Authentication
All requests require an API key passed via the x-api-key header, along with a tenant_id query parameter.
Query Parameters
The visit number to look up claim status for.
Response
Check or EFT trace number.
Remittance date (YYYY-MM-DD).
Carrier run date (YYYY-MM-DD).
Claim account identifier.
Patient name on the claim.
Internal control number (payer’s claim reference).
Claim status code (e.g. 1 = processed as primary, 2 = processed as secondary, 4 = denied).
Total billed amount for the claim.
Total allowed amount for the claim.
Deductible applied to the claim.
Coinsurance applied to the claim.
Total adjustment amount on the claim.
Amount paid to the provider.
Patient responsibility amount.
Claim-level remittance advice remark codes (RARC), e.g. ["N381", "M15"].
Individual service lines on the claim.
Position of the service line within the claim.
CPT/HCPCS procedure code.
Procedure modifiers (e.g. "25", "59").
Service start date (YYYY-MM-DD).
Service end date (YYYY-MM-DD).
Billed amount for this service line.
Allowed amount for this service line.
Deductible applied to this service line.
Coinsurance applied to this service line.
Adjustment amount for this service line.
Amount paid to provider for this service line.
Line-level claim adjustment codes (CARC).Show ServiceLineAdjustment
Claim adjustment group code (e.g. CO, PR, OA).
Claim adjustment reason code (e.g. 45, 16, 197).
Dollar amount of this adjustment.
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"
{
"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"]
}
]
}