{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-structure/provider-claim-inquiry-response-structure.json",
  "name": "UnitedHealthcare Claim Inquiry Response",
  "type": "object",
  "description": "Claim status inquiry response with payment details",
  "fields": [
    {
      "name": "claimNumber",
      "type": "string",
      "description": "UHC claim number"
    },
    {
      "name": "claimStatus",
      "type": "string",
      "description": "Claim status",
      "enum": [
        "RECEIVED",
        "IN_PROCESS",
        "PROCESSED",
        "DENIED",
        "ADJUSTED",
        "REVERSED"
      ]
    },
    {
      "name": "serviceDate",
      "type": "date",
      "description": "Date of service"
    },
    {
      "name": "billedAmount",
      "type": "decimal",
      "description": "Total billed charges"
    },
    {
      "name": "allowedAmount",
      "type": "decimal",
      "description": "Allowed amount"
    },
    {
      "name": "paidAmount",
      "type": "decimal",
      "description": "Amount paid"
    },
    {
      "name": "patientResponsibility",
      "type": "decimal",
      "description": "Patient responsibility"
    },
    {
      "name": "paymentDate",
      "type": "date",
      "description": "Payment date"
    },
    {
      "name": "checkNumber",
      "type": "string",
      "description": "Check or EFT trace number"
    },
    {
      "name": "denialReasonCode",
      "type": "string",
      "description": "Denial reason code"
    },
    {
      "name": "denialReasonDescription",
      "type": "string",
      "description": "Denial reason description"
    }
  ]
}