Check Claim Status

curl -X GET "https://api.example.com/claim-status?tenant_id=1&visit_number=V12345" \
  -H "x-api-key: your-api-key"

{
  "status": "completed",
  "payer_name": "Aetna",
  "check_eft_number": "1234567890",
  "remittance_date": "2026-03-01",
  "carrier_run_date": "2026-02-28",
  "account": "ACC-001",
  "patient_name": "John Doe",
  "subscriber_id": "MEM123456",
  "icn": "ICN789012",
  "claim_status_code": "1",
  "billed_amount": 1500.00,
  "allowed_amount": 1200.00,
  "deductible_amount": 200.00,
  "coinsurance_amount": 100.00,
  "adjustment_amount": 300.00,
  "provider_paid_amount": 900.00,
  "patient_responsibility": 300.00,
  "remark_codes": ["N381"],
  "service_lines": [
    {
      "line_index": 1,
      "procedure_code": "99213",
      "modifiers": "25",
      "service_date_from": "2026-02-15",
      "service_date_to": "2026-02-15",
      "units": 1.0,
      "billed_amount": 750.00,
      "allowed_amount": 600.00,
      "deductible_amount": 100.00,
      "coinsurance_amount": 50.00,
      "adjustment_amount": 150.00,
      "provider_paid_amount": 450.00,
      "adjustment_codes": [
        {
          "group_code": "CO",
          "reason_code": "45",
          "amount": 150.00
        }
      ],
      "remark_codes": ["N381"]
    }
  ]
}

curl -X GET "https://api.example.com/claim-status?tenant_id=1&visit_number=V12345" \
  -H "x-api-key: your-api-key"

{
  "status": "completed",
  "payer_name": "Aetna",
  "check_eft_number": "1234567890",
  "remittance_date": "2026-03-01",
  "carrier_run_date": "2026-02-28",
  "account": "ACC-001",
  "patient_name": "John Doe",
  "subscriber_id": "MEM123456",
  "icn": "ICN789012",
  "claim_status_code": "1",
  "billed_amount": 1500.00,
  "allowed_amount": 1200.00,
  "deductible_amount": 200.00,
  "coinsurance_amount": 100.00,
  "adjustment_amount": 300.00,
  "provider_paid_amount": 900.00,
  "patient_responsibility": 300.00,
  "remark_codes": ["N381"],
  "service_lines": [
    {
      "line_index": 1,
      "procedure_code": "99213",
      "modifiers": "25",
      "service_date_from": "2026-02-15",
      "service_date_to": "2026-02-15",
      "units": 1.0,
      "billed_amount": 750.00,
      "allowed_amount": 600.00,
      "deductible_amount": 100.00,
      "coinsurance_amount": 50.00,
      "adjustment_amount": 150.00,
      "provider_paid_amount": 450.00,
      "adjustment_codes": [
        {
          "group_code": "CO",
          "reason_code": "45",
          "amount": 150.00
        }
      ],
      "remark_codes": ["N381"]
    }
  ]
}

Authentication

All requests require an API key passed via the x-api-key header, along with a tenant_id query parameter.

string

required

Your tenant API key.

Query Parameters

integer

required

Your tenant ID.

string

required

The visit number to look up claim status for.

Response

string

Call status. One of completed, in_progress, or failed.

string

Name of the payer.

string

Check or EFT trace number.

string

Remittance date (YYYY-MM-DD).

string

Carrier run date (YYYY-MM-DD).

string

Claim account identifier.

string

Patient name on the claim.

string

Subscriber/member ID.

string

Internal control number (payer’s claim reference).

string

Claim status code (e.g. 1 = processed as primary, 2 = processed as secondary, 4 = denied).

number

Total billed amount for the claim.

number

Total allowed amount for the claim.

number

Deductible applied to the claim.

number

Coinsurance applied to the claim.

number

Total adjustment amount on the claim.

number

Amount paid to the provider.

number

Patient responsibility amount.

string[]

Claim-level remittance advice remark codes (RARC), e.g. ["N381", "M15"].

ServiceLineResult[]

Individual service lines on the claim.

Show ServiceLineResult

integer

Position of the service line within the claim.

string

CPT/HCPCS procedure code.

string

Procedure modifiers (e.g. "25", "59").

string

Service start date (YYYY-MM-DD).

string

Service end date (YYYY-MM-DD).

number

Number of units billed.

number

Billed amount for this service line.

number

Allowed amount for this service line.

number

Deductible applied to this service line.

number

Coinsurance applied to this service line.

number

Adjustment amount for this service line.

number

Amount paid to provider for this service line.

ServiceLineAdjustment[]

Line-level claim adjustment codes (CARC).

Show ServiceLineAdjustment

string

Claim adjustment group code (e.g. CO, PR, OA).

string

Claim adjustment reason code (e.g. 45, 16, 197).

number

Dollar amount of this adjustment.

string[]

Line-level remittance advice remark codes (RARC).

curl -X GET "https://api.example.com/claim-status?tenant_id=1&visit_number=V12345" \
  -H "x-api-key: your-api-key"

{
  "status": "completed",
  "payer_name": "Aetna",
  "check_eft_number": "1234567890",
  "remittance_date": "2026-03-01",
  "carrier_run_date": "2026-02-28",
  "account": "ACC-001",
  "patient_name": "John Doe",
  "subscriber_id": "MEM123456",
  "icn": "ICN789012",
  "claim_status_code": "1",
  "billed_amount": 1500.00,
  "allowed_amount": 1200.00,
  "deductible_amount": 200.00,
  "coinsurance_amount": 100.00,
  "adjustment_amount": 300.00,
  "provider_paid_amount": 900.00,
  "patient_responsibility": 300.00,
  "remark_codes": ["N381"],
  "service_lines": [
    {
      "line_index": 1,
      "procedure_code": "99213",
      "modifiers": "25",
      "service_date_from": "2026-02-15",
      "service_date_to": "2026-02-15",
      "units": 1.0,
      "billed_amount": 750.00,
      "allowed_amount": 600.00,
      "deductible_amount": 100.00,
      "coinsurance_amount": 50.00,
      "adjustment_amount": 150.00,
      "provider_paid_amount": 450.00,
      "adjustment_codes": [
        {
          "group_code": "CO",
          "reason_code": "45",
          "amount": 150.00
        }
      ],
      "remark_codes": ["N381"]
    }
  ]
}

Getting Started

Data Import

Pre-Service

Claim Follow-Up

Denial Management

Authentication

Query Parameters

Response

​Authentication

​Query Parameters

​Response

Authentication

Query Parameters

Response