API documentation for HeyDonto API users
Overview
Languages
Servers
Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/
Sandbox
https://api-staging.heydonto.com/
Production
https://api.heydonto.com/
Query
Sort the results by a given field, e.g. _sort=family or _sort=-date.
Example: _sort=family
Restrict returned fields, e.g. _elements=identifier,name.
Example: _elements=identifier,name
Filter by resource telecom, e.g. date=[SYSTEM]|[VALUE].
Example: telecom=telecom=phone|555-555-5555
Search for resources by identifier token, e.g. identifier=http://hospital.org|12345.
Example: identifier=http://hospital.org|12345
Include related resources, e.g. _include=Appointment:patient.
Example: _include=Appointment:patient
Include related patient resources, e.g. patient=Patient/[id]&.
Example: patient=patient=Patient/[id]&
Reverse include related resources, e.g. _revinclude=Observation:subject.
Example: _revinclude=Observation:subject
Reverse chaining, e.g. _has:Observation:subject:code=http://loinc.org|1234-5.
Example: _has=Observation:subject:code=http://loinc.org|1234-5
Search by tag on the resource meta, e.g. _tag=http://example.org/tags|sample-tag.
Example: _tag=http://example.org/tags|sample-tag
Search by security label on resource meta, e.g. _security=RBAC|CONFIDENTIAL.
Example: _security=RBAC|CONFIDENTIAL
- Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim
- Sandbox
https://api-staging.heydonto.com/site/{siteId}/fhir/claim
- Production
https://api.heydonto.com/site/{siteId}/fhir/claim
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X GET \
'https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim?_count=10&_page_token=CgYK...&_sort=family&_elements=identifier%2Cname&telecom=telecom%3Dphone%2C555-555-5555&_id=abc123&identifier=http%3A%2F%2Fhospital.org%2C12345&_include=Appointment%3Apatient&patient=patient%3DPatient%2F%5Bid%5D%26&_revinclude=Observation%3Asubject&_has=Observation%3Asubject%3Acode%3Dhttp%3A%2F%2Floinc.org%2C1234-5&_tag=http%3A%2F%2Fexample.org%2Ftags%2Csample-tag&_security=RBAC%2CCONFIDENTIAL&_profile=http%3A%2F%2Fexample.org%2Ffhir%2FStructureDefinition%2Fcustom-profile' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>'Bodyapplication/json
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
Example: "example-id"
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
String of characters used to identify a name or a resource
Example: "https://example.org/resource"
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Indicates the purpose of this bundle - how it is intended to be used.
Enum"document""message""transaction""transaction-response""batch""batch-response""history""searchset""collection"
Example: "searchset"
An instant in time - known at least to the second
Example: "2024-01-01T00:00:00Z"
An integer with a value that is not negative (e.g. >= 0)
Example: 0
A series of links that provide context to this bundle.
Example: [{"relation":"search","url":"https://api.heydonto.com/fhir/claim/?_count=20"},{"relation":"next","url":"https://api.heydonto.com/fhir/claim/?_count=20&_page_token=TOKEN"},{"relation":"first","url":"https://api.heydonto.com/fhir/claim/?_count=20"},{"relation":"self","url":"https://api.heydonto.com/fhir/claim/?_count=20"}]
An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
Example: [{"resourceType":"Claim","id":"100150","text":{"status":"generated","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>"},"identifier":[{"system":"http://happyvalley.com/claim","value":"12345"}],"status":"active","type":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"oral"}]},"use":"claim","patient":{"reference":"Patient/1"},"created":"2014-08-16","insurer":{"reference":"Organization/2"},"provider":{"reference":"Organization/1"},"priority":{"coding":[{"code":"normal"}]},"payee":{"type":{"coding":[{"code":"provider"}]}},"careTeam":[{"sequence":1,"provider":{"reference":"Practitioner/example"}}],"diagnosis":[{"sequence":1,"diagnosisCodeableConcept":{"coding":[{"code":"123456"}]}}],"insurance":[{"sequence":1,"focal":true,"identifier":{"system":"http://happyvalley.com/claim","value":"12345"},"coverage":{"reference":"Coverage/9876B1"}}],"item":[{"sequence":1,"careTeamSequence":[1],"productOrService":{"coding":[{"code":"1200"}]},"servicedDate":"2014-08-16","unitPrice":{"value":135.57,"currency":"USD"},"net":{"value":135.57,"currency":"USD"}}]}]
A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.
Response
application/json
{ "resourceType": "Bundle", "type": "searchset", "total": 100, "link": [ { … }, { … }, { … }, { … } ], "entry": [ { … } ] }
Bodyapplication/jsonrequired
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
Example: "example-id"
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
String of characters used to identify a name or a resource
Example: "https://example.org/resource"
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
containedArray of #Account (object) or #ActivityDefinition (object) or #AdverseEvent (object) or #AllergyIntolerance (object) or #Appointment (object) or #AppointmentResponse (object) or #AuditEvent (object) or #Basic (object) or #Binary (object) or #BiologicallyDerivedProduct (object) or #BodyStructure (object) or #Bundle (object) or #CapabilityStatement (object) or #CarePlan (object) or #CareTeam (object) or #CatalogEntry (object) or #ChargeItem (object) or #ChargeItemDefinition (object) or #Claim (object) or #ClaimResponse (object) or #ClinicalImpression (object) or #CodeSystem (object) or #Communication (object) or #CommunicationRequest (object) or #CompartmentDefinition (object) or #Composition (object) or #ConceptMap (object) or #Condition (object) or #Consent (object) or #Contract (object) or #Coverage (object) or #CoverageEligibilityRequest (object) or #CoverageEligibilityResponse (object) or #DetectedIssue (object) or #Device (object) or #DeviceDefinition (object) or #DeviceMetric (object) or #DeviceRequest (object) or #DeviceUseStatement (object) or #DiagnosticReport (object) or #DocumentManifest (object) or #DocumentReference (object) or #EffectEvidenceSynthesis (object) or #Encounter (object) or #Endpoint (object) or #EnrollmentRequest (object) or #EnrollmentResponse (object) or #EpisodeOfCare (object) or #EventDefinition (object) or #Evidence (object) or #EvidenceVariable (object) or #ExampleScenario (object) or #ExplanationOfBenefit (object) or #FamilyMemberHistory (object) or #Flag (object) or #Goal (object) or #GraphDefinition (object) or #Group (object) or #GuidanceResponse (object) or #HealthcareService (object) or #ImagingStudy (object) or #Immunization (object) or #ImmunizationEvaluation (object) or #ImmunizationRecommendation (object) or #ImplementationGuide (object) or #InsurancePlan (object) or #Invoice (object) or #Library (object) or #Linkage (object) or #List (object) or #Location (object) or #Measure (object) or #MeasureReport (object) or #Media (object) or #Medication (object) or #MedicationAdministration (object) or #MedicationDispense (object) or #MedicationKnowledge (object) or #MedicationRequest (object) or #MedicationStatement (object) or #MedicinalProduct (object) or #MedicinalProductAuthorization (object) or #MedicinalProductContraindication (object) or #MedicinalProductIndication (object) or #MedicinalProductIngredient (object) or #MedicinalProductInteraction (object) or #MedicinalProductManufactured (object) or #MedicinalProductPackaged (object) or #MedicinalProductPharmaceutical (object) or #MedicinalProductUndesirableEffect (object) or #MessageDefinition (object) or #MessageHeader (object) or #MolecularSequence (object) or #NamingSystem (object) or #NutritionOrder (object) or #Observation (object) or #ObservationDefinition (object) or #OperationDefinition (object) or #OperationOutcome (object) or #Organization (object) or #OrganizationAffiliation (object) or #Parameters (object) or #Patient (object) or #PaymentNotice (object) or #PaymentReconciliation (object) or #Person (object) or #PlanDefinition (object) or #Practitioner (object) or #PractitionerRole (object) or #Procedure (object) or #Provenance (object) or #Questionnaire (object) or #QuestionnaireResponse (object) or #RelatedPerson (object) or #RequestGroup (object) or #ResearchDefinition (object) or #ResearchElementDefinition (object) or #ResearchStudy (object) or #ResearchSubject (object) or #RiskAssessment (object) or #RiskEvidenceSynthesis (object) or #Schedule (object) or #SearchParameter (object) or #ServiceRequest (object) or #Slot (object) or #Specimen (object) or #SpecimenDefinition (object) or #StructureDefinition (object) or #StructureMap (object) or #Subscription (object) or #Substance (object) or #SubstanceNucleicAcid (object) or #SubstancePolymer (object) or #SubstanceProtein (object) or #SubstanceReferenceInformation (object) or #SubstanceSourceMaterial (object) or #SubstanceSpecification (object) or #SupplyDelivery (object) or #SupplyRequest (object) or #Task (object) or #TerminologyCapabilities (object) or #TestReport (object) or #TestScript (object) or #ValueSet (object) or #VerificationResult (object) or #VisionPrescription (object)(ResourceList)
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this claim.
Example: [{"system":"http://happyvalley.com/claim","value":"12345"}]
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Enum"claim""preauthorization""predetermination"
Example: "claim"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
Example: "2024-01-01T00:00:00Z"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
The members of the team who provided the products and services.
Example: [{"sequence":1,"provider":{"reference":"Practitioner/example"}}]
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Example: [{"sequence":1,"diagnosisCodeableConcept":{"coding":[{"code":"123456"}]}}]
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
Example: [{"sequence":1,"focal":true,"identifier":{"system":"http://happyvalley.com/claim","value":"12345"},"coverage":{"reference":"Coverage/9876B1"}}]
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
Example: ["example-string"]
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Example: [{"sequence":1,"careTeamSequence":[1],"productOrService":{"coding":[{"code":"1200"}]},"servicedDate":"2014-08-16","unitPrice":{"value":135.57,"currency":"USD"},"net":{"value":135.57,"currency":"USD"}}]
- Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim
- Sandbox
https://api-staging.heydonto.com/site/{siteId}/fhir/claim
- Production
https://api.heydonto.com/site/{siteId}/fhir/claim
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X POST \
'https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>' \
-H 'Content-Type: application/json' \
-d '{
"resourceType": "Claim",
"id": "100150",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>"
},
"identifier": [
{
"system": "http://happyvalley.com/claim",
"value": "12345"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "oral"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/1"
},
"created": "2014-08-16",
"insurer": {
"reference": "Organization/2"
},
"provider": {
"reference": "Organization/1"
},
"priority": {
"coding": [
{
"code": "normal"
}
]
},
"payee": {
"type": {
"coding": [
{
"code": "provider"
}
]
}
},
"careTeam": [
{
"sequence": 1,
"provider": {
"reference": "Practitioner/example"
}
}
],
"diagnosis": [
{
"sequence": 1,
"diagnosisCodeableConcept": {
"coding": [
{
"code": "123456"
}
]
}
}
],
"insurance": [
{
"sequence": 1,
"focal": true,
"identifier": {
"system": "http://happyvalley.com/claim",
"value": "12345"
},
"coverage": {
"reference": "Coverage/9876B1"
}
}
],
"item": [
{
"sequence": 1,
"careTeamSequence": [
1
],
"productOrService": {
"coding": [
{
"code": "1200"
}
]
},
"servicedDate": "2014-08-16",
"unitPrice": {
"value": 135.57,
"currency": "USD"
},
"net": {
"value": 135.57,
"currency": "USD"
}
}
]
}'Bodyapplication/json
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
Example: "example-id"
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
String of characters used to identify a name or a resource
Example: "https://example.org/resource"
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
containedArray of #Account (object) or #ActivityDefinition (object) or #AdverseEvent (object) or #AllergyIntolerance (object) or #Appointment (object) or #AppointmentResponse (object) or #AuditEvent (object) or #Basic (object) or #Binary (object) or #BiologicallyDerivedProduct (object) or #BodyStructure (object) or #Bundle (object) or #CapabilityStatement (object) or #CarePlan (object) or #CareTeam (object) or #CatalogEntry (object) or #ChargeItem (object) or #ChargeItemDefinition (object) or #Claim (object) or #ClaimResponse (object) or #ClinicalImpression (object) or #CodeSystem (object) or #Communication (object) or #CommunicationRequest (object) or #CompartmentDefinition (object) or #Composition (object) or #ConceptMap (object) or #Condition (object) or #Consent (object) or #Contract (object) or #Coverage (object) or #CoverageEligibilityRequest (object) or #CoverageEligibilityResponse (object) or #DetectedIssue (object) or #Device (object) or #DeviceDefinition (object) or #DeviceMetric (object) or #DeviceRequest (object) or #DeviceUseStatement (object) or #DiagnosticReport (object) or #DocumentManifest (object) or #DocumentReference (object) or #EffectEvidenceSynthesis (object) or #Encounter (object) or #Endpoint (object) or #EnrollmentRequest (object) or #EnrollmentResponse (object) or #EpisodeOfCare (object) or #EventDefinition (object) or #Evidence (object) or #EvidenceVariable (object) or #ExampleScenario (object) or #ExplanationOfBenefit (object) or #FamilyMemberHistory (object) or #Flag (object) or #Goal (object) or #GraphDefinition (object) or #Group (object) or #GuidanceResponse (object) or #HealthcareService (object) or #ImagingStudy (object) or #Immunization (object) or #ImmunizationEvaluation (object) or #ImmunizationRecommendation (object) or #ImplementationGuide (object) or #InsurancePlan (object) or #Invoice (object) or #Library (object) or #Linkage (object) or #List (object) or #Location (object) or #Measure (object) or #MeasureReport (object) or #Media (object) or #Medication (object) or #MedicationAdministration (object) or #MedicationDispense (object) or #MedicationKnowledge (object) or #MedicationRequest (object) or #MedicationStatement (object) or #MedicinalProduct (object) or #MedicinalProductAuthorization (object) or #MedicinalProductContraindication (object) or #MedicinalProductIndication (object) or #MedicinalProductIngredient (object) or #MedicinalProductInteraction (object) or #MedicinalProductManufactured (object) or #MedicinalProductPackaged (object) or #MedicinalProductPharmaceutical (object) or #MedicinalProductUndesirableEffect (object) or #MessageDefinition (object) or #MessageHeader (object) or #MolecularSequence (object) or #NamingSystem (object) or #NutritionOrder (object) or #Observation (object) or #ObservationDefinition (object) or #OperationDefinition (object) or #OperationOutcome (object) or #Organization (object) or #OrganizationAffiliation (object) or #Parameters (object) or #Patient (object) or #PaymentNotice (object) or #PaymentReconciliation (object) or #Person (object) or #PlanDefinition (object) or #Practitioner (object) or #PractitionerRole (object) or #Procedure (object) or #Provenance (object) or #Questionnaire (object) or #QuestionnaireResponse (object) or #RelatedPerson (object) or #RequestGroup (object) or #ResearchDefinition (object) or #ResearchElementDefinition (object) or #ResearchStudy (object) or #ResearchSubject (object) or #RiskAssessment (object) or #RiskEvidenceSynthesis (object) or #Schedule (object) or #SearchParameter (object) or #ServiceRequest (object) or #Slot (object) or #Specimen (object) or #SpecimenDefinition (object) or #StructureDefinition (object) or #StructureMap (object) or #Subscription (object) or #Substance (object) or #SubstanceNucleicAcid (object) or #SubstancePolymer (object) or #SubstanceProtein (object) or #SubstanceReferenceInformation (object) or #SubstanceSourceMaterial (object) or #SubstanceSpecification (object) or #SupplyDelivery (object) or #SupplyRequest (object) or #Task (object) or #TerminologyCapabilities (object) or #TestReport (object) or #TestScript (object) or #ValueSet (object) or #VerificationResult (object) or #VisionPrescription (object)(ResourceList)
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this claim.
Example: [{"system":"http://happyvalley.com/claim","value":"12345"}]
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Enum"claim""preauthorization""predetermination"
Example: "claim"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
Example: "2024-01-01T00:00:00Z"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
The members of the team who provided the products and services.
Example: [{"sequence":1,"provider":{"reference":"Practitioner/example"}}]
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Example: [{"sequence":1,"diagnosisCodeableConcept":{"coding":[{"code":"123456"}]}}]
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
Example: [{"sequence":1,"focal":true,"identifier":{"system":"http://happyvalley.com/claim","value":"12345"},"coverage":{"reference":"Coverage/9876B1"}}]
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
Example: ["example-string"]
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Example: [{"sequence":1,"careTeamSequence":[1],"productOrService":{"coding":[{"code":"1200"}]},"servicedDate":"2014-08-16","unitPrice":{"value":135.57,"currency":"USD"},"net":{"value":135.57,"currency":"USD"}}]
Response
application/json
{ "resourceType": "Claim", "id": "100150", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>" }, "identifier": [ { … } ], "status": "active", "type": { "coding": [ … ] }, "use": "claim", "patient": { "reference": "Patient/1" }, "created": "2014-08-16", "insurer": { "reference": "Organization/2" }, "provider": { "reference": "Organization/1" }, "priority": { "coding": [ … ] }, "payee": { "type": { … } }, "careTeam": [ { … } ], "diagnosis": [ { … } ], "insurance": [ { … } ], "item": [ { … } ] }
- Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}
- Sandbox
https://api-staging.heydonto.com/site/{siteId}/fhir/claim/{id}
- Production
https://api.heydonto.com/site/{siteId}/fhir/claim/{id}
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X GET \
'https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>'Bodyapplication/json
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
Example: "example-id"
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
String of characters used to identify a name or a resource
Example: "https://example.org/resource"
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
containedArray of #Account (object) or #ActivityDefinition (object) or #AdverseEvent (object) or #AllergyIntolerance (object) or #Appointment (object) or #AppointmentResponse (object) or #AuditEvent (object) or #Basic (object) or #Binary (object) or #BiologicallyDerivedProduct (object) or #BodyStructure (object) or #Bundle (object) or #CapabilityStatement (object) or #CarePlan (object) or #CareTeam (object) or #CatalogEntry (object) or #ChargeItem (object) or #ChargeItemDefinition (object) or #Claim (object) or #ClaimResponse (object) or #ClinicalImpression (object) or #CodeSystem (object) or #Communication (object) or #CommunicationRequest (object) or #CompartmentDefinition (object) or #Composition (object) or #ConceptMap (object) or #Condition (object) or #Consent (object) or #Contract (object) or #Coverage (object) or #CoverageEligibilityRequest (object) or #CoverageEligibilityResponse (object) or #DetectedIssue (object) or #Device (object) or #DeviceDefinition (object) or #DeviceMetric (object) or #DeviceRequest (object) or #DeviceUseStatement (object) or #DiagnosticReport (object) or #DocumentManifest (object) or #DocumentReference (object) or #EffectEvidenceSynthesis (object) or #Encounter (object) or #Endpoint (object) or #EnrollmentRequest (object) or #EnrollmentResponse (object) or #EpisodeOfCare (object) or #EventDefinition (object) or #Evidence (object) or #EvidenceVariable (object) or #ExampleScenario (object) or #ExplanationOfBenefit (object) or #FamilyMemberHistory (object) or #Flag (object) or #Goal (object) or #GraphDefinition (object) or #Group (object) or #GuidanceResponse (object) or #HealthcareService (object) or #ImagingStudy (object) or #Immunization (object) or #ImmunizationEvaluation (object) or #ImmunizationRecommendation (object) or #ImplementationGuide (object) or #InsurancePlan (object) or #Invoice (object) or #Library (object) or #Linkage (object) or #List (object) or #Location (object) or #Measure (object) or #MeasureReport (object) or #Media (object) or #Medication (object) or #MedicationAdministration (object) or #MedicationDispense (object) or #MedicationKnowledge (object) or #MedicationRequest (object) or #MedicationStatement (object) or #MedicinalProduct (object) or #MedicinalProductAuthorization (object) or #MedicinalProductContraindication (object) or #MedicinalProductIndication (object) or #MedicinalProductIngredient (object) or #MedicinalProductInteraction (object) or #MedicinalProductManufactured (object) or #MedicinalProductPackaged (object) or #MedicinalProductPharmaceutical (object) or #MedicinalProductUndesirableEffect (object) or #MessageDefinition (object) or #MessageHeader (object) or #MolecularSequence (object) or #NamingSystem (object) or #NutritionOrder (object) or #Observation (object) or #ObservationDefinition (object) or #OperationDefinition (object) or #OperationOutcome (object) or #Organization (object) or #OrganizationAffiliation (object) or #Parameters (object) or #Patient (object) or #PaymentNotice (object) or #PaymentReconciliation (object) or #Person (object) or #PlanDefinition (object) or #Practitioner (object) or #PractitionerRole (object) or #Procedure (object) or #Provenance (object) or #Questionnaire (object) or #QuestionnaireResponse (object) or #RelatedPerson (object) or #RequestGroup (object) or #ResearchDefinition (object) or #ResearchElementDefinition (object) or #ResearchStudy (object) or #ResearchSubject (object) or #RiskAssessment (object) or #RiskEvidenceSynthesis (object) or #Schedule (object) or #SearchParameter (object) or #ServiceRequest (object) or #Slot (object) or #Specimen (object) or #SpecimenDefinition (object) or #StructureDefinition (object) or #StructureMap (object) or #Subscription (object) or #Substance (object) or #SubstanceNucleicAcid (object) or #SubstancePolymer (object) or #SubstanceProtein (object) or #SubstanceReferenceInformation (object) or #SubstanceSourceMaterial (object) or #SubstanceSpecification (object) or #SupplyDelivery (object) or #SupplyRequest (object) or #Task (object) or #TerminologyCapabilities (object) or #TestReport (object) or #TestScript (object) or #ValueSet (object) or #VerificationResult (object) or #VisionPrescription (object)(ResourceList)
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this claim.
Example: [{"system":"http://happyvalley.com/claim","value":"12345"}]
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Enum"claim""preauthorization""predetermination"
Example: "claim"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
Example: "2024-01-01T00:00:00Z"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
The members of the team who provided the products and services.
Example: [{"sequence":1,"provider":{"reference":"Practitioner/example"}}]
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Example: [{"sequence":1,"diagnosisCodeableConcept":{"coding":[{"code":"123456"}]}}]
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
Example: [{"sequence":1,"focal":true,"identifier":{"system":"http://happyvalley.com/claim","value":"12345"},"coverage":{"reference":"Coverage/9876B1"}}]
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
Example: ["example-string"]
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Example: [{"sequence":1,"careTeamSequence":[1],"productOrService":{"coding":[{"code":"1200"}]},"servicedDate":"2014-08-16","unitPrice":{"value":135.57,"currency":"USD"},"net":{"value":135.57,"currency":"USD"}}]
Response
application/json
{ "resourceType": "Claim", "id": "100150", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>" }, "identifier": [ { … } ], "status": "active", "type": { "coding": [ … ] }, "use": "claim", "patient": { "reference": "Patient/1" }, "created": "2014-08-16", "insurer": { "reference": "Organization/2" }, "provider": { "reference": "Organization/1" }, "priority": { "coding": [ … ] }, "payee": { "type": { … } }, "careTeam": [ { … } ], "diagnosis": [ { … } ], "insurance": [ { … } ], "item": [ { … } ] }
Bodyapplication/jsonrequired
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
Example: "example-id"
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
String of characters used to identify a name or a resource
Example: "https://example.org/resource"
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
containedArray of #Account (object) or #ActivityDefinition (object) or #AdverseEvent (object) or #AllergyIntolerance (object) or #Appointment (object) or #AppointmentResponse (object) or #AuditEvent (object) or #Basic (object) or #Binary (object) or #BiologicallyDerivedProduct (object) or #BodyStructure (object) or #Bundle (object) or #CapabilityStatement (object) or #CarePlan (object) or #CareTeam (object) or #CatalogEntry (object) or #ChargeItem (object) or #ChargeItemDefinition (object) or #Claim (object) or #ClaimResponse (object) or #ClinicalImpression (object) or #CodeSystem (object) or #Communication (object) or #CommunicationRequest (object) or #CompartmentDefinition (object) or #Composition (object) or #ConceptMap (object) or #Condition (object) or #Consent (object) or #Contract (object) or #Coverage (object) or #CoverageEligibilityRequest (object) or #CoverageEligibilityResponse (object) or #DetectedIssue (object) or #Device (object) or #DeviceDefinition (object) or #DeviceMetric (object) or #DeviceRequest (object) or #DeviceUseStatement (object) or #DiagnosticReport (object) or #DocumentManifest (object) or #DocumentReference (object) or #EffectEvidenceSynthesis (object) or #Encounter (object) or #Endpoint (object) or #EnrollmentRequest (object) or #EnrollmentResponse (object) or #EpisodeOfCare (object) or #EventDefinition (object) or #Evidence (object) or #EvidenceVariable (object) or #ExampleScenario (object) or #ExplanationOfBenefit (object) or #FamilyMemberHistory (object) or #Flag (object) or #Goal (object) or #GraphDefinition (object) or #Group (object) or #GuidanceResponse (object) or #HealthcareService (object) or #ImagingStudy (object) or #Immunization (object) or #ImmunizationEvaluation (object) or #ImmunizationRecommendation (object) or #ImplementationGuide (object) or #InsurancePlan (object) or #Invoice (object) or #Library (object) or #Linkage (object) or #List (object) or #Location (object) or #Measure (object) or #MeasureReport (object) or #Media (object) or #Medication (object) or #MedicationAdministration (object) or #MedicationDispense (object) or #MedicationKnowledge (object) or #MedicationRequest (object) or #MedicationStatement (object) or #MedicinalProduct (object) or #MedicinalProductAuthorization (object) or #MedicinalProductContraindication (object) or #MedicinalProductIndication (object) or #MedicinalProductIngredient (object) or #MedicinalProductInteraction (object) or #MedicinalProductManufactured (object) or #MedicinalProductPackaged (object) or #MedicinalProductPharmaceutical (object) or #MedicinalProductUndesirableEffect (object) or #MessageDefinition (object) or #MessageHeader (object) or #MolecularSequence (object) or #NamingSystem (object) or #NutritionOrder (object) or #Observation (object) or #ObservationDefinition (object) or #OperationDefinition (object) or #OperationOutcome (object) or #Organization (object) or #OrganizationAffiliation (object) or #Parameters (object) or #Patient (object) or #PaymentNotice (object) or #PaymentReconciliation (object) or #Person (object) or #PlanDefinition (object) or #Practitioner (object) or #PractitionerRole (object) or #Procedure (object) or #Provenance (object) or #Questionnaire (object) or #QuestionnaireResponse (object) or #RelatedPerson (object) or #RequestGroup (object) or #ResearchDefinition (object) or #ResearchElementDefinition (object) or #ResearchStudy (object) or #ResearchSubject (object) or #RiskAssessment (object) or #RiskEvidenceSynthesis (object) or #Schedule (object) or #SearchParameter (object) or #ServiceRequest (object) or #Slot (object) or #Specimen (object) or #SpecimenDefinition (object) or #StructureDefinition (object) or #StructureMap (object) or #Subscription (object) or #Substance (object) or #SubstanceNucleicAcid (object) or #SubstancePolymer (object) or #SubstanceProtein (object) or #SubstanceReferenceInformation (object) or #SubstanceSourceMaterial (object) or #SubstanceSpecification (object) or #SupplyDelivery (object) or #SupplyRequest (object) or #Task (object) or #TerminologyCapabilities (object) or #TestReport (object) or #TestScript (object) or #ValueSet (object) or #VerificationResult (object) or #VisionPrescription (object)(ResourceList)
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this claim.
Example: [{"system":"http://happyvalley.com/claim","value":"12345"}]
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Enum"claim""preauthorization""predetermination"
Example: "claim"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
Example: "2024-01-01T00:00:00Z"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
The members of the team who provided the products and services.
Example: [{"sequence":1,"provider":{"reference":"Practitioner/example"}}]
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Example: [{"sequence":1,"diagnosisCodeableConcept":{"coding":[{"code":"123456"}]}}]
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
Example: [{"sequence":1,"focal":true,"identifier":{"system":"http://happyvalley.com/claim","value":"12345"},"coverage":{"reference":"Coverage/9876B1"}}]
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
Example: ["example-string"]
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Example: [{"sequence":1,"careTeamSequence":[1],"productOrService":{"coding":[{"code":"1200"}]},"servicedDate":"2014-08-16","unitPrice":{"value":135.57,"currency":"USD"},"net":{"value":135.57,"currency":"USD"}}]
- Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}
- Sandbox
https://api-staging.heydonto.com/site/{siteId}/fhir/claim/{id}
- Production
https://api.heydonto.com/site/{siteId}/fhir/claim/{id}
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X PUT \
'https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>' \
-H 'Content-Type: application/json' \
-d '{
"resourceType": "Claim",
"id": "100150",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>"
},
"identifier": [
{
"system": "http://happyvalley.com/claim",
"value": "12345"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "oral"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/1"
},
"created": "2014-08-16",
"insurer": {
"reference": "Organization/2"
},
"provider": {
"reference": "Organization/1"
},
"priority": {
"coding": [
{
"code": "normal"
}
]
},
"payee": {
"type": {
"coding": [
{
"code": "provider"
}
]
}
},
"careTeam": [
{
"sequence": 1,
"provider": {
"reference": "Practitioner/example"
}
}
],
"diagnosis": [
{
"sequence": 1,
"diagnosisCodeableConcept": {
"coding": [
{
"code": "123456"
}
]
}
}
],
"insurance": [
{
"sequence": 1,
"focal": true,
"identifier": {
"system": "http://happyvalley.com/claim",
"value": "12345"
},
"coverage": {
"reference": "Coverage/9876B1"
}
}
],
"item": [
{
"sequence": 1,
"careTeamSequence": [
1
],
"productOrService": {
"coding": [
{
"code": "1200"
}
]
},
"servicedDate": "2014-08-16",
"unitPrice": {
"value": 135.57,
"currency": "USD"
},
"net": {
"value": 135.57,
"currency": "USD"
}
}
]
}'Bodyapplication/json
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
Example: "example-id"
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
String of characters used to identify a name or a resource
Example: "https://example.org/resource"
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
containedArray of #Account (object) or #ActivityDefinition (object) or #AdverseEvent (object) or #AllergyIntolerance (object) or #Appointment (object) or #AppointmentResponse (object) or #AuditEvent (object) or #Basic (object) or #Binary (object) or #BiologicallyDerivedProduct (object) or #BodyStructure (object) or #Bundle (object) or #CapabilityStatement (object) or #CarePlan (object) or #CareTeam (object) or #CatalogEntry (object) or #ChargeItem (object) or #ChargeItemDefinition (object) or #Claim (object) or #ClaimResponse (object) or #ClinicalImpression (object) or #CodeSystem (object) or #Communication (object) or #CommunicationRequest (object) or #CompartmentDefinition (object) or #Composition (object) or #ConceptMap (object) or #Condition (object) or #Consent (object) or #Contract (object) or #Coverage (object) or #CoverageEligibilityRequest (object) or #CoverageEligibilityResponse (object) or #DetectedIssue (object) or #Device (object) or #DeviceDefinition (object) or #DeviceMetric (object) or #DeviceRequest (object) or #DeviceUseStatement (object) or #DiagnosticReport (object) or #DocumentManifest (object) or #DocumentReference (object) or #EffectEvidenceSynthesis (object) or #Encounter (object) or #Endpoint (object) or #EnrollmentRequest (object) or #EnrollmentResponse (object) or #EpisodeOfCare (object) or #EventDefinition (object) or #Evidence (object) or #EvidenceVariable (object) or #ExampleScenario (object) or #ExplanationOfBenefit (object) or #FamilyMemberHistory (object) or #Flag (object) or #Goal (object) or #GraphDefinition (object) or #Group (object) or #GuidanceResponse (object) or #HealthcareService (object) or #ImagingStudy (object) or #Immunization (object) or #ImmunizationEvaluation (object) or #ImmunizationRecommendation (object) or #ImplementationGuide (object) or #InsurancePlan (object) or #Invoice (object) or #Library (object) or #Linkage (object) or #List (object) or #Location (object) or #Measure (object) or #MeasureReport (object) or #Media (object) or #Medication (object) or #MedicationAdministration (object) or #MedicationDispense (object) or #MedicationKnowledge (object) or #MedicationRequest (object) or #MedicationStatement (object) or #MedicinalProduct (object) or #MedicinalProductAuthorization (object) or #MedicinalProductContraindication (object) or #MedicinalProductIndication (object) or #MedicinalProductIngredient (object) or #MedicinalProductInteraction (object) or #MedicinalProductManufactured (object) or #MedicinalProductPackaged (object) or #MedicinalProductPharmaceutical (object) or #MedicinalProductUndesirableEffect (object) or #MessageDefinition (object) or #MessageHeader (object) or #MolecularSequence (object) or #NamingSystem (object) or #NutritionOrder (object) or #Observation (object) or #ObservationDefinition (object) or #OperationDefinition (object) or #OperationOutcome (object) or #Organization (object) or #OrganizationAffiliation (object) or #Parameters (object) or #Patient (object) or #PaymentNotice (object) or #PaymentReconciliation (object) or #Person (object) or #PlanDefinition (object) or #Practitioner (object) or #PractitionerRole (object) or #Procedure (object) or #Provenance (object) or #Questionnaire (object) or #QuestionnaireResponse (object) or #RelatedPerson (object) or #RequestGroup (object) or #ResearchDefinition (object) or #ResearchElementDefinition (object) or #ResearchStudy (object) or #ResearchSubject (object) or #RiskAssessment (object) or #RiskEvidenceSynthesis (object) or #Schedule (object) or #SearchParameter (object) or #ServiceRequest (object) or #Slot (object) or #Specimen (object) or #SpecimenDefinition (object) or #StructureDefinition (object) or #StructureMap (object) or #Subscription (object) or #Substance (object) or #SubstanceNucleicAcid (object) or #SubstancePolymer (object) or #SubstanceProtein (object) or #SubstanceReferenceInformation (object) or #SubstanceSourceMaterial (object) or #SubstanceSpecification (object) or #SupplyDelivery (object) or #SupplyRequest (object) or #Task (object) or #TerminologyCapabilities (object) or #TestReport (object) or #TestScript (object) or #ValueSet (object) or #VerificationResult (object) or #VisionPrescription (object)(ResourceList)
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this claim.
Example: [{"system":"http://happyvalley.com/claim","value":"12345"}]
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Example: "sample-code"
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Enum"claim""preauthorization""predetermination"
Example: "claim"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
Example: "2024-01-01T00:00:00Z"
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
The members of the team who provided the products and services.
Example: [{"sequence":1,"provider":{"reference":"Practitioner/example"}}]
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Example: [{"sequence":1,"diagnosisCodeableConcept":{"coding":[{"code":"123456"}]}}]
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
Example: [{"sequence":1,"focal":true,"identifier":{"system":"http://happyvalley.com/claim","value":"12345"},"coverage":{"reference":"Coverage/9876B1"}}]
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
Example: ["example-string"]
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Example: [{"sequence":1,"careTeamSequence":[1],"productOrService":{"coding":[{"code":"1200"}]},"servicedDate":"2014-08-16","unitPrice":{"value":135.57,"currency":"USD"},"net":{"value":135.57,"currency":"USD"}}]
Response
application/json
{ "resourceType": "Claim", "id": "100150", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>" }, "identifier": [ { … } ], "status": "active", "type": { "coding": [ … ] }, "use": "claim", "patient": { "reference": "Patient/1" }, "created": "2014-08-16", "insurer": { "reference": "Organization/2" }, "provider": { "reference": "Organization/1" }, "priority": { "coding": [ … ] }, "payee": { "type": { … } }, "careTeam": [ { … } ], "diagnosis": [ { … } ], "insurance": [ { … } ], "item": [ { … } ] }
- Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}
- Sandbox
https://api-staging.heydonto.com/site/{siteId}/fhir/claim/{id}
- Production
https://api.heydonto.com/site/{siteId}/fhir/claim/{id}
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X DELETE \
'https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>'Response
application/json
{ "statusText": "OK", "status": 200 }
- Mock server
https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}/history
- Sandbox
https://api-staging.heydonto.com/site/{siteId}/fhir/claim/{id}/history
- Production
https://api.heydonto.com/site/{siteId}/fhir/claim/{id}/history
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X GET \
'https://docs.heydonto.com/_mock/apis/fhir/openapi/site/{siteId}/fhir/claim/{id}/history' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>'Response
application/json
{ "resourceType": "Bundle", "type": "history", "entry": [ { … } ], "total": 2 }