openapi: 3.2.0
info:
title: Reference V2 API
version: 1.0.0
servers:
- url: https://pre-api.joincandidhealth.com
description: Production
- url: https://pre-api-staging.joincandidhealth.com
description: Staging
- url: https://sandbox-pre-api.joincandidhealth.com
description: CandidSandbox
- url: https://staging-pre-api.joincandidhealth.com
description: CandidStaging
- url: http://localhost:4000
description: Local
- url: https://api.joincandidhealth.com
description: Production
- url: https://api-staging.joincandidhealth.com
description: Staging
- url: https://sandbox-api.joincandidhealth.com
description: CandidSandbox
- url: https://staging-api.joincandidhealth.com
description: CandidStaging
- url: http://localhost:5050
description: Local
tags:
- name: v2
paths:
/api/billing_notes/v2:
post:
operationId: create
summary: Create billing note
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNote'
requestBody:
content:
application/json:
schema:
type: object
properties:
text:
type: string
description: Empty string not allowed.
encounter_id:
$ref: '#/components/schemas/type_commons_EncounterId'
required:
- text
- encounter_id
/api/billing_notes/v2/{billing_note_id}:
delete:
operationId: delete
summary: Delete billing note
tags:
- v2
parameters:
- name: billing_note_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNoteId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'400':
description: Error response with status 400
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- OrganizationNotAuthorizedError
content:
$ref: '#/components/schemas/type_commons_OrganizationNotAuthorizedErrorMessage'
required:
- errorName
- content
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
patch:
operationId: update
summary: Update
tags:
- v2
parameters:
- name: billing_note_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNoteId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNote'
'400':
description: Error response with status 400
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- OrganizationNotAuthorizedError
content:
$ref: '#/components/schemas/type_commons_OrganizationNotAuthorizedErrorMessage'
required:
- errorName
- content
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
type: object
properties:
text:
type: string
description: Empty string not allowed.
required:
- text
/api/contracts/v2/{contract_id}:
get:
operationId: get
summary: Get contract
description: This API provides access to Professional Contracts. For Professional and Institutional Contracts use Contracts V3.
tags:
- v2
parameters:
- name: contract_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractId'
- name: organization_id
in: query
description: Organization context for cross-org access. If not provided, defaults to the requesting user's organization.
required: false
schema:
$ref: '#/components/schemas/type_commons_OrganizationId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractWithProviders'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
delete:
operationId: delete
summary: Delete contract
tags:
- v2
parameters:
- name: contract_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- ContractIsLinkedToFeeScheduleHttpError
content:
$ref: '#/components/schemas/type_contracts_v2_ContractIsLinkedToFeeScheduleError'
required:
- errorName
- content
patch:
operationId: update
summary: Update contract
tags:
- v2
parameters:
- name: contract_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractWithProviders'
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- ContractInvalidExpirationDateHttpError
content:
$ref: '#/components/schemas/type_contracts_v2_ContractInvalidExpirationDateError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
type: object
properties:
rendering_provider_ids:
type: array
uniqueItems: true
items:
$ref: '#/components/schemas/type_contracts_v2_RenderingProviderid'
description: 'A rendering provider isn''t contracted directly with the payer but can render
services under the contract held by the contracting provider.
Max items is 4000.'
effective_date:
$ref: '#/components/schemas/type_commons_Date'
description: The starting day upon which the contract is effective
expiration_date:
$ref: '#/components/schemas/type_contracts_v2_DateUpdate'
description: An optional end day upon which the contract expires
regions:
$ref: '#/components/schemas/type_contracts_v2_RegionsUpdate'
description: 'If present, the contract''s rendering providers will be patched to this exact
value, overriding what was set before.'
contract_status:
$ref: '#/components/schemas/type_contracts_v2_ContractStatus'
authorized_signatory:
$ref: '#/components/schemas/type_contracts_v2_AuthorizedSignatoryUpdate'
commercial_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
medicare_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
medicaid_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
/api/contracts/v2:
get:
operationId: get_multi
summary: Get all contracts
description: This API provides access to Professional Contracts. For Professional and Institutional Contracts use Contracts V3.
tags:
- v2
parameters:
- name: page_token
in: query
required: false
schema:
$ref: '#/components/schemas/type_commons_PageToken'
- name: limit
in: query
description: Max number of contracts returned. Defaults to 1000. Max is 1000.
required: false
schema:
type: integer
- name: contracting_provider_id
in: query
required: false
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractingProviderId'
- name: rendering_provider_ids
in: query
required: false
schema:
$ref: '#/components/schemas/type_contracts_v2_RenderingProviderid'
- name: payer_names
in: query
description: Filter to contracts that include any of the included payer names.
required: false
schema:
type: string
- name: states
in: query
required: false
schema:
$ref: '#/components/schemas/type_commons_State'
- name: contract_status
in: query
description: The status of the contract. Defaults to `pending`
required: false
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractStatus'
- name: sort
in: query
description: Potentially sort by a contract related attribute. Defaults to created_at
required: false
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractSortField'
- name: sort_direction
in: query
description: Direction of sort, defaulting to desc
required: false
schema:
$ref: '#/components/schemas/type_commons_SortDirection'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractsPage'
post:
operationId: create
summary: Create contract
description: Creates a new contract within the user's current organization
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_contracts_v2_ContractWithProviders'
requestBody:
content:
application/json:
schema:
type: object
properties:
effective_date:
$ref: '#/components/schemas/type_commons_Date'
description: The starting day upon which the contract is effective
expiration_date:
$ref: '#/components/schemas/type_commons_Date'
description: An optional end day upon which the contract expires
regions:
$ref: '#/components/schemas/type_commons_Regions'
description: 'The state(s) to which the contract''s coverage extends.
It may also be set to "national" for the entirety of the US.'
contract_status:
$ref: '#/components/schemas/type_contracts_v2_ContractStatus'
authorized_signatory:
$ref: '#/components/schemas/type_contracts_v2_AuthorizedSignatory'
commercial_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The commercial plan insurance types this contract applies.
medicare_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The Medicare plan insurance types this contract applies.
medicaid_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The Medicaid plan insurance types this contract applies.
contracting_provider_id:
$ref: '#/components/schemas/type_contracts_v2_ContractingProviderId'
description: The UUID of the provider under agreement to the contract
rendering_provider_ids:
type: array
uniqueItems: true
items:
$ref: '#/components/schemas/type_contracts_v2_RenderingProviderid'
description: 'A rendering provider isn''t contracted directly with the payer but can render
services under the contract held by the contracting provider.
Max items is 4000.'
payer_uuid:
type: string
format: uuid
description: The UUID of the insurance company under agreement to the contract
required:
- effective_date
- regions
- commercial_insurance_types
- medicare_insurance_types
- medicaid_insurance_types
- contracting_provider_id
- rendering_provider_ids
- payer_uuid
/api/provider-credentialing-span/v2/facility:
post:
operationId: createFacility
summary: Create facility credentialing span
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpan'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
type: object
properties:
service_facility_id:
type: string
format: uuid
description: The ID of the service facility covered by the credentialing span.
contracting_provider_id:
type: string
format: uuid
description: The ID of the billing provider for which the rendering provider is covered by the credentialing span.
payer_uuid:
type: string
format: uuid
description: The ID of the payer covered by the credentialing span.
start_date:
type: string
format: date
description: Start date of the credentialing span.
end_date:
type: string
format: date
description: End date of the credentialing span.
submitted_date:
type: string
format: date
description: Date that the credential paperwork was submitted.
payer_loaded_date:
type: string
format: date
description: Date that the payer loaded the credentialing span into their system.
required:
- service_facility_id
- contracting_provider_id
- payer_uuid
get:
operationId: getAllFacilities
summary: Get all facility credentialing spans
tags:
- v2
parameters:
- name: limit
in: query
description: Maximum number of entities per page, defaults to 100.
required: false
schema:
type: integer
- name: page_token
in: query
required: false
schema:
$ref: '#/components/schemas/type_commons_PageToken'
- name: payer_uuid
in: query
description: Filter by payer.
required: false
schema:
type: string
format: uuid
- name: contracting_provider_id
in: query
description: Filter to a particular contracting provider.
required: false
schema:
type: string
format: uuid
- name: service_facility_id
in: query
description: Filter to a particular service facility.
required: false
schema:
type: string
format: uuid
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpanPage'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnprocessableEntityError
content:
$ref: '#/components/schemas/type_commons_UnprocessableEntityErrorMessage'
required:
- errorName
- content
/api/provider-credentialing-span/v2/facility/{facility_credentialing_id}:
get:
operationId: getFacility
summary: Get facility credentialing span
tags:
- v2
parameters:
- name: facility_credentialing_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpanId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpan'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
delete:
operationId: deleteFacility
summary: Delete facility credentialing span
description: Soft deletes a credentialing span rate from the system.
tags:
- v2
parameters:
- name: facility_credentialing_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpanId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
patch:
operationId: updateFacility
summary: Update facility credentialing span
tags:
- v2
parameters:
- name: facility_credentialing_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpanId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpan'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnprocessableEntityError
content:
$ref: '#/components/schemas/type_commons_UnprocessableEntityErrorMessage'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
type: object
properties:
contracting_provider_id:
type: string
format: uuid
description: The ID of the billing provider for which the rendering provider is covered by the credentialing span.
payer_uuid:
type: string
format: uuid
description: The ID of the payer doing the credentialing.
start_date:
type: string
format: date
description: Start date of the credentialing span.
end_date:
type: string
format: date
description: End date of the credentialing span.
submitted_date:
type: string
format: date
description: Date that the credential paperwork was submitted.
payer_loaded_date:
type: string
format: date
description: Date that the payer loaded the credentialing span into their system.
required:
- contracting_provider_id
/api/provider-credentialing-span/v2:
post:
operationId: create
summary: Create provider credentialing span
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_ProviderCredentialingSpan'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
type: object
properties:
rendering_provider_id:
type: string
format: uuid
description: The ID of the rendering provider covered by the credentialing span.
contracting_provider_id:
type: string
format: uuid
description: The ID of the billing provider for which the rendering provider is covered by the credentialing span.
payer_uuid:
type: string
format: uuid
description: The ID of the payer covered by the credentialing span.
start_date:
type: string
format: date
description: Start date of the credentialing span.
end_date:
type: string
format: date
description: End date of the credentialing span.
regions:
$ref: '#/components/schemas/type_commons_Regions'
description: The states covered by the credentialing span. A span may be national and cover all states.
submitted_date:
type: string
format: date
description: Date that the credential paperwork was submitted.
payer_loaded_date:
type: string
format: date
description: Date that the payer loaded the credentialing span into their system.
required:
- rendering_provider_id
- contracting_provider_id
- payer_uuid
- regions
get:
operationId: getAll
summary: Get all provider credentialing spans
tags:
- v2
parameters:
- name: limit
in: query
description: Maximum number of entities per page, defaults to 100.
required: false
schema:
type: integer
- name: page_token
in: query
required: false
schema:
$ref: '#/components/schemas/type_commons_PageToken'
- name: payer_uuid
in: query
description: Filter by payer.
required: false
schema:
type: string
format: uuid
- name: provider_id
in: query
description: Filter to a particular provider. Use in conjunction as_rendering_provider and as_contracting_provider.
required: false
schema:
type: string
format: uuid
- name: as_rendering_provider
in: query
description: Filter to credentialing spans where the provider is a rendering provider. To use this filter provider_id is required.
required: false
schema:
type: boolean
- name: as_contracting_provider
in: query
description: Filter to credentialing spans where the provider is a contracting provider. To use this filter provider_id is required.
required: false
schema:
type: boolean
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_ProviderCredentialingSpanPage'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnprocessableEntityError
content:
$ref: '#/components/schemas/type_commons_UnprocessableEntityErrorMessage'
required:
- errorName
- content
/api/provider-credentialing-span/v2/{provider_credentialing_id}:
get:
operationId: get
summary: Get provider credentialing span
tags:
- v2
parameters:
- name: provider_credentialing_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ProviderCredentialingSpanId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_ProviderCredentialingSpan'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
delete:
operationId: delete
summary: Delete provider credentialing span
description: Soft deletes a credentialing span rate from the system.
tags:
- v2
parameters:
- name: provider_credentialing_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ProviderCredentialingSpanId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
patch:
operationId: update
summary: Update provider credentialing span
tags:
- v2
parameters:
- name: provider_credentialing_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ProviderCredentialingSpanId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_credentialing_v2_ProviderCredentialingSpan'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnprocessableEntityError
content:
$ref: '#/components/schemas/type_commons_UnprocessableEntityErrorMessage'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
type: object
properties:
contracting_provider_id:
type: string
format: uuid
description: The ID of the billing provider for which the rendering provider is covered by the credentialing span.
payer_uuid:
type: string
format: uuid
description: The ID of the payer doing the credentialing.
start_date:
type: string
format: date
description: Start date of the credentialing span.
end_date:
type: string
format: date
description: End date of the credentialing span.
regions:
$ref: '#/components/schemas/type_commons_Regions'
description: The states covered by the credentialing span. A span may be national and cover all states.
submitted_date:
type: string
format: date
description: Date that the credential paperwork was submitted.
payer_loaded_date:
type: string
format: date
description: Date that the payer loaded the credentialing span into their system.
/api/eligibility/v2/availity:
get:
operationId: submit_eligibility_check_availity
summary: Submit encounter eligibility check (Availity)
description: 'Candid is deprecating support for this endpoint. It is instead recommended to use [Candid''s Stedi passthrough endpoint](https://docs.joincandidhealth.com/api-reference/pre-encounter/eligibility-checks/v-1/post).
For assistance with the transition, please reference the [Transitioning to Candid''s New Eligibility Endpoint](https://support.joincandidhealth.com/hc/en-us/articles/34918552872980) document in the Candid Support Center.
**Availity has transitioned their GET endpoint to a POST endpoint. Candid has updated their pass-through integration to enable backwards compatibility for the GET endpoint so that customers do not have to immediately update their integrations.**
**Candid recommends integrations with the [POST endpoint](https://docs.joincandidhealth.com/api-reference/eligibility/v-2/submit-eligibility-check-availity-post) to ensure the best possible integration experience. Given the transition, Availity’s documentation will be out of sync with this endpoint.**
If you''d like access to this endpoint, please reach out to support@joincandidhealth.com with the subject line "Action: Activate Availity Eligibility API Endpoint
This API is a wrapper around Availity''s coverages API. Below are some helpful documentation links:
- [Availity - Coverages 1.0.0 API](https://developer.availity.com/partner/documentation#c_coverages_references)
- [Candid Availity Eligibility Integration Guide](https://support.joincandidhealth.com/hc/en-us/articles/24218441631892--Availity-Eligibility-Integration-Guide)
A schema of the response object can be found here: [Availity Docs](https://developer.availity.com/partner/product/191210/api/190898#/Coverages_100/operation/%2Fcoverages%2F{id}/get)
* Note Availity requires a free developer account to access this documentation.
Check connection status of Availity API and partners here:
- [Availity Trading Partner Connection Status](https://www.availity.com/status/)'
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
description: Any type
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
post:
operationId: submit_eligibility_check_availity_post
summary: Submit encounter eligibility check (Availity Post)
description: 'Candid is deprecating support for this endpoint. It is instead recommended to use [Candid''s Stedi passthrough endpoint](https://docs.joincandidhealth.com/api-reference/pre-encounter/eligibility-checks/v-1/post).
For assistance with the transition, please reference the [Transitioning to Candid''s New Eligibility Endpoint](https://support.joincandidhealth.com/hc/en-us/articles/34918552872980) document in the Candid Support Center.
If you''d like access to this endpoint, please reach out to support@joincandidhealth.com with the subject line "Action: Activate Availity Eligibility API Endpoint
This API is a wrapper around Availity''s coverages API. Below are some helpful documentation links:
- [Availity - Coverages 1.0.0 API](https://developer.availity.com/partner/documentation#c_coverages_references)
- [Candid Availity Eligibility Integration Guide](https://support.joincandidhealth.com/hc/en-us/articles/24218441631892--Availity-Eligibility-Integration-Guide)
A schema of the response object can be found here: [Availity Docs](https://developer.availity.com/partner/product/191210/api/190898#/Coverages_100/operation/%2Fcoverages%2F{id}/get)
* Note Availity requires a free developer account to access this documentation.
Check connection status of Availity API and partners here:
- [Availity Trading Partner Connection Status](https://www.availity.com/status/)'
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
description: Any type
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
description: Any type
/api/encounter-providers/v2/{encounter_id}:
patch:
operationId: update_referring_provider
summary: Update Referring Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProviderUpdate'
/api/encounter-providers/v2/{encounter_id}/initial-referring-provider:
patch:
operationId: update_initial_referring_provider
summary: Update Initial Referring Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_InitialReferringProviderUpdate'
delete:
operationId: delete_initial_referring_provider
summary: Delete Initial Referring Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
/api/encounter-providers/v2/{encounter_id}/supervising-provider:
patch:
operationId: update_supervising_provider
summary: Update Supervising Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_SupervisingProviderUpdate'
delete:
operationId: delete_supervising_provider
summary: Delete Supervising Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
/api/encounter-providers/v2/{service_line_id}/ordering-provider:
patch:
operationId: update_ordering_provider
summary: Update Ordering Provider
tags:
- v2
parameters:
- name: service_line_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ServiceLineId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_OrderingProviderUpdate'
delete:
operationId: delete_ordering_provider
summary: Delete Ordering Provider
tags:
- v2
parameters:
- name: service_line_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ServiceLineId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
/api/encounter-providers/v2/{encounter_id}/create-referring-provider:
post:
operationId: create_referring_provider
summary: Create Referring Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProvider'
/api/encounter-providers/v2/{encounter_id}/create-initial-referring-provider:
post:
operationId: create_initial_referring_provider
summary: Create Initial Referring Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_InitialReferringProvider'
/api/encounter-providers/v2/{encounter_id}/create-supervising-provider:
post:
operationId: create_supervising_provider
summary: Create Supervising Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_SupervisingProvider'
/api/encounter-providers/v2/{service_line_id}/create-ordering-provider:
post:
operationId: create_ordering_provider
summary: Create Ordering Provider
tags:
- v2
parameters:
- name: service_line_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ServiceLineId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationsError
content:
type: array
items:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_encounter-providers_v2_OrderingProvider'
/api/encounter-providers/v2/{encounter_id}/referring-provider:
delete:
operationId: delete_referring_provider
summary: Delete Referring Provider
tags:
- v2
parameters:
- name: encounter_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_EncounterId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
/api/organization-service-facilities/v2/{organization_service_facility_id}:
get:
operationId: get
summary: Get organization service facility
tags:
- v2
parameters:
- name: organization_service_facility_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacility'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
patch:
operationId: update
summary: Update organization service facility
tags:
- v2
parameters:
- name: organization_service_facility_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacility'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityUpdate'
delete:
operationId: delete
summary: Delete organization service facility
tags:
- v2
parameters:
- name: organization_service_facility_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
/api/organization-service-facilities/v2:
get:
operationId: get_multi
summary: Get all organization service facilities
tags:
- v2
parameters:
- name: limit
in: query
description: Limit the number of results returned. Defaults to 100.
required: false
schema:
type: integer
- name: name
in: query
description: Filter to a name or a part of a name.
required: false
schema:
type: string
- name: organization_service_facility_ids
in: query
description: Filter to the provided organization service facility IDs.
required: false
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
- name: external_ids
in: query
description: Filter by one or more external_ids.
required: false
schema:
type: string
- name: place_of_service_code
in: query
description: Filter by Place of Service (POS) code.
required: false
schema:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
- name: page_token
in: query
description: The page token to continue paging through a previous request.
required: false
schema:
$ref: '#/components/schemas/type_commons_PageToken'
- name: organization_id
in: query
description: Filter to a specific organization's service facilities. If not provided, defaults to the requesting user's organization.
required: false
schema:
$ref: '#/components/schemas/type_commons_OrganizationId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityPage'
post:
operationId: create
summary: Create organization service facility
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacility'
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityCreate'
/api/organization-service-facilities/v2/external-id/{external_id}:
get:
operationId: get_by_external_id
summary: Get organization service facility by external_id
description: 'Looks up a single organization service facility by its `external_id` field. This can be useful
for finding service facilities within Candid which are associated with service facilities in
an external system.'
tags:
- v2
parameters:
- name: external_id
in: path
required: true
schema:
type: string
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacility'
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
/api/service-lines/v2:
post:
operationId: create
summary: Create Service Line
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLine'
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineCreateStandalone'
/api/service-lines/v2/universal:
post:
operationId: create-universal
summary: Create Professional or Institutional Service Line
tags:
- v2
parameters:
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLine'
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_UniversalServiceLineCreateStandalone'
/api/service-lines/v2/{service_line_id}/universal:
patch:
operationId: update-universal
summary: Update service line for encounter that may be institutional or professional.
tags:
- v2
parameters:
- name: service_line_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ServiceLineId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLine'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_UniversalServiceLineUpdate'
/api/service-lines/v2/{service_line_id}:
patch:
operationId: update
summary: Update Service Line
tags:
- v2
parameters:
- name: service_line_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ServiceLineId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Response with status 200
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLine'
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'422':
description: Error response with status 422
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- HttpRequestValidationError
content:
$ref: '#/components/schemas/type_commons_RequestValidationError'
required:
- errorName
- content
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineUpdate'
delete:
operationId: delete
summary: Delete Service Line
tags:
- v2
parameters:
- name: service_line_id
in: path
required: true
schema:
$ref: '#/components/schemas/type_commons_ServiceLineId'
- name: Authorization
in: header
description: OAuth authentication
required: true
schema:
type: string
responses:
'200':
description: Successful response
'403':
description: Error response with status 403
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- UnauthorizedError
content:
$ref: '#/components/schemas/type_commons_UnauthorizedErrorMessage'
required:
- errorName
- content
'404':
description: Error response with status 404
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityNotFoundError
content:
$ref: '#/components/schemas/type_commons_EntityNotFoundErrorMessage'
required:
- errorName
- content
'409':
description: Error response with status 409
content:
application/json:
schema:
type: object
properties:
errorName:
type: string
enum:
- EntityConflictError
content:
$ref: '#/components/schemas/type_commons_EntityConflictErrorMessage'
required:
- errorName
- content
components:
schemas:
type_encounter-providers_v2_ReferringProviderSecondaryIdentificationQualifier:
type: string
enum:
- 0B
- 1G
- G2
title: ReferringProviderSecondaryIdentificationQualifier
type_commons_EncounterId:
type: string
format: uuid
title: EncounterId
type_contracts_v2_AuthorizedSignatoryUpdate:
oneOf:
- type: object
properties:
type:
type: string
enum:
- set
description: 'Discriminator value: set'
first_name:
type: string
last_name:
type: string
title:
type: string
email:
type: string
phone:
type: string
fax:
type: string
required:
- type
- type: object
properties:
type:
type: string
enum:
- remove
description: 'Discriminator value: remove'
required:
- type
discriminator:
propertyName: type
title: AuthorizedSignatoryUpdate
type_commons_UnprocessableEntityErrorMessage:
type: object
properties:
message:
type: string
title: UnprocessableEntityErrorMessage
type_contracts_v2_ContractId:
type: string
format: uuid
title: ContractId
type_service-lines_v2_ServiceLine:
type: object
properties:
created_at:
type: string
format: date-time
modifiers:
type: array
items:
$ref: '#/components/schemas/type_commons_ProcedureModifier'
charge_amount_cents:
type: integer
allowed_amount_cents:
type: integer
insurance_balance_cents:
type: integer
patient_balance_cents:
type: integer
paid_amount_cents:
type: integer
primary_paid_amount_cents:
type: integer
secondary_paid_amount_cents:
type: integer
tertiary_paid_amount_cents:
type: integer
patient_responsibility_cents:
type: integer
copay_cents:
type: integer
coinsurance_cents:
type: integer
deductible_cents:
type: integer
diagnosis_id_zero:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_one:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_two:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_three:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
drug_identification:
$ref: '#/components/schemas/type_service-lines_v2_DrugIdentification'
service_line_era_data:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineERAData'
service_line_manual_adjustments:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineAdjustment'
related_invoices:
type: array
items:
$ref: '#/components/schemas/type_invoices_Invoice'
related_invoice_info:
type: array
items:
$ref: '#/components/schemas/type_invoices_v2_InvoiceInfo'
denial_reason:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineDenialReason'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: 837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
place_of_service_code_as_submitted:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: 837p Loop2300, SV105. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
service_line_id:
$ref: '#/components/schemas/type_commons_ServiceLineId'
procedure_code:
type: string
ordering_provider:
$ref: '#/components/schemas/type_encounter-providers_v2_EncounterProvider'
revenue_code:
type: string
description: A 4 digit code that specifies facility department or type of service arrangement for institutional service line items (837i). This code is not required for professional claim billing (837p).
quantity:
$ref: '#/components/schemas/type_commons_Decimal'
description: 'String representation of a Decimal that can be parsed by most libraries.
For professional claims, a ServiceLine quantity cannot contain more than one digit of precision
(Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain
more than three decimal digits of precision.'
units:
$ref: '#/components/schemas/type_commons_ServiceLineUnits'
claim_id:
$ref: '#/components/schemas/type_commons_ClaimId'
date_of_service_range:
$ref: '#/components/schemas/type_commons_DateRangeOptionalEnd'
description: 'A range of dates of service for this service line. If the service line is for a single date, the end date
will be empty.'
description:
type: string
description: A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.
date_of_service:
type: string
format: date
end_date_of_service:
type: string
format: date
test_results:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_TestResult'
description: 'Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit).
This is unused by 837-i and ignored for institutional service lines.
No more than 5 MEA-02 test results may be submitted per service line.'
has_epsdt_indicator:
type: boolean
description: 'Maps to SV1-11 on the 837-P and Box 24H on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
has_family_planning_indicator:
type: boolean
description: 'Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
note:
type: string
description: Maps to NTE02 loop 2400 on the EDI 837.
prior_authorization_number:
type: string
description: Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).
external_id:
type: string
description: 'An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems.
This field should not contain PHI. Must be unique on a given claim.'
required:
- created_at
- service_line_id
- procedure_code
- quantity
- units
- claim_id
- date_of_service_range
- date_of_service
title: ServiceLine
type_service-lines_v2_ServiceLineUpdate:
type: object
properties:
edit_reason:
type: string
modifiers:
type: array
items:
$ref: '#/components/schemas/type_commons_ProcedureModifier'
charge_amount_cents:
type: integer
description: The total amount charged for this service line, factoring in quantity. If procedure_code is updated and this is not, the system will attempt to set it based on chargemasters entries and the service line’s quantity. For example, if a single unit has an entry of 100 cents and 2 units were rendered, the charge_amount_cents will be set to 200, if there is no chargemaster entry, it will default to the amount set in this field.
drug_identification:
$ref: '#/components/schemas/type_service-lines_v2_DrugIdentification'
denial_reason:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineDenialReason'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: 837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
units:
$ref: '#/components/schemas/type_commons_ServiceLineUnits'
procedure_code:
type:
- string
- 'null'
description: 'If `procedure_code` is updated, and `charge_amount_cents` is not, then `charge_amount_cents` will be set by the system.
Pass `null` to uncode the service line, which is valid for institutional (837i) claims that bill by revenue code
rather than a CPT/HCPCS code.'
quantity:
$ref: '#/components/schemas/type_commons_Decimal'
description: 'String representation of a Decimal that can be parsed by most libraries.
For professional claims, a ServiceLine quantity cannot contain more than one digit of precision
(Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain
more than three decimal digits of precision.'
description:
type: string
description: A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.
date_of_service:
type: string
format: date
description: date_of_service must be defined on either the encounter or the service lines but not both.
end_date_of_service:
type: string
format: date
test_results:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_TestResult'
description: 'Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit).
This is unused by 837-i and ignored for institutional service lines.
No more than 5 MEA-02 test results may be submitted per service line.
Updating test results utilizes PUT semantics, so the test results on the service line will be set to whatever inputs are provided.'
has_epsdt_indicator:
type: boolean
description: Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500. If the value is true, the box will be populated with “Y”. Otherwise, the box will not be populated. This box is not used on an 837i.
has_family_planning_indicator:
type: boolean
description: 'Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
note:
type: string
description: Maps to NTE02 loop 2400 on the EDI 837.
prior_authorization_number:
type: string
description: Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).
external_id:
type: string
description: 'An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems.
This field should not contain PHI. Must be unique on a given claim.'
diagnosis_id_zero:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_one:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_two:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_three:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
title: ServiceLineUpdate
type_organization-service-facilities_v2_OrganizationServiceFacilityId:
type: string
format: uuid
title: OrganizationServiceFacilityId
type_encounter-providers_v2_ReferringProvider:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProviderSecondaryIdentification'
required:
- npi
title: ReferringProvider
type_credentialing_v2_FacilityCredentialingSpanId:
type: string
format: uuid
title: FacilityCredentialingSpanId
type_credentialing_v2_ProviderCredentialingSpan:
type: object
properties:
contracting_provider:
$ref: '#/components/schemas/type_organization-providers_v3_OrganizationProviderV2'
description: The practice location at which the rendering provider is covered by the credentialing span.
payer:
$ref: '#/components/schemas/type_payers_v3_Payer'
description: The payer doing the credentialing.
start_date:
type: string
format: date
description: Start date of the credentialing span.
end_date:
type: string
format: date
description: End date of the credentialing span.
submitted_date:
type: string
format: date
description: Date that the credential paperwork was submitted.
credentialing_status:
$ref: '#/components/schemas/type_credentialing_v2_CredentialingSpanStatus'
description: Status of the credentialing span.
payer_loaded_date:
type: string
format: date
description: Date that the payer loaded the credentialing span into their system.
is_enabled:
type: boolean
description: Is the credentialing span enabled?
provider_credentialing_span_id:
$ref: '#/components/schemas/type_credentialing_v2_ProviderCredentialingSpanId'
rendering_provider:
$ref: '#/components/schemas/type_organization-providers_v3_OrganizationProviderV2'
description: The rendering provider covered by the credentialing span.
regions:
$ref: '#/components/schemas/type_commons_Regions'
description: The states covered by the credentialing span. A span may be national and cover all states.
medallion_payer_enrollment_id:
type: string
format: uuid
description: Provider ID for the related medallion payer enrollment.
source:
type: string
description: Source of the credentialing span.
required:
- contracting_provider
- payer
- credentialing_status
- is_enabled
- provider_credentialing_span_id
- rendering_provider
- regions
- source
title: ProviderCredentialingSpan
type_contracts_v2_ContractStatus:
type: string
enum:
- pending
- effective
- cancelled
title: ContractStatus
type_contracts_v2_InsuranceTypes:
oneOf:
- type: object
properties:
type:
type: string
enum:
- allApply
description: 'Discriminator value: allApply'
required:
- type
- type: object
properties:
type:
type: string
enum:
- noneApply
description: 'Discriminator value: noneApply'
required:
- type
- type: object
properties:
type:
type: string
enum:
- theseApply
description: 'Discriminator value: theseApply'
value:
type: array
uniqueItems: true
items:
$ref: '#/components/schemas/type_commons_InsuranceTypeCode'
required:
- type
- value
discriminator:
propertyName: type
title: InsuranceTypes
type_organization-service-facilities_v2_ServiceFacilityPhysicalType:
type: string
enum:
- si
- bu
- wi
- wa
- lvl
- co
- ro
- bd
- ve
- ho
- ca
- rd
- area
- jdn
title: ServiceFacilityPhysicalType
type_contracts_v2_ContractIsLinkedToFeeScheduleError:
type: object
properties:
message:
type: string
required:
- message
title: ContractIsLinkedToFeeScheduleError
type_commons_ProviderCredentialingSpanId:
type: string
format: uuid
title: ProviderCredentialingSpanId
type_identifiers_IdentifierId:
type: string
format: uuid
title: IdentifierId
type_commons_Decimal:
type: string
description: String representation of a Decimal that can be parsed by most libraries.
title: Decimal
type_commons_Date:
type: string
description: ISO 8601 date; formatted YYYY-MM-DD (i.e. 2012-02-01)
title: Date
type_service-lines_v2_ServiceIdQualifier:
type: string
enum:
- EN
- EO
- HI
- N4
- 'ON'
- UK
- UP
title: ServiceIdQualifier
type_encounter-providers_v2_ProviderSecondaryIdentification:
type: object
properties:
reference_identification:
type: string
description: Represents REF02 on the EDI 837 Loop 2010BB Billing Provider Secondary Identification segment. Value cannot exceed 50 characters
reference_identification_qualifier:
$ref: '#/components/schemas/type_encounter-providers_v2_ProviderSecondaryIdentificationQualifier'
description: Represents REF01 on the EDI 837 Loop 2010BB Provider Secondary Identification segment.
required:
- reference_identification
title: ProviderSecondaryIdentification
type_encounter-providers_v2_EncounterProvider:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
provider_id:
$ref: '#/components/schemas/type_encounter-providers_v2_ProviderId'
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
tax_id:
type: string
npi:
type: string
taxonomy_code:
type: string
qualifier:
$ref: '#/components/schemas/type_commons_QualifierCode'
provider_commercial_license_type:
$ref: '#/components/schemas/type_commons_BillingProviderCommercialLicenseType'
description: '837i Loop2010BB G2
Provider Commercial Number'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_ProviderSecondaryIdentification'
description: 'Only one of provider_commercial_license_type or secondary_identification may be provided
837i Loop2010BB G2
Secondary Identification'
required:
- provider_id
- address
- npi
title: EncounterProvider
type_commons_InvoiceId:
type: string
format: uuid
title: InvoiceId
type_commons_UnauthorizedErrorMessage:
type: object
properties:
message:
type: string
title: UnauthorizedErrorMessage
type_encounter-providers_v2_ProviderId:
type: string
format: uuid
title: ProviderId
type_organization-service-facilities_v2_OrganizationServiceFacility:
type: object
properties:
organization_service_facility_id:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
name:
type: string
description: The name of the service facility.
aliases:
type: array
items:
type: string
description: A list of alternate names for the service facility.
description:
type: string
description: A description of the service facility.
external_id:
type: string
description: An ID for this service facility used in an external system (e.g. your EMR). Service facilities can be queried by this field.
npi:
type: string
description: 'An NPI specific to the service facility if applicable, i.e. if it has one and is not under the billing provider''s NPI.
Box 32 section (a) of the CMS-1500 claim form.'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: The Place of Service (POS) code for this service facility.
clia_number:
type: string
description: The associated CLIA number with this service facility. Can be used to populate CLIA numbers on encounters.
mammography_certification_number:
type: string
description: The associated mammography certification number for this service facility. This is a 6 digit code assigned by the FDA.
status:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityStatus'
description: The status of the service facility.
operational_status:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityOperationalStatus'
description: The operational status of the service facility.
mode:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityMode'
description: The mode of the service facility.
type:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityType'
description: The type of the service facility.
physical_type:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityPhysicalType'
description: The physical type of the service facility.
telecoms:
type: array
items:
type: string
description: A list of contact methods for the service facility.
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
description: The address of the service facility.
required:
- organization_service_facility_id
- name
- aliases
- telecoms
- address
title: OrganizationServiceFacility
type_invoices_v2_ClaimInvoiceItemInfo:
type: object
properties:
claim_invoice_item:
$ref: '#/components/schemas/type_invoices_v2_ClaimInvoiceItem'
service_line_invoice_items:
type: object
additionalProperties:
$ref: '#/components/schemas/type_invoices_v2_ServiceLineInvoiceItem'
required:
- service_line_invoice_items
title: ClaimInvoiceItemInfo
type_commons_SortDirection:
type: string
enum:
- asc
- desc
title: SortDirection
type_contracts_v2_ContractingProviderId:
type: string
format: uuid
title: ContractingProviderId
type_billing-notes_v2_BillingNoteMetadata:
oneOf:
- type: object
properties:
type:
type: string
enum:
- queue_added
description: 'Discriminator value: queue_added'
queue_id:
type: string
queue_name:
type: string
required:
- type
- queue_id
- queue_name
- type: object
properties:
type:
type: string
enum:
- queue_moved
description: 'Discriminator value: queue_moved'
from_queue_id:
type: string
from_queue_name:
type: string
to_queue_id:
type: string
to_queue_name:
type: string
required:
- type
- from_queue_id
- from_queue_name
- to_queue_id
- to_queue_name
- type: object
properties:
type:
type: string
enum:
- task_created
description: 'Discriminator value: task_created'
task_id:
type: string
format: uuid
task_type:
type: string
required:
- type
- task_id
- task_type
discriminator:
propertyName: type
title: BillingNoteMetadata
type_contracts_v2_ContractsPage:
type: object
properties:
prev_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
next_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
items:
type: array
items:
$ref: '#/components/schemas/type_contracts_v2_Contract'
required:
- items
title: ContractsPage
type_service-lines_v2_DenialReasonContent:
type: string
enum:
- Authorization Required
- Referral Required
- Medical Records Requested
- Timely Filing
- Duplicate Claim
- Full Contractual Adjustment
- Incorrect Place of Service
- Incorrect Patient Gender
- Incorrect Patient Info
- Bundled
- Exceeded Billable Time
- Invalid Provider Information
- Invalid Diagnosis Code
- Incorrect Procedure Code
- Invalid Modifier
- Missing NDC Code
- Invalid Insurance Data
- No Active Coverage
- Coordination of Benefits
- Incorrect Payer
- Credentialing
- No Effective Contract
- Missing W-9
- Missing Contract Linkage
- Non-Covered Benefit
- Experimental Procedure
- Not Medically Necessary
- Info Requested from Provider
- Info Requested from Patient
- Billing Error
- Unknown
- Max Benefit Reached
title: DenialReasonContent
type_service-lines_v2_ServiceLineERAData:
type: object
properties:
service_line_adjustments:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineAdjustment'
description: 'Deprecated. This field aggregates all CARCs across a service line''s history
without granular context
(e.g., which CARCs relate to denials vs. payments vs. reversals), making it
unsuitable for denial analysis or operational workflows.'
remittance_advice_remark_codes:
type: array
items:
type: string
required:
- service_line_adjustments
- remittance_advice_remark_codes
title: ServiceLineERAData
type_contracts_v2_RenderingProviderid:
type: string
format: uuid
title: RenderingProviderid
type_organization-service-facilities_v2_ServiceFacilityStatus:
type: string
enum:
- active
- inactive
- suspended
title: ServiceFacilityStatus
type_billing-notes_v2_BillingNote:
type: object
properties:
text:
type: string
description: Empty string not allowed.
billing_note_id:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNoteId'
encounter_id:
$ref: '#/components/schemas/type_commons_EncounterId'
created_at:
type: string
format: date-time
description: 'An [RFC 3339, section 5.6 datetime](https://ijmacd.github.io/rfc3339-iso8601/).
For example, 2017-07-21T17:32:28Z.'
author_auth0_id:
type: string
author_name:
type: string
billing_note_type:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNoteType'
billing_note_metadata:
$ref: '#/components/schemas/type_billing-notes_v2_BillingNoteMetadata'
required:
- text
- billing_note_id
- encounter_id
- created_at
title: BillingNote
type_commons_ProcedureModifier:
type: string
enum:
- AV
- AU
- AW
- AY
- '07'
- 08
- 09
- '10'
- '11'
- '12'
- '13'
- '14'
- '15'
- '16'
- '22'
- '23'
- '24'
- '25'
- '26'
- '27'
- '28'
- '32'
- '33'
- '47'
- '50'
- '51'
- '52'
- '53'
- '54'
- '55'
- '56'
- '57'
- '58'
- '59'
- '62'
- '63'
- '66'
- '73'
- '74'
- '76'
- '77'
- '78'
- '79'
- '80'
- '81'
- '82'
- '90'
- '91'
- '92'
- '93'
- '95'
- '96'
- '97'
- '99'
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- AA
- AB
- AD
- AE
- AF
- AG
- AH
- AI
- AJ
- AK
- AM
- AO
- AP
- AQ
- AR
- AS
- AT
- AZ
- BA
- BL
- BO
- BP
- BR
- BU
- CA
- CB
- CC
- CD
- CE
- CF
- CG
- CH
- CI
- CJ
- CK
- CL
- CM
- CN
- CR
- CS
- CT
- CO
- CQ
- DA
- E1
- E2
- E3
- E4
- EA
- EB
- EC
- ED
- EE
- EJ
- EM
- EP
- ER
- ET
- EV
- EX
- EY
- F1
- F2
- F3
- F4
- F5
- F6
- F7
- F8
- F9
- FA
- FB
- FC
- FP
- FQ
- FR
- FS
- FT
- FX
- FY
- G0
- G1
- G2
- G3
- G4
- G5
- G6
- G7
- G8
- G9
- GA
- GB
- GC
- GE
- GF
- GG
- GH
- GJ
- GK
- GL
- GM
- GN
- GO
- GP
- GQ
- GR
- GS
- GT
- GU
- GV
- GW
- GX
- GY
- GZ
- HA
- HB
- HC
- HD
- HE
- HF
- HG
- HH
- HI
- HJ
- HK
- HL
- HM
- HN
- HO
- HP
- HQ
- HR
- HS
- HT
- HU
- HV
- HW
- HX
- HY
- HZ
- J1
- J2
- J3
- J4
- J5
- JA
- JB
- JC
- JD
- JE
- JG
- JW
- JZ
- K0
- K1
- K2
- K3
- K4
- KA
- KB
- KC
- KD
- KE
- KF
- KG
- KH
- KI
- KJ
- KK
- KL
- KM
- KN
- KO
- KP
- KQ
- KR
- KS
- KT
- KU
- KV
- KW
- KX
- KY
- KZ
- LC
- LD
- LL
- LM
- LR
- LS
- LT
- LU
- M2
- MA
- MB
- MC
- MD
- ME
- MF
- MG
- MH
- MS
- N1
- N2
- N3
- NB
- NR
- NU
- P1
- P2
- P3
- P4
- P5
- P6
- PA
- PB
- PC
- PD
- PI
- PL
- PM
- PN
- PO
- PS
- PT
- Q0
- Q1
- Q2
- Q3
- Q4
- Q5
- Q6
- Q7
- Q8
- Q9
- QA
- QB
- QC
- QD
- QE
- QF
- QG
- QH
- QJ
- QK
- QL
- QM
- QN
- QP
- QQ
- QR
- QS
- QT
- QW
- QX
- QY
- QZ
- RA
- RB
- RC
- RD
- RE
- RI
- RR
- RT
- SA
- SB
- SC
- SD
- SE
- SF
- SG
- SH
- SJ
- SL
- SM
- SN
- SQ
- SS
- ST
- SU
- SV
- SW
- SY
- T1
- T2
- T3
- T4
- T5
- T6
- T7
- T8
- T9
- TA
- TB
- TC
- TD
- TE
- TF
- TG
- TH
- TJ
- TK
- TL
- TM
- TN
- TP
- TQ
- TR
- TS
- TT
- TU
- TV
- TW
- U1
- U2
- U3
- U4
- U5
- U6
- U7
- U8
- U9
- UA
- UB
- UC
- UD
- UE
- UF
- UG
- UH
- UJ
- UK
- UN
- UP
- UQ
- UR
- US
- V1
- V2
- V3
- W1
- W2
- W3
- X4
- XE
- XP
- XS
- XU
- XY
- ZZ
title: ProcedureModifier
type_encounter-providers_v2_ReferringProviderUpdate:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProviderSecondaryIdentification'
title: ReferringProviderUpdate
type_commons_FacilityTypeCode:
type: string
enum:
- '01'
- '02'
- '03'
- '04'
- '05'
- '06'
- '07'
- 08
- 09
- '10'
- '11'
- '12'
- '13'
- '14'
- '15'
- '16'
- '17'
- '18'
- '19'
- '20'
- '21'
- '22'
- '23'
- '24'
- '25'
- '26'
- '31'
- '32'
- '33'
- '34'
- '41'
- '42'
- '49'
- '50'
- '51'
- '52'
- '53'
- '54'
- '55'
- '56'
- '57'
- '58'
- '60'
- '61'
- '62'
- '65'
- '71'
- '72'
- '81'
- '99'
description: 'Box 24B on the CMS-1500 claim form. Line-level place of service is not currently supported.
02 for telemedicine, 11 for in-person. Full list here:
https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set'
title: FacilityTypeCode
type_identifiers_IdentifierCode:
type: string
enum:
- MCR
- MCD
title: IdentifierCode
type_organization-service-facilities_v2_OrganizationServiceFacilityPage:
type: object
properties:
prev_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
next_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
items:
type: array
items:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacility'
required:
- items
title: OrganizationServiceFacilityPage
type_commons_Regions:
oneOf:
- type: object
properties:
type:
type: string
enum:
- states
description: 'Discriminator value: states'
states:
type: array
items:
$ref: '#/components/schemas/type_commons_State'
required:
- type
- states
- type: object
properties:
type:
type: string
enum:
- national
description: 'Discriminator value: national'
required:
- type
discriminator:
propertyName: type
title: Regions
type_service-lines_v2_TestResult:
type: object
properties:
value:
type: number
format: double
result_type:
$ref: '#/components/schemas/type_service-lines_v2_TestResultType'
required:
- value
- result_type
title: TestResult
type_billing-notes_v2_BillingNoteId:
type: string
format: uuid
title: BillingNoteId
type_commons_DateRangeOptionalEnd:
type: object
properties:
start_date:
$ref: '#/components/schemas/type_commons_Date'
end_date:
$ref: '#/components/schemas/type_commons_Date'
required:
- start_date
title: DateRangeOptionalEnd
type_organization-providers_v2_EmploymentStatus:
type: string
enum:
- ACTIVE
- TERMINATED
title: EmploymentStatus
type_organization-service-facilities_v2_ServiceFacilityOperationalStatus:
type: string
enum:
- C
- H
- I
- K
- O
- U
title: ServiceFacilityOperationalStatus
type_contracts_v2_ContractInvalidExpirationDateError:
type: object
properties:
message:
type: string
required:
- message
title: ContractInvalidExpirationDateError
type_invoices_v2_InvoiceStatus:
type: string
enum:
- DRAFT
- OPEN
- PAID
- VOID
- UNCOLLECTIBLE
- HELD
title: InvoiceStatus
type_invoices_v2_UnattributedInvoiceItem:
type: object
properties:
amount_cents:
type: integer
required:
- amount_cents
title: UnattributedInvoiceItem
type_commons_OrganizationNotAuthorizedErrorMessage:
type: object
properties:
message:
type: string
required:
- message
title: OrganizationNotAuthorizedErrorMessage
type_identifiers_IdentifierValue:
oneOf:
- type: object
properties:
type:
type: string
enum:
- medicare_provider_identifier
description: 'Discriminator value: medicare_provider_identifier'
state:
$ref: '#/components/schemas/type_commons_State'
provider_number:
type: string
organization_service_facility_id:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
description: When set, this identifier applies only to the given service facility.
required:
- type
- state
- provider_number
- type: object
properties:
type:
type: string
enum:
- medicaid_provider_identifier
description: 'Discriminator value: medicaid_provider_identifier'
state:
$ref: '#/components/schemas/type_commons_State'
provider_number:
type: string
organization_service_facility_id:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacilityId'
description: When set, this identifier applies only to the given service facility.
required:
- type
- state
- provider_number
discriminator:
propertyName: type
title: IdentifierValue
type_credentialing_v2_ProviderCredentialingSpanId:
type: string
format: uuid
title: ProviderCredentialingSpanId
type_organization-service-facilities_v2_ServiceFacilityType:
type: string
enum:
- DX
- CVDX
- CATH
- ECHO
- GIDX
- ENDOS
- RADDX
- RADO
- RNEU
- HOSP
- CHR
- GACH
- MHSP
- PSYCHF
- RH
- RHAT
- RHII
- RHMAD
- RHPI
- RHPIH
- RHPIMS
- RHPIVS
- RHYAD
- HU
- BMTU
- CCU
- CHEST
- EPIL
- ER
- ETU
- HD
- HLAB
- INLAB
- OUTLAB
- HRAD
- HUSCS
- ICU
- PEDICU
- PEDNICU
- INPHARM
- MBL
- NCCS
- NS
- OUTPHARM
- PEDU
- PHU
- RHU
- SLEEP
- NCCF
- SNF
- OF
- ALL
- AMPUT
- BMTC
- BREAST
- CANC
- CAPC
- CARD
- PEDCARD
- COAG
- CRS
- DERM
- ENDO
- PEDE
- ENT
- FMC
- GI
- PEDGI
- GIM
- GYN
- HEM
- PEDHEM
- HTN
- IEC
- INFD
- PEDID
- INV
- LYMPH
- MGEN
- NEPH
- PEDNEPH
- NEUR
- OB
- OMS
- ONCL
- PEDHO
- OPH
- OPTC
- ORTHO
- HAND
- PAINCL
- PC
- PEDC
- PEDRHEUM
- POD
- PREV
- PROCTO
- PROFF
- PROS
- PSI
- PSY
- RHEUM
- SPMED
- SU
- PLS
- URO
- TR
- TRAVEL
- WND
- RTF
- PRC
- SURF
- DADDR
- MOBL
- AMB
- PHARM
- ACC
- COMM
- CSC
- PTRES
- SCHOOL
- UPC
- WORK
title: ServiceFacilityType
type_contracts_v2_AuthorizedSignatory:
type: object
properties:
first_name:
type: string
last_name:
type: string
title:
type: string
email:
type: string
phone:
type: string
fax:
type: string
title: AuthorizedSignatory
type_invoices_v2_InvoiceDestination:
type: string
enum:
- STRIPE
- CEDAR
- HEALTHIE
- COLLECTLY
- THIRD_PARTY_PAYERS
- INSTAMED
- REVSPRING
title: InvoiceDestination
type_organization-service-facilities_v2_OrganizationServiceFacilityCreate:
type: object
properties:
name:
type: string
description: The name of the service facility.
aliases:
type: array
items:
type: string
description: A list of alternate names for the service facility.
description:
type: string
description: A description of the service facility.
external_id:
type: string
description: An ID for this service facility used in an external system (e.g. your EMR). Service facilities can be queried by this field.
npi:
type: string
description: 'An NPI specific to the service facility if applicable, i.e. if it has one and is not under the billing provider''s NPI.
Box 32 section (a) of the CMS-1500 claim form.'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: The Place of Service (POS) code for this service facility.
clia_number:
type: string
description: The associated CLIA number with this service facility. Can be used to populate CLIA numbers on encounters.
mammography_certification_number:
type: string
description: The associated mammography certification number for this service facility. This is a 6 digit code assigned by the FDA.
status:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityStatus'
description: The status of the service facility.
operational_status:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityOperationalStatus'
description: The operational status of the service facility.
mode:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityMode'
description: The mode of the service facility.
type:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityType'
description: The type of the service facility.
physical_type:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityPhysicalType'
description: The physical type of the service facility.
telecoms:
type: array
items:
type: string
description: A list of contact methods for the service facility.
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
description: The address of the service facility.
required:
- name
- aliases
- telecoms
- address
title: OrganizationServiceFacilityCreate
type_commons_ServiceLineId:
type: string
format: uuid
title: ServiceLineId
type_encounter-providers_v2_InitialReferringProviderUpdate:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
qualifier:
$ref: '#/components/schemas/type_commons_QualifierCode'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProviderSecondaryIdentification'
title: InitialReferringProviderUpdate
type_encounter-providers_v2_ProviderSecondaryIdentificationQualifier:
type: string
enum:
- 0B
- 1G
- G2
- LU
title: ProviderSecondaryIdentificationQualifier
type_organization-providers_v2_OrganizationProviderAddress:
type: object
properties:
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
description: The address of the provider
address_type:
$ref: '#/components/schemas/type_organization-providers_v2_AddressType'
description: The address type of the provider
required:
- address
- address_type
title: OrganizationProviderAddress
type_invoices_v2_Invoice:
type: object
properties:
amount_cents:
type: integer
description: Total monetary amount (in cents) of all Invoice Items
created_at:
type: string
format: date-time
updated_at:
type: string
format: date-time
organization_id:
$ref: '#/components/schemas/type_commons_OrganizationId'
invoice_destination_metadata:
$ref: '#/components/schemas/type_invoices_v2_InvoiceDestinationMetadata'
description: Contains all relevant information from the third-party service this invoice was created in
patient_external_id:
$ref: '#/components/schemas/type_commons_PatientExternalId'
note:
type: string
due_date:
type: string
format: date
status:
$ref: '#/components/schemas/type_invoices_v2_InvoiceStatus'
url:
type: string
description: Link to the admin view of the invoice in the third-party service
customer_invoice_url:
type: string
description: Link to the patient view of the invoice in the third-party service
items:
$ref: '#/components/schemas/type_invoices_v2_InvoiceItemInfo'
description: The InvoiceItem rollup which contains all claim and service line invoice items
required:
- amount_cents
- created_at
- updated_at
- organization_id
- invoice_destination_metadata
- patient_external_id
- due_date
- status
- items
title: Invoice
type_encounter-providers_v2_OrderingProvider:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
required:
- npi
title: OrderingProvider
type_organization-providers_v2_ProviderType:
type: string
enum:
- INDIVIDUAL
- ORGANIZATION
title: ProviderType
type_organization-providers_v2_AddressType:
type: string
enum:
- DEFAULT
title: AddressType
type_credentialing_v2_CredentialingSpanStatus:
type: string
enum:
- work_in_progress
- pending
- effective
- expired
description: Stage of a credentialing span in the credentialing workflow.
title: CredentialingSpanStatus
type_credentialing_v2_FacilityCredentialingSpanPage:
type: object
properties:
prev_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
next_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
items:
type: array
items:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpan'
required:
- items
title: FacilityCredentialingSpanPage
type_service-lines_v2_TestResultType:
type: string
enum:
- HEMATOCRIT
- HEMOGLOBIN
- LDL
- VITAMIN_D
title: TestResultType
type_commons_RequestValidationError:
type: object
properties:
fieldName:
type: string
humanReadableMessage:
type: string
required:
- fieldName
title: RequestValidationError
type_organization-providers_v2_OrganizationProvider:
type: object
properties:
npi:
type: string
description: The NPI of the provider. This must be all digits [0-9] and exactly 10 characters long.
is_rendering:
type: boolean
description: Whether the provider can be used to render services.
is_billing:
type: boolean
description: Whether the provider can be used to bill services.
first_name:
type: string
description: The first name of the provider, if the provider is an individual.
last_name:
type: string
description: The last name of the provider, if the provider is an individual.
organization_name:
type: string
description: The name of the provider, if the provider is an organization.
provider_type:
$ref: '#/components/schemas/type_organization-providers_v2_ProviderType'
description: Whether the provider is an individual (NPPES Type 1) or organization (NPPES Type 2) provider.
tax_id:
type: string
description: If the provider has a contract with insurance, this must be the same tax ID given to the payer on an IRS W-9 form completed during contracting.
taxonomy_code:
type: string
description: A code designating classification and specialization.
license_type:
$ref: '#/components/schemas/type_organization-providers_v2_LicenseType'
description: The type of license that the provider holds.
ptan:
type: string
description: The Provider Transaction Access Number for the provider.
medicaid_provider_id:
type: string
description: The medicaid provider ID for the provider.
addresses:
type: array
items:
$ref: '#/components/schemas/type_organization-providers_v2_OrganizationProviderAddress'
description: The addresses associated with this provider.
organization_provider_id:
$ref: '#/components/schemas/type_organization-providers_v2_OrganizationProviderId'
description: Auto-generated ID set on creation
employment_status:
$ref: '#/components/schemas/type_organization-providers_v2_EmploymentStatus'
description: The employment status for the provider.
employment_start_date:
$ref: '#/components/schemas/type_commons_Date'
description: The employment start date for the provider.
employment_termination_date:
$ref: '#/components/schemas/type_commons_Date'
description: The employment termination date for the provider.
required:
- npi
- is_rendering
- is_billing
- provider_type
- license_type
- organization_provider_id
- employment_status
title: OrganizationProvider
type_encounter-providers_v2_SupervisingProvider:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_SupervisingProviderSecondaryIdentification'
required:
- npi
title: SupervisingProvider
type_encounter-providers_v2_SupervisingProviderUpdate:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_SupervisingProviderSecondaryIdentification'
title: SupervisingProviderUpdate
type_contracts_v2_RegionsUpdate:
oneOf:
- type: object
properties:
type:
type: string
enum:
- set
description: 'Discriminator value: set'
value:
$ref: '#/components/schemas/type_commons_Regions'
required:
- type
- value
- type: object
properties:
type:
type: string
enum:
- remove
description: 'Discriminator value: remove'
required:
- type
discriminator:
propertyName: type
title: RegionsUpdate
type_contracts_v2_ContractWithProviders:
type: object
properties:
effective_date:
$ref: '#/components/schemas/type_commons_Date'
description: The starting day upon which the contract is effective
expiration_date:
$ref: '#/components/schemas/type_commons_Date'
description: An optional end day upon which the contract expires
regions:
$ref: '#/components/schemas/type_commons_Regions'
description: 'The state(s) to which the contract''s coverage extends.
It may also be set to "national" for the entirety of the US.'
contract_status:
$ref: '#/components/schemas/type_contracts_v2_ContractStatus'
authorized_signatory:
$ref: '#/components/schemas/type_contracts_v2_AuthorizedSignatory'
commercial_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The commercial plan insurance types this contract applies.
medicare_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The Medicare plan insurance types this contract applies.
medicaid_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The Medicaid plan insurance types this contract applies.
contract_id:
$ref: '#/components/schemas/type_contracts_v2_ContractId'
contracting_provider:
$ref: '#/components/schemas/type_organization-providers_v2_OrganizationProvider'
description: The provider under contract
provider_count:
type: integer
description: The number of linked providers who can render medical services under this contract
payer:
$ref: '#/components/schemas/type_payers_v3_Payer'
description: The insurance company under contract
rendering_provider_ids:
type: array
uniqueItems: true
items:
type: string
format: uuid
description: The providers who can render medical services under the contract
required:
- effective_date
- regions
- commercial_insurance_types
- medicare_insurance_types
- medicaid_insurance_types
- contract_id
- contracting_provider
- provider_count
- payer
- rendering_provider_ids
title: ContractWithProviders
type_organization-service-facilities_v2_OrganizationServiceFacilityUpdate:
type: object
properties:
name:
type: string
description: The name of the service facility.
aliases:
type: array
items:
type: string
description: A list of alternate names for the service facility.
description:
type: string
description: A description of the service facility.
external_id:
type: string
description: An ID for this service facility used in an external system (e.g. your EMR). Service facilities can be queried by this field.
npi:
type: string
description: 'An NPI specific to the service facility if applicable, i.e. if it has one and is not under the billing provider''s NPI.
Box 32 section (a) of the CMS-1500 claim form.'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: The Place of Service (POS) code for this service facility.
clia_number:
type: string
description: The associated CLIA number with this service facility. Can be used to populate CLIA numbers on encounters.
mammography_certification_number:
type: string
description: The associated mammography certification number for this service facility. This is a 6 digit code assigned by the FDA.
status:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityStatus'
description: The status of the service facility.
operational_status:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityOperationalStatus'
description: The operational status of the service facility.
mode:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityMode'
description: The mode of the service facility.
type:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityType'
description: The type of the service facility.
physical_type:
$ref: '#/components/schemas/type_organization-service-facilities_v2_ServiceFacilityPhysicalType'
description: The physical type of the service facility.
telecoms:
type: array
items:
type: string
description: A list of contact methods for the service facility.
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
description: The address of the service facility.
title: OrganizationServiceFacilityUpdate
type_credentialing_v2_FacilityCredentialingSpan:
type: object
properties:
contracting_provider:
$ref: '#/components/schemas/type_organization-providers_v3_OrganizationProviderV2'
description: The practice location at which the rendering provider is covered by the credentialing span.
payer:
$ref: '#/components/schemas/type_payers_v3_Payer'
description: The payer doing the credentialing.
start_date:
type: string
format: date
description: Start date of the credentialing span.
end_date:
type: string
format: date
description: End date of the credentialing span.
submitted_date:
type: string
format: date
description: Date that the credential paperwork was submitted.
credentialing_status:
$ref: '#/components/schemas/type_credentialing_v2_CredentialingSpanStatus'
description: Status of the credentialing span.
payer_loaded_date:
type: string
format: date
description: Date that the payer loaded the credentialing span into their system.
is_enabled:
type: boolean
description: Is the credentialing span enabled?
facility_credentialing_span_id:
$ref: '#/components/schemas/type_credentialing_v2_FacilityCredentialingSpanId'
service_facility:
$ref: '#/components/schemas/type_organization-service-facilities_v2_OrganizationServiceFacility'
description: The service facility covered by the credentialing span.
required:
- contracting_provider
- payer
- credentialing_status
- is_enabled
- facility_credentialing_span_id
- service_facility
title: FacilityCredentialingSpan
type_encounter-providers_v2_ReferringProviderSecondaryIdentification:
type: object
properties:
reference_identification:
type: string
reference_identification_qualifier:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProviderSecondaryIdentificationQualifier'
required:
- reference_identification
- reference_identification_qualifier
title: ReferringProviderSecondaryIdentification
type_commons_PageToken:
type: string
title: PageToken
type_billing-notes_v2_BillingNoteType:
type: string
enum:
- manual
- system
- queue_added
- queue_moved
- task_created
title: BillingNoteType
type_commons_QualifierCode:
type: string
enum:
- DQ
- DN
- DK
- P3
title: QualifierCode
type_commons_OrganizationId:
type: string
format: uuid
title: OrganizationId
type_service-lines_v2_UniversalServiceLineUpdate:
type: object
properties:
edit_reason:
type: string
modifiers:
type: array
items:
$ref: '#/components/schemas/type_commons_ProcedureModifier'
charge_amount_cents:
type: integer
description: The total amount charged for this service line, factoring in quantity. If procedure_code is updated and this is not, the system will attempt to set it based on chargemasters entries and the service line’s quantity. For example, if a single unit has an entry of 100 cents and 2 units were rendered, the charge_amount_cents will be set to 200, if there is no chargemaster entry, it will default to the amount set in this field.
drug_identification:
$ref: '#/components/schemas/type_service-lines_v2_DrugIdentification'
denial_reason:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineDenialReason'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: 837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
units:
$ref: '#/components/schemas/type_commons_ServiceLineUnits'
procedure_code:
type:
- string
- 'null'
description: 'If `procedure_code` is updated, and `charge_amount_cents` is not, then `charge_amount_cents` will be set by the system.
Pass `null` to uncode the service line, which is valid for institutional (837i) claims that bill by revenue code
rather than a CPT/HCPCS code.'
quantity:
$ref: '#/components/schemas/type_commons_Decimal'
description: 'String representation of a Decimal that can be parsed by most libraries.
For professional claims, a ServiceLine quantity cannot contain more than one digit of precision
(Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain
more than three decimal digits of precision.'
description:
type: string
description: A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.
date_of_service:
type: string
format: date
description: date_of_service must be defined on either the encounter or the service lines but not both.
end_date_of_service:
type: string
format: date
test_results:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_TestResult'
description: 'Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit).
This is unused by 837-i and ignored for institutional service lines.
No more than 5 MEA-02 test results may be submitted per service line.
Updating test results utilizes PUT semantics, so the test results on the service line will be set to whatever inputs are provided.'
has_epsdt_indicator:
type: boolean
description: Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500. If the value is true, the box will be populated with “Y”. Otherwise, the box will not be populated. This box is not used on an 837i.
has_family_planning_indicator:
type: boolean
description: 'Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
note:
type: string
description: Maps to NTE02 loop 2400 on the EDI 837.
prior_authorization_number:
type: string
description: Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).
external_id:
type: string
description: 'An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems.
This field should not contain PHI. Must be unique on a given claim.'
revenue_code:
type: string
description: A 4 digit code that specifies facility department or type of service arrangement for institutional service line items (837i). This code is not required for professional claim billing (837p).
diagnosis_id_zero:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_one:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_two:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_three:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
title: UniversalServiceLineUpdate
type_invoices_v2_InvoiceInfo:
type: object
properties:
id:
$ref: '#/components/schemas/type_commons_InvoiceId'
invoice:
$ref: '#/components/schemas/type_invoices_v2_Invoice'
invoice_type:
$ref: '#/components/schemas/type_invoices_v2_InvoiceDestination'
required:
- id
- invoice
- invoice_type
title: InvoiceInfo
type_encounter-providers_v2_InitialReferringProvider:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
qualifier:
$ref: '#/components/schemas/type_commons_QualifierCode'
secondary_identification:
$ref: '#/components/schemas/type_encounter-providers_v2_ReferringProviderSecondaryIdentification'
required:
- npi
title: InitialReferringProvider
type_invoices_InvoiceItem:
type: object
properties:
service_line_id:
$ref: '#/components/schemas/type_commons_ServiceLineId'
amount_cents:
type: integer
required:
- service_line_id
- amount_cents
title: InvoiceItem
type_commons_StreetAddressLongZip:
type: object
properties:
address1:
type: string
address2:
type: string
city:
type: string
state:
$ref: '#/components/schemas/type_commons_State'
zip_code:
type: string
description: 5-digit zip code
zip_plus_four_code:
type: string
description: 4-digit zip add-on code https://en.wikipedia.org/wiki/ZIP_Code#ZIP+4
required:
- address1
- city
- state
- zip_code
- zip_plus_four_code
title: StreetAddressLongZip
type_service-lines_v2_UniversalServiceLineCreateStandalone:
type: object
properties:
modifiers:
type: array
items:
$ref: '#/components/schemas/type_commons_ProcedureModifier'
charge_amount_cents:
type: integer
description: The total amount charged for this service line, factoring in quantity. The system will attempt to set it based on the chargemaster configuration and the service line’s quantity. For example, if a single unit has an entry of 100 cents and 2 units were rendered, the charge_amount_cents will be set to 200. If there is no chargemaster entry, the system will default to the amount set via this field.
denial_reason:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineDenialReason'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: 837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
quantity:
$ref: '#/components/schemas/type_commons_Decimal'
description: 'String representation of a Decimal that can be parsed by most libraries.
For professional claims, a ServiceLine quantity cannot contain more than one digit of precision
(Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain
more than three decimal digits of precision.'
units:
$ref: '#/components/schemas/type_commons_ServiceLineUnits'
claim_id:
$ref: '#/components/schemas/type_commons_ClaimId'
description:
type: string
description: A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.
date_of_service:
type: string
format: date
end_date_of_service:
type: string
format: date
drug_identification:
$ref: '#/components/schemas/type_service-lines_v2_DrugIdentification'
ordering_provider:
$ref: '#/components/schemas/type_encounter-providers_v2_OrderingProvider'
description: 'Required when the service or supply was ordered by a provider who is different than the rendering provider for this service line.
If not required by this implementation guide, do not send.'
test_results:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_TestResult'
description: 'Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit).
This is unused by 837-i and ignored for institutional service lines.
No more than 5 MEA-02 test results may be submitted per service line.'
has_epsdt_indicator:
type: boolean
description: 'Maps to SV1-11 on the 837-P and Box 24H on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
has_family_planning_indicator:
type: boolean
description: 'Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
note:
type: string
description: Maps to NTE02 loop 2400 on the EDI 837.
diagnosis_id_zero:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_one:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_two:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_three:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
revenue_code:
type: string
description: A 4 digit code that specifies facility department or type of service arrangement for institutional service line items (837i). This code is not required for professional claim billing (837p).
procedure_code:
type:
- string
- 'null'
description: 'Pass `null` to create the service line as uncoded, which is valid for institutional (837i) claims that bill by
revenue code rather than a CPT/HCPCS code.'
prior_authorization_number:
type: string
description: Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).
external_id:
type: string
description: 'An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems.
This field should not contain PHI. Must be unique on a given claim.'
required:
- quantity
- units
- claim_id
title: UniversalServiceLineCreateStandalone
type_contracts_v2_ContractSortField:
type: string
enum:
- created_at
- payer_name
- payer_id
- billing_provider_name
- effective_date
- contract_status
title: ContractSortField
type_encounter-providers_v2_SupervisingProviderSecondaryIdentification:
type: object
properties:
reference_identification:
type: string
reference_identification_qualifier:
$ref: '#/components/schemas/type_encounter-providers_v2_ProviderSecondaryIdentificationQualifier'
required:
- reference_identification
- reference_identification_qualifier
title: SupervisingProviderSecondaryIdentification
type_invoices_Invoice:
type: object
properties:
id:
$ref: '#/components/schemas/type_commons_InvoiceId'
created_at:
type: string
format: date-time
updated_at:
type: string
format: date-time
organzation_id:
$ref: '#/components/schemas/type_commons_OrganizationId'
source_id:
type: string
source_customer_id:
type: string
patient_external_id:
$ref: '#/components/schemas/type_commons_PatientExternalId'
note:
type: string
due_date:
$ref: '#/components/schemas/type_commons_Date'
status:
$ref: '#/components/schemas/type_invoices_InvoiceStatus'
url:
type: string
customer_invoice_url:
type: string
items:
type: array
items:
$ref: '#/components/schemas/type_invoices_InvoiceItem'
required:
- id
- created_at
- updated_at
- organzation_id
- source_id
- source_customer_id
- patient_external_id
- due_date
- status
- items
title: Invoice
type_identifiers_Identifier:
type: object
properties:
period:
$ref: '#/components/schemas/type_commons_DateRangeOptionalEnd'
identifier_code:
$ref: '#/components/schemas/type_identifiers_IdentifierCode'
identifier_value:
$ref: '#/components/schemas/type_identifiers_IdentifierValue'
identifier_id:
$ref: '#/components/schemas/type_identifiers_IdentifierId'
required:
- identifier_code
- identifier_value
- identifier_id
title: Identifier
type_invoices_v2_ClaimInvoiceItem:
type: object
properties:
claim_id:
$ref: '#/components/schemas/type_commons_ClaimId'
amount_cents:
type: integer
required:
- claim_id
- amount_cents
title: ClaimInvoiceItem
type_commons_EntityConflictErrorMessage:
type: object
properties:
entity_name:
type: string
required:
- entity_name
title: EntityConflictErrorMessage
type_invoices_v2_InvoiceItemInfo:
type: object
properties:
claim_invoice_items:
type: object
additionalProperties:
$ref: '#/components/schemas/type_invoices_v2_ClaimInvoiceItemInfo'
unattributed_items:
type: array
items:
$ref: '#/components/schemas/type_invoices_v2_UnattributedInvoiceItem'
required:
- claim_invoice_items
- unattributed_items
title: InvoiceItemInfo
type_payers_v3_Payer:
type: object
properties:
payer_uuid:
$ref: '#/components/schemas/type_payers_v3_PayerUuid'
description: Auto-generated ID set on creation.
payer_id:
type: string
description: The primary national payer ID of the payer.
payer_name:
type: string
description: The primary display name of the payer.
availity_payer_name:
type: string
description: The name of the payer as it appears in Availity.
availity_claims_payer_id:
type: string
description: The ID of the payer as it appears in Availity.
availity_eligibility_id:
type: string
description: The eligibility ID of the payer as it appears in Availity.
availity_remittance_payer_id:
type: string
description: The remittance ID of the payer as it appears in Availity.
street_address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
required:
- payer_uuid
- payer_id
- payer_name
title: Payer
type_commons_EntityNotFoundErrorMessage:
type: object
properties:
id:
type: string
required:
- id
title: EntityNotFoundErrorMessage
type_contracts_v2_DateUpdate:
oneOf:
- type: object
properties:
type:
type: string
enum:
- set
description: 'Discriminator value: set'
value:
$ref: '#/components/schemas/type_commons_Date'
required:
- type
- value
- type: object
properties:
type:
type: string
enum:
- remove
description: 'Discriminator value: remove'
required:
- type
discriminator:
propertyName: type
title: DateUpdate
type_commons_InsuranceTypeCode:
type: string
enum:
- '01'
- '12'
- '13'
- '14'
- '15'
- '16'
- '17'
- '18'
- '19'
- '41'
- '42'
- '43'
- '47'
- AP
- C1
- CO
- CP
- D
- DB
- E
- EP
- FF
- GP
- HA
- HB
- HD
- HG
- HM
- HN
- HP
- HS
- IN
- IP
- LC
- LD
- LI
- LT
- M
- MA
- MB
- MC
- MD
- ME
- MF
- MH
- MI
- MJ
- MK
- ML
- MM
- MN
- MO
- MP
- MR
- MT
- MV
- OA
- OT
- PE
- PL
- PP
- PR
- PS
- QM
- RP
- SP
- TF
- U
- WC
- WU
description: Code identifying the type of insurance policy within a specific insurance program (X12 008020 Element 1336)
title: InsuranceTypeCode
type_organization-providers_v2_OrganizationProviderId:
type: string
format: uuid
title: OrganizationProviderId
type_commons_State:
type: string
enum:
- AA
- AE
- AP
- AL
- AK
- AS
- AZ
- AR
- CA
- CO
- CT
- DC
- DE
- FL
- FM
- GA
- GU
- HI
- ID
- IL
- IN
- IA
- KS
- KY
- LA
- ME
- MD
- MA
- MH
- MI
- MN
- MP
- MS
- MO
- MT
- NE
- NV
- NH
- NJ
- NM
- NY
- NC
- ND
- OH
- OK
- OR
- PA
- PR
- PW
- RI
- SC
- SD
- TN
- TX
- UT
- VI
- VT
- VA
- WA
- WV
- WI
- WY
title: State
type_service-lines_v2_ServiceLineCreateStandalone:
type: object
properties:
modifiers:
type: array
items:
$ref: '#/components/schemas/type_commons_ProcedureModifier'
charge_amount_cents:
type: integer
description: The total amount charged for this service line, factoring in quantity. The system will attempt to set it based on the chargemaster configuration and the service line’s quantity. For example, if a single unit has an entry of 100 cents and 2 units were rendered, the charge_amount_cents will be set to 200. If there is no chargemaster entry, the system will default to the amount set via this field.
denial_reason:
$ref: '#/components/schemas/type_service-lines_v2_ServiceLineDenialReason'
place_of_service_code:
$ref: '#/components/schemas/type_commons_FacilityTypeCode'
description: 837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
quantity:
$ref: '#/components/schemas/type_commons_Decimal'
description: 'String representation of a Decimal that can be parsed by most libraries.
For professional claims, a ServiceLine quantity cannot contain more than one digit of precision
(Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain
more than three decimal digits of precision.'
units:
$ref: '#/components/schemas/type_commons_ServiceLineUnits'
claim_id:
$ref: '#/components/schemas/type_commons_ClaimId'
description:
type: string
description: A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.
date_of_service:
type: string
format: date
end_date_of_service:
type: string
format: date
drug_identification:
$ref: '#/components/schemas/type_service-lines_v2_DrugIdentification'
ordering_provider:
$ref: '#/components/schemas/type_encounter-providers_v2_OrderingProvider'
description: 'Required when the service or supply was ordered by a provider who is different than the rendering provider for this service line.
If not required by this implementation guide, do not send.'
test_results:
type: array
items:
$ref: '#/components/schemas/type_service-lines_v2_TestResult'
description: 'Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit).
This is unused by 837-i and ignored for institutional service lines.
No more than 5 MEA-02 test results may be submitted per service line.'
has_epsdt_indicator:
type: boolean
description: 'Maps to SV1-11 on the 837-P and Box 24H on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
has_family_planning_indicator:
type: boolean
description: 'Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500.
If the value is true, the box will be populated with "Y". Otherwise, the box will not be populated.'
note:
type: string
description: Maps to NTE02 loop 2400 on the EDI 837.
procedure_code:
type: string
diagnosis_id_zero:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_one:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_two:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
diagnosis_id_three:
$ref: '#/components/schemas/type_diagnoses_DiagnosisId'
prior_authorization_number:
type: string
description: Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).
external_id:
type: string
description: 'An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems.
This field should not contain PHI. Must be unique on a given claim.'
required:
- quantity
- units
- claim_id
- procedure_code
title: ServiceLineCreateStandalone
type_organization-service-facilities_v2_ServiceFacilityMode:
type: string
enum:
- instance
- kind
title: ServiceFacilityMode
type_diagnoses_DiagnosisId:
type: string
format: uuid
title: DiagnosisId
type_payers_v3_PayerUuid:
type: string
format: uuid
title: PayerUuid
type_invoices_InvoiceStatus:
type: string
enum:
- draft
- open
- paid
- void
- uncollectible
- held
title: InvoiceStatus
type_invoices_v2_InvoiceDestinationMetadata:
type: object
properties:
invoice_destination:
$ref: '#/components/schemas/type_invoices_v2_InvoiceDestination'
description: Defines which third-party service this invoice was created in
source_id:
type: string
description: The id of the invoice in the third-party service
source_customer_id:
type: string
description: The id of the customer that the invoice is attributed to in the third-party service
destination_status:
type: string
description: The status of the invoice in the third-party service
required:
- invoice_destination
- source_id
- source_customer_id
title: InvoiceDestinationMetadata
type_credentialing_v2_ProviderCredentialingSpanPage:
type: object
properties:
prev_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
next_page_token:
$ref: '#/components/schemas/type_commons_PageToken'
items:
type: array
items:
$ref: '#/components/schemas/type_credentialing_v2_ProviderCredentialingSpan'
required:
- items
title: ProviderCredentialingSpanPage
type_invoices_v2_ServiceLineInvoiceItem:
type: object
properties:
service_line_id:
$ref: '#/components/schemas/type_commons_ServiceLineId'
amount_cents:
type: integer
required:
- service_line_id
- amount_cents
title: ServiceLineInvoiceItem
type_commons_ServiceLineUnits:
type: string
enum:
- MJ
- UN
title: ServiceLineUnits
type_service-lines_v2_ServiceLineAdjustment:
type: object
properties:
created_at:
type: string
format: date-time
adjustment_group_code:
type: string
adjustment_reason_code:
type: string
adjustment_amount_cents:
type: integer
adjustment_note:
type: string
required:
- created_at
title: ServiceLineAdjustment
type_encounter-providers_v2_OrderingProviderUpdate:
type: object
properties:
first_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
last_name:
type: string
description: If the provider is an individual, this should be set instead of organization name
organization_name:
type: string
description: If the provider is an organization, this should be set instead of first + last name
npi:
type: string
description: 'A National Provider Identifier is a unique 10-digit identification
number issued to health care providers in the United States'
taxonomy_code:
type: string
address:
$ref: '#/components/schemas/type_commons_StreetAddressLongZip'
title: OrderingProviderUpdate
type_commons_PatientExternalId:
type: string
title: PatientExternalId
type_service-lines_v2_MeasurementUnitCode:
type: string
enum:
- ML
- UN
- GR
- F2
- ME
title: MeasurementUnitCode
type_service-lines_v2_ServiceLineDenialReason:
type: object
properties:
reason:
$ref: '#/components/schemas/type_service-lines_v2_DenialReasonContent'
description: Text of the denial reason
description: 'The reason a given service line was denied within a given time range.
A service line may be denied for different reasons over time, but only one reason at a time.'
title: ServiceLineDenialReason
type_contracts_v2_Contract:
type: object
properties:
effective_date:
$ref: '#/components/schemas/type_commons_Date'
description: The starting day upon which the contract is effective
expiration_date:
$ref: '#/components/schemas/type_commons_Date'
description: An optional end day upon which the contract expires
regions:
$ref: '#/components/schemas/type_commons_Regions'
description: 'The state(s) to which the contract''s coverage extends.
It may also be set to "national" for the entirety of the US.'
contract_status:
$ref: '#/components/schemas/type_contracts_v2_ContractStatus'
authorized_signatory:
$ref: '#/components/schemas/type_contracts_v2_AuthorizedSignatory'
commercial_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The commercial plan insurance types this contract applies.
medicare_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The Medicare plan insurance types this contract applies.
medicaid_insurance_types:
$ref: '#/components/schemas/type_contracts_v2_InsuranceTypes'
description: The Medicaid plan insurance types this contract applies.
contract_id:
$ref: '#/components/schemas/type_contracts_v2_ContractId'
contracting_provider:
$ref: '#/components/schemas/type_organization-providers_v2_OrganizationProvider'
description: The provider under contract
provider_count:
type: integer
description: The number of linked providers who can render medical services under this contract
payer:
$ref: '#/components/schemas/type_payers_v3_Payer'
description: The insurance company under contract
required:
- effective_date
- regions
- commercial_insurance_types
- medicare_insurance_types
- medicaid_insurance_types
- contract_id
- contracting_provider
- provider_count
- payer
title: Contract
type_organization-providers_v2_LicenseType:
type: string
enum:
- MD
- NP
- PA
- LMFT
- LCPC
- LCSW
- PMHNP
- FNP
- LPCC
- DO
- RD
- SLP
- APRN
- LPC
- PHD
- PSYD
- LMSW
- LMHC
- OTHER_MASTERS
- BCBA
- UNKNOWN
- RPH
- PHT
- LAC
- LMT
- DC
- ND
- MA
- PT
- IBCLC
- RN
- DPT
- LCMHC
- CNM
- RNFA
- ACSW
- APC
- BCABA
- BHA
- OD
- DPM
- DA
- DDS
- DEH
- DMD
- PTA
- LCADC
- LCAT
- LCMHCS
- LCMHCA
- LCSWA
- LICSW
- LISW
- LMFTS
- LMFTA
- LPCI
- LSCSW
- MHCA
- MHT
- RBT
- RCSWI
- RHMCI
- LPN
- OTD
- OMS
- MFTA
- APCC
- DNP
- AGNPBC
- ANP
- FNPPP
- LCSWR
- ALC
- RMFTI
- LAMFT
- LPCA
- LSWI
- CSW
- CPC
- LGMFT
- LLPC
- PLPC
- PLMFT
- LMHCA
- CIT
- CT
- MFT
- LSW
- PLMHP
- PCMSW
- LMHP
- OTR/L
- RPA
- COTA
- CRNP
- SLP-CF
- NP-C
- PA-C
- AMFT
- CDN
- CGC
- CNS
- MDPHD
- AuD
- ATC
- LAT
- OTA
- LSSP
- SLPA
title: LicenseType
type_commons_ClaimId:
type: string
format: uuid
title: ClaimId
type_organization-providers_v3_OrganizationProviderV2:
type: object
properties:
npi:
type: string
description: The NPI of the provider. This must be all digits [0-9] and exactly 10 characters long.
is_rendering:
type: boolean
description: Whether the provider can be used to render services.
is_billing:
type: boolean
description: Whether the provider can be used to bill services.
first_name:
type: string
description: The first name of the provider, if the provider is an individual.
last_name:
type: string
description: The last name of the provider, if the provider is an individual.
organization_name:
type: string
description: The name of the provider, if the provider is an organization.
provider_type:
$ref: '#/components/schemas/type_organization-providers_v2_ProviderType'
description: Whether the provider is an individual (NPPES Type 1) or organization (NPPES Type 2) provider.
tax_id:
type: string
description: If the provider has a contract with insurance, this must be the same tax ID given to the payer on an IRS W-9 form completed during contracting.
taxonomy_code:
type: string
description: A code designating classification and specialization.
license_type:
$ref: '#/components/schemas/type_organization-providers_v2_LicenseType'
description: The type of license that the provider holds.
addresses:
type: array
items:
$ref: '#/components/schemas/type_organization-providers_v2_OrganizationProviderAddress'
description: The addresses associated with this provider.
employment_start_date:
type: string
format: date
description: The employment start date for the provider.
employment_termination_date:
type: string
format: date
description: The employment termination date for the provider.
organization_provider_id:
$ref: '#/components/schemas/type_organization-providers_v2_OrganizationProviderId'
description: Auto-generated ID set on creation.
qualifications:
type: array
items:
$ref: '#/components/schemas/type_identifiers_Identifier'
description: Qualification given to a provider (PTAN, Medicaid Provider Id etc.).
required:
- npi
- is_rendering
- is_billing
- provider_type
- license_type
- organization_provider_id
- qualifications
title: OrganizationProviderV2
type_service-lines_v2_DrugIdentification:
type: object
properties:
service_id_qualifier:
$ref: '#/components/schemas/type_service-lines_v2_ServiceIdQualifier'
national_drug_code:
type: string
national_drug_unit_count:
type: string
measurement_unit_code:
$ref: '#/components/schemas/type_service-lines_v2_MeasurementUnitCode'
link_sequence_number:
type: string
pharmacy_prescription_number:
type: string
conversion_formula:
type: string
drug_description:
type: string
required:
- service_id_qualifier
- national_drug_code
- national_drug_unit_count
- measurement_unit_code
title: DrugIdentification
type_commons_BillingProviderCommercialLicenseType:
type: string
enum:
- '0'
- A
- B
- C
- D
- E
- F
- G
- H
- I
title: BillingProviderCommercialLicenseType
securitySchemes:
OAuthScheme:
type: http
scheme: bearer
description: OAuth 2.0 authentication