> ## Documentation Index
> Fetch the complete documentation index at: https://docs.refactorbilling.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Check Claim Status

> Retrieve remittance and claim payment details for a visit.

## Authentication

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

<ParamField header="x-api-key" type="string" required>
  Your tenant API key.
</ParamField>

## Query Parameters

<ParamField query="tenant_id" type="integer" required>
  Your tenant ID.
</ParamField>

<ParamField query="visit_number" type="string" required>
  The visit number to look up claim status for.
</ParamField>

## Response

<ResponseField name="status" type="string">
  Call status. One of `completed`, `in_progress`, or `failed`.
</ResponseField>

<ResponseField name="payer_name" type="string">
  Name of the payer.
</ResponseField>

<ResponseField name="check_eft_number" type="string">
  Check or EFT trace number.
</ResponseField>

<ResponseField name="remittance_date" type="string" format="date">
  Remittance date (YYYY-MM-DD).
</ResponseField>

<ResponseField name="carrier_run_date" type="string" format="date">
  Carrier run date (YYYY-MM-DD).
</ResponseField>

<ResponseField name="account" type="string">
  Claim account identifier.
</ResponseField>

<ResponseField name="patient_name" type="string">
  Patient name on the claim.
</ResponseField>

<ResponseField name="subscriber_id" type="string">
  Subscriber/member ID.
</ResponseField>

<ResponseField name="icn" type="string">
  Internal control number (payer's claim reference).
</ResponseField>

<ResponseField name="claim_status_code" type="string">
  Claim status code (e.g. `1` = processed as primary, `2` = processed as secondary, `4` = denied).
</ResponseField>

<ResponseField name="billed_amount" type="number">
  Total billed amount for the claim.
</ResponseField>

<ResponseField name="allowed_amount" type="number">
  Total allowed amount for the claim.
</ResponseField>

<ResponseField name="deductible_amount" type="number">
  Deductible applied to the claim.
</ResponseField>

<ResponseField name="coinsurance_amount" type="number">
  Coinsurance applied to the claim.
</ResponseField>

<ResponseField name="adjustment_amount" type="number">
  Total adjustment amount on the claim.
</ResponseField>

<ResponseField name="provider_paid_amount" type="number">
  Amount paid to the provider.
</ResponseField>

<ResponseField name="patient_responsibility" type="number">
  Patient responsibility amount.
</ResponseField>

<ResponseField name="remark_codes" type="string[]">
  Claim-level remittance advice remark codes (RARC), e.g. `["N381", "M15"]`.
</ResponseField>

<ResponseField name="service_lines" type="ServiceLineResult[]">
  Individual service lines on the claim.

  <Expandable title="ServiceLineResult">
    <ResponseField name="line_index" type="integer">
      Position of the service line within the claim.
    </ResponseField>

    <ResponseField name="procedure_code" type="string">
      CPT/HCPCS procedure code.
    </ResponseField>

    <ResponseField name="modifiers" type="string">
      Procedure modifiers (e.g. `"25"`, `"59"`).
    </ResponseField>

    <ResponseField name="service_date_from" type="string" format="date">
      Service start date (YYYY-MM-DD).
    </ResponseField>

    <ResponseField name="service_date_to" type="string" format="date">
      Service end date (YYYY-MM-DD).
    </ResponseField>

    <ResponseField name="units" type="number">
      Number of units billed.
    </ResponseField>

    <ResponseField name="billed_amount" type="number">
      Billed amount for this service line.
    </ResponseField>

    <ResponseField name="allowed_amount" type="number">
      Allowed amount for this service line.
    </ResponseField>

    <ResponseField name="deductible_amount" type="number">
      Deductible applied to this service line.
    </ResponseField>

    <ResponseField name="coinsurance_amount" type="number">
      Coinsurance applied to this service line.
    </ResponseField>

    <ResponseField name="adjustment_amount" type="number">
      Adjustment amount for this service line.
    </ResponseField>

    <ResponseField name="provider_paid_amount" type="number">
      Amount paid to provider for this service line.
    </ResponseField>

    <ResponseField name="adjustment_codes" type="ServiceLineAdjustment[]">
      Line-level claim adjustment codes (CARC).

      <Expandable title="ServiceLineAdjustment">
        <ResponseField name="group_code" type="string">
          Claim adjustment group code (e.g. `CO`, `PR`, `OA`).
        </ResponseField>

        <ResponseField name="reason_code" type="string">
          Claim adjustment reason code (e.g. `45`, `16`, `197`).
        </ResponseField>

        <ResponseField name="amount" type="number">
          Dollar amount of this adjustment.
        </ResponseField>
      </Expandable>
    </ResponseField>

    <ResponseField name="remark_codes" type="string[]">
      Line-level remittance advice remark codes (RARC).
    </ResponseField>
  </Expandable>
</ResponseField>

<RequestExample>
  ```bash cURL theme={null}
  curl -X GET "https://api.example.com/claim-status?tenant_id=1&visit_number=V12345" \
    -H "x-api-key: your-api-key"
  ```
</RequestExample>

<ResponseExample>
  ```json 200 theme={null}
  {
    "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"]
      }
    ]
  }
  ```
</ResponseExample>