top of page

FHIR Claims status check API

FHIR Claims status check API

FHIR Claims status check API
Complete Claims Status Check API

The Claim is used by providers and payors, insurers, to exchange the financial information, and supporting clinical information, regarding the provision of health care services with payors and for reporting to regulatory bodies and firms which provide data analytics. The primary uses of this resource is to support eClaims, the exchange of information relating to the proposed or actual provision of healthcare-related goods and services for patients to their benefit payors, insurers and national health programs, for treatment payment planning and reimbursement.

"resourceType" : "Claim",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business Identifier for claim
"traceNumber" : [{ Identifier }], // Number for tracking
"status" : "<code>", // R! active | cancelled | draft | entered-in-error
"type" : { CodeableConcept }, // R! Category or discipline

All FHIR resoruces required for Claims Status

Claim, ClaimResponse, CoverageEligibilityRequest, Patient, practioner, ExplanationOfBenefit

"resourceType" : "ClaimResponse",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business Identifier for a claim response
"traceNumber" : [{ Identifier }], // Number for tracking
"status" : "<code>", // R! active | cancelled | draft | entered-in-error
"type" : { CodeableConcept }, // R! More granular claim type
"subType" : { CodeableConcept }, // More granular cla

lookup.png
bottom of page