Athena Validate claim

POSThttps://api.ontross.com/api/integrations/athena/validate-claim

input.org_id

integer

required

Org id

Example

1

input.patient_id

integer

required

Patient id

Example

1

input.patient_department_id

integer

required

Patient department id

Example

1

input.service_department_id

integer

required

Service department id

Example

1

input.rendering_provider_id

string

required

Source identifiers remain strings.

Example

"12345"

input.supervising_provider_id

string

required

Source identifiers remain strings.

Example

"12345"

input.primary_patient_insurance_id

string

required

Source identifiers remain strings.

Example

"12345"

input.secondary_patient_insurance_id

string

required

Source identifiers remain strings.

Example

"12345"

input.place_of_service_code

string

required

Place of service code

Example

"string"

input.post_date

string

required

Post date

Example

"2026-01-01"

input.billing_context_token

string

required

Billing context token

Example

"string"

input.lines

array

required

List of lines.

input.lines[].procedure_code

string

required

Procedure code

Example

"string"

input.lines[].modifiers

array

required

List of modifiers.

input.lines[].units

string

required

Units

Example

"12345"

input.lines[].diagnosis_codes

array

required

List of diagnosis codes.

input.lines[].expected_unit_fee

string

required

Expectation to compare with the tenant fee schedule, never a silently forced price.

Example

"12345"

input.lines[].service_start_date

string

required

Service start date

Example

"2026-01-01"

input.lines[].service_end_date

string

required

Service end date

Example

"2026-01-01"

input.signatures

object

required

Signatures object.

input.signatures.release_of_information

boolean

required

Release of information

Example

false

input.signatures.assignment_of_benefits

boolean

required

Assignment of benefits

Example

false

input.signatures.signature_source_code

string

required

Signature source code

Example

"string"

input.requested_behavior

string

required

Requested behavior

Example

"create_only"

Accepted values

create_only

input.auto_scan_and_submit

boolean

required

Auto scan and submit

Example

false

input.validation_purpose

string

required

Validation purpose

Example

"create"

Accepted values

createreplace_linesupdate_details

input.department_id

integer

required

Runtime Athena context department; distinct from the portal route number.

Example

1

input.source_document_ids

array

List of source document ids.

input.external_claim_reference

string

External claim reference

Example

"string"

input.billing_rule_set_version

string

Billing rule set version

Example

"string"

input.service_evidence_reference

string

Service evidence reference

Example

"string"

input.claim_note

string

Claim note

Example

"string"

input.target_claim_id

string

Target claim id

Example

"12345"

input.expected_source_version

string

Expected source version

Example

"string"

input.detail_changes

object

Changes object.

input.detail_changes.patient_department_id

integer

Patient department id

Example

1

input.detail_changes.service_department_id

integer

Service department id

Example

1

input.detail_changes.rendering_provider_id

string

Rendering provider id

Example

"12345"

input.detail_changes.supervising_provider_id

string

Supervising provider id

Example

"12345"

input.detail_changes.primary_patient_insurance_id

string

Primary patient insurance id

Example

"12345"

input.detail_changes.secondary_patient_insurance_id

string

Secondary patient insurance id

Example

"12345"

input.detail_changes.place_of_service_code

string

Place of service code

Example

"string"

input.detail_changes.post_date

string

Post date

Example

"2026-01-01"

input.detail_changes.signatures

object

Signatures object.

input.detail_changes.signatures.release_of_information

boolean

Release of information

Example

false

input.detail_changes.signatures.assignment_of_benefits

boolean

Assignment of benefits

Example

false

input.detail_changes.signatures.signature_source_code

string

Signature source code

Example

"string"

input.detail_changes.authorization

object

Authorization object.

input.detail_changes.authorization.mode

string

Mode

Example

"none"

input.detail_changes.authorization.authorization_id

string

Authorization id

Example

"12345"

input.detail_changes.authorization.authorization_number

string

Authorization number

Example

"string"

input.authorization

object

Authorization object.

input.authorization.mode

string

Mode

Example

"none"

input.authorization.authorization_id

string

Authorization id

Example

"12345"

input.authorization.authorization_number

string

Authorization number

Example

"string"

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"

valid

boolean

Valid

validation_token

string

Validation token

expires_at

string

Expires at

errors

array

List of errors.

errors[].field

string

Field

errors[].code

string

Code

errors[].message

string

Message

warnings

array

List of warnings.

warnings[].field

string

Field

warnings[].code

string

Code

warnings[].message

string

Message

resolved_unit_fees

array

List of resolved unit fees.

resolved_unit_fees[].procedure_code

string

Procedure code

resolved_unit_fees[].unit_fee

string

Unit fee

resolved_unit_fees[].currency

string

Currency

resolved_unit_fees[].fee_schedule_id

string

Source identifiers remain strings.

claim_creation_supported

boolean

Claim creation supported

curl --request POST \
  --url https://api.ontross.com/api/integrations/athena/validate-claim \
  --header 'X-API-Key: REPLACE_KEY_VALUE' \
  --header 'content-type: application/json' \
  --data '{"input":{"org_id":1,"patient_id":1,"patient_department_id":1,"service_department_id":1,"rendering_provider_id":"12345","supervising_provider_id":"12345","primary_patient_insurance_id":"12345","secondary_patient_insurance_id":"12345","place_of_service_code":"string","post_date":"2026-01-01","billing_context_token":"string","source_document_ids":[],"external_claim_reference":"string","billing_rule_set_version":"string","service_evidence_reference":"string","lines":[{"procedure_code":"string","modifiers":[],"units":"12345","diagnosis_codes":["string"],"expected_unit_fee":"12345","service_start_date":"2026-01-01","service_end_date":"2026-01-01"}],"claim_note":"string","signatures":{"release_of_information":false,"assignment_of_benefits":false,"signature_source_code":"string"},"requested_behavior":"create_only","auto_scan_and_submit":false,"validation_purpose":"create","target_claim_id":"12345","expected_source_version":"string","detail_changes":{"patient_department_id":1,"service_department_id":1,"rendering_provider_id":"12345","supervising_provider_id":"12345","primary_patient_insurance_id":"12345","secondary_patient_insurance_id":"12345","place_of_service_code":"string","post_date":"2026-01-01","signatures":{"release_of_information":false,"assignment_of_benefits":false,"signature_source_code":"string"},"authorization":{"mode":"none","authorization_id":"12345","authorization_number":"string"}},"authorization":{"mode":"none","authorization_id":"12345","authorization_number":"string"},"department_id":1},"auth_id":"auth_uuid_here"}'

Request BODY

{
  "input": {
    "org_id": 1,
    "patient_id": 1,
    "patient_department_id": 1,
    "service_department_id": 1,
    "rendering_provider_id": "12345",
    "supervising_provider_id": "12345",
    "primary_patient_insurance_id": "12345",
    "secondary_patient_insurance_id": "12345",
    "place_of_service_code": "string",
    "post_date": "2026-01-01",
    "billing_context_token": "string",
    "source_document_ids": [],
    "external_claim_reference": "string",
    "billing_rule_set_version": "string",
    "service_evidence_reference": "string",
    "lines": [
      {
        "procedure_code": "string",
        "modifiers": [],
        "units": "12345",
        "diagnosis_codes": [
          "string"
        ],
        "expected_unit_fee": "12345",
        "service_start_date": "2026-01-01",
        "service_end_date": "2026-01-01"
      }
    ],
    "claim_note": "string",
    "signatures": {
      "release_of_information": false,
      "assignment_of_benefits": false,
      "signature_source_code": "string"
    },
    "requested_behavior": "create_only",
    "auto_scan_and_submit": false,
    "validation_purpose": "create",
    "target_claim_id": "12345",
    "expected_source_version": "string",
    "detail_changes": {
      "patient_department_id": 1,
      "service_department_id": 1,
      "rendering_provider_id": "12345",
      "supervising_provider_id": "12345",
      "primary_patient_insurance_id": "12345",
      "secondary_patient_insurance_id": "12345",
      "place_of_service_code": "string",
      "post_date": "2026-01-01",
      "signatures": {
        "release_of_information": false,
        "assignment_of_benefits": false,
        "signature_source_code": "string"
      },
      "authorization": {
        "mode": "none",
        "authorization_id": "12345",
        "authorization_number": "string"
      }
    },
    "authorization": {
      "mode": "none",
      "authorization_id": "12345",
      "authorization_number": "string"
    },
    "department_id": 1
  },
  "auth_id": "auth_uuid_here"
}

Response BODY

{
  "id": "string",
  "workflow_id": "string",
  "auth_id": "string",
  "status": "string",
  "input": {},
  "output": {
    "valid": true,
    "validation_token": "string",
    "expires_at": "2019-08-24T14:15:22Z",
    "errors": [
      {
        "field": "string",
        "code": "string",
        "message": "string"
      }
    ],
    "warnings": [
      {
        "field": "string",
        "code": "string",
        "message": "string"
      }
    ],
    "resolved_unit_fees": [
      {
        "procedure_code": "string",
        "unit_fee": "string",
        "currency": "USD",
        "fee_schedule_id": "string"
      }
    ],
    "claim_creation_supported": true
  },
  "files": null,
  "created_at": "2019-08-24T14:15:22Z",
  "started_at": "2019-08-24T14:15:22Z",
  "completed_at": "2019-08-24T14:15:22Z"
}