation through, from the Authentication page. It decides which practice and login the call uses.
Example
"00000000-0000-4000-8000-000000000000"
Output Fields
claim
object
Item object.
claim.claim_id
string
Source identifiers remain strings.
claim.patient_id
string
Source identifiers remain strings.
claim.patient_department_id
string
Source identifiers remain strings.
claim.department_id
string
Source identifiers remain strings.
claim.place_of_service_code
string
Place of service code
claim.insurances
array
List of insurances.
claim.insurances[].sequence
string
Sequence
claim.insurances[].patient_insurance_id
string
Source identifiers remain strings.
claim.insurances[].package_id
string
Package id
claim.insurances[].name
string
Name
claim.insurances[].is_self_pay
boolean
Is self pay
claim.insurances[].eligibility
object
Eligibility object.
claim.insurances[].eligibility.status
string
Status
claim.insurances[].eligibility.source_status
string
Source status
claim.insurances[].eligibility.service_date
string
Service date
claim.insurances[].eligibility.checked_at
string
Checked at
claim.rendering_provider_id
string
Source identifiers remain strings.
claim.supervising_provider_id
string
Source identifiers remain strings.
claim.lines
array
List of lines.
claim.lines[].line_id
string
Line id
claim.lines[].service_date
string
Service date
claim.lines[].service_end_date
string
Service end date
claim.lines[].procedure_code
string
Procedure code
claim.lines[].modifiers
array
List of modifiers.
claim.lines[].units
string
Units
claim.lines[].diagnosis_codes
array
List of diagnosis codes.
claim.lines[].charge_amount
string
Charge amount
claim.lines[].unit_fee
string
Unit fee
claim.lines[].procedure_description
string
Procedure description
claim.lines[].rvu
string
Rvu
claim.lines[].diagnosis_descriptions
array
List of diagnosis descriptions.
claim.states
array
List of states.
claim.states[].sequence
string
Sequence
claim.states[].source_status
string
Source status
claim.states[].outstanding_amount
string
Outstanding amount
claim.active_holds
array
List of active holds.
claim.active_holds[].source_rule_id
string
Source rule id
claim.active_holds[].name
string
Name
claim.active_holds[].sequence
string
Sequence
claim.active_holds[].source_status
string
Source status
claim.active_holds[].next_action
string
Next action
claim.last_billed_dates
object
Last billed dates object.
claim.last_billed_dates.primary
string
Primary
claim.last_billed_dates.secondary
string
Secondary
claim.last_billed_dates.patient
string
Patient
claim.source_version
string
Source version
claim.submission_status
string
Submission status
claim.service_start_date
string
Service start date
claim.service_end_date
string
Service end date
claim.post_date
string
Post date
claim.signatures
object
Signatures object.
claim.signatures.release_of_information
boolean
Release of information
Example
false
claim.signatures.assignment_of_benefits
boolean
Assignment of benefits
Example
false
claim.signatures.signature_source_code
string
Signature source code
Example
"string"
claim.authorization
object
Authorization object.
claim.authorization.mode
string
Mode
Example
"none"
claim.authorization.authorization_id
string
Authorization id
Example
"12345"
claim.authorization.authorization_number
string
Authorization number
Example
"string"
claim.claim_notes
array
List of claim notes.
claim.claim_notes[].note_id
string
Note id
claim.claim_notes[].sequence
string
Sequence
claim.claim_notes[].text
string
Text
claim.readback_missing_fields
array
List of readback missing fields.
claim.patient_department_name
string
Patient department name
claim.service_department_name
string
Service department name
claim.rendering_provider_name
string
Rendering provider name
claim.supervising_provider_name
string
Supervising provider name
edit_context_token
string
Edit context token
expires_at
string
Expires at
supported_edits
array
List of supported edits.
concurrency_limitations
array
List of concurrency limitations.
Code
curl --request POST \
  --url https://api.ontross.com/api/integrations/athena/fetch-claim \
  --header 'X-API-Key: REPLACE_KEY_VALUE' \
  --header 'content-type: application/json' \
  --data '{"input":{"org_id":25910,"department_id":3,"patient_id":596,"claim_id":"1348"},"auth_id":"auth_uuid_here"}'
Request BODY
{
  "input": {
    "org_id": 25910,
    "department_id": 3,
    "patient_id": 596,
    "claim_id": "1348"
  },
  "auth_id": "auth_uuid_here"
}
Response BODY
{
  "id": "string",
  "workflow_id": "string",
  "auth_id": "string",
  "status": "string",
  "input": {},
  "output": {
    "claim": {
      "claim_id": "string",
      "patient_id": "string",
      "patient_department_id": "string",
      "department_id": "string",
      "place_of_service_code": "string",
      "insurances": [
        {
          "sequence": "primary",
          "patient_insurance_id": "string",
          "package_id": "string",
          "name": "string",
          "is_self_pay": true,
          "eligibility": {
            "status": "eligible",
            "source_status": "string",
            "service_date": "2019-08-24",
            "checked_at": "2019-08-24T14:15:22Z"
          }
        }
      ],
      "rendering_provider_id": "string",
      "supervising_provider_id": "string",
      "lines": [
        {
          "line_id": "string",
          "service_date": "2019-08-24",
          "service_end_date": "2019-08-24",
          "procedure_code": "string",
          "modifiers": [
            "string"
          ],
          "units": "string",
          "diagnosis_codes": [
            "string"
          ],
          "charge_amount": "string",
          "unit_fee": "string",
          "procedure_description": "string",
          "rvu": "string",
          "diagnosis_descriptions": [
            "string"
          ]
        }
      ],
      "states": [
        {
          "sequence": "primary",
          "source_status": "string",
          "outstanding_amount": "string"
        }
      ],
      "active_holds": [
        {
          "source_rule_id": "string",
          "name": "string",
          "sequence": "primary",
          "source_status": "string",
          "next_action": "string"
        }
      ],
      "last_billed_dates": {
        "primary": "2019-08-24",
        "secondary": "2019-08-24",
        "patient": "2019-08-24"
      },
      "source_version": "string",
      "submission_status": "string",
      "service_start_date": "2019-08-24",
      "service_end_date": "2019-08-24",
      "post_date": "2019-08-24",
      "signatures": {
        "release_of_information": false,
        "assignment_of_benefits": false,
        "signature_source_code": "string"
      },
      "authorization": {
        "mode": "none",
        "authorization_id": "12345",
        "authorization_number": "string"
      },
      "claim_notes": [
        {
          "note_id": "string",
          "sequence": "primary",
          "text": "string"
        }
      ],
      "readback_missing_fields": [
        "string"
      ],
      "patient_department_name": "string",
      "service_department_name": "string",
      "rendering_provider_name": "string",
      "supervising_provider_name": "string"
    },
    "edit_context_token": "string",
    "expires_at": "2019-08-24T14:15:22Z",
    "supported_edits": [
      "claim_note"
    ],
    "concurrency_limitations": [
      "string"
    ]
  },
  "files": null,
  "created_at": "2019-08-24T14:15:22Z",
  "started_at": "2019-08-24T14:15:22Z",
  "completed_at": "2019-08-24T14:15:22Z"
}