Claim
Claims are sent from a healthcare provider to an insurer detailing the services provided. Claim transactions between a payor and provider can include: a submission of a payment request, the status of that submission, the details of the payment, and the explanation of benefits (EOB).
SubmissionBatchlink
DEV PREVIEWSubmissionBatch message is used to send a payment request, typically from a healthcare provider to an insurer. This is functionally identical to the Submission Event, but allows for multiple transactions to be sent in a batch.
Fields
Meta
Meta.DataModel
String
ReliableRequiredClaim
Meta.EventType
String
ReliableRequiredSubmissionBatch
Meta.EventDateTime
DateTime
ReliableDateTime of the event.
ISO 8601 Format
Meta.Test
Boolean
ReliableFlag as a test message
Meta.Source
String
ReliableWhere the message originated.
Included in messages from Redox
Meta.Source.ID
String
ReliableID of the source.
UUID
Meta.Source.Name
String
ReliableName of the source
Meta.Destinations[]
Array of Objects
ReliableList of destinations to send your message to. All messages must have at least one destination. Queries accept only one destination.
Required when sending data to Redox
Meta.Destinations[].ID
String
ReliableID of the destination.
UUID
Meta.Destinations[].Name
String
ReliableName of the destination
Meta.Logs[]
Array of Objects
ReliableRequest log identifiers.
Meta.Logs[].ID
String
ReliableID of a request log that corresponds to this request, used for support and reference within the Redox dashboard.
UUID
Meta.Logs[].AttemptID
String
ReliableID of request log attempt. Useful in cases where retries are possible.
UUID
Meta.Message
String
ReliableRecord in Redox that corresponds to the communication sent from the source to Redox.
Included in messages from Redox
Meta.Message.ID
Numeric
ReliableID of the message created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.Transmission
String
ReliableRecord in Redox that corresponds to the communication sent from Redox to your destination.
Included in messages from Redox
Meta.Transmission.ID
Numeric
ReliableID of the transmission created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.FacilityCode
String
PossibleCode for the facility related to the message.
Only use this field if a health system indicates you should. The code is specific to the health system's EHR and might not be unique across health systems. In general, the facility fields within the data models (e.g. OrderingFacility) are more reliable and informative.
Transactions
Transactions[].ID
String
ReliableID used by submitter to reference this Claim Submission
Transactions[].IDType
String
ReliableType of ID
Transactions[].Type
String
ReliableValueSetThe type of Claim Submission, Institutional or Professional
-
Additional values may be added by Redox in the future.
-
Transactions[].Submitter
Object
ReliableSubmitter of a Claim Submission
Transactions[].Submitter.Identifiers[]
Array of Objects
ReliableList of IDs and ID Types that identify the concept
Transactions[].Submitter.Identifiers[].ID
String
ReliableID for the submitter
Transactions[].Submitter.Identifiers[].IDType
String
ReliableThe type of ID
Transactions[].Submitter.Name
String
Reliable
Transactions[].Submitter.Address
Object
ProbableAddress of the Submitter
Transactions[].Submitter.Address.StreetAddress
String
ProbableStreet address
Transactions[].Submitter.Address.City
String
ProbableCity
Transactions[].Submitter.Address.State
String
ProbableState
Transactions[].Submitter.Address.ZIP
String
ProbableZIP
Transactions[].Submitter.Address.County
String
PossibleCounty
Transactions[].Submitter.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submitter.EmailAddress
String
Probable
Transactions[].Submitter.PhoneNumber.Office
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Submitter.PhoneNumber.Fax
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Receiver
Object
ReliableReceiver of a Claim Submission
Transactions[].Receiver.Identifiers[]
Array of Objects
ReliableList of IDs and ID Types that identify the concept
Transactions[].Receiver.Identifiers[].ID
String
ReliableID for the receiver
Transactions[].Receiver.Identifiers[].IDType
String
ReliableThe type of ID
Transactions[].Receiver.Name
String
Reliable
Transactions[].Receiver.Address
Object
ProbableAddress of the Receiver
Transactions[].Receiver.Address.StreetAddress
String
ProbableStreet address
Transactions[].Receiver.Address.City
String
ProbableCity
Transactions[].Receiver.Address.State
String
ProbableState
Transactions[].Receiver.Address.ZIP
String
ProbableZIP
Transactions[].Receiver.Address.County
String
PossibleCounty
Transactions[].Receiver.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Receiver.EmailAddress
String
Probable
Transactions[].Receiver.PhoneNumber.Office
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Receiver.PhoneNumber.Fax
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[]
Array of Objects
ReliableA collection of claims submissions from a provider for services provided to patients.
Transactions[].Submissions[].BillingProvider
Object
ReliableBilling Provider
Transactions[].Submissions[].BillingProvider.Identifiers[]
Array of Objects
ReliableList of IDs and ID Types that identify the concept
Transactions[].Submissions[].BillingProvider.Identifiers[].ID
String
ReliableID for the business
Transactions[].Submissions[].BillingProvider.Identifiers[].IDType
String
ReliableThe type of ID
Transactions[].Submissions[].BillingProvider.Name
String
Reliable
Transactions[].Submissions[].BillingProvider.Address
Object
ProbableAddress of the business
Transactions[].Submissions[].BillingProvider.Address.StreetAddress
String
ProbableStreet address
Transactions[].Submissions[].BillingProvider.Address.City
String
ProbableCity
Transactions[].Submissions[].BillingProvider.Address.State
String
ProbableState
Transactions[].Submissions[].BillingProvider.Address.ZIP
String
ProbableZIP
Transactions[].Submissions[].BillingProvider.Address.County
String
PossibleCounty
Transactions[].Submissions[].BillingProvider.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].BillingProvider.EmailAddress
String
Probable
Transactions[].Submissions[].BillingProvider.PhoneNumber.Office
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].BillingProvider.PhoneNumber.Fax
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].BillingProvider.Specialty.ID
String
ReliableBilling provider's specialty.
Commonly the taxonomy ID
Transactions[].Submissions[].BillingProvider.Specialty.Description
String
ReliableBilling provider's specialty description
Transactions[].Submissions[].Subscribers[]
Array of Objects
PossibleThe subscriber is the individual who is contracted with the insurance plan
Transactions[].Submissions[].Subscribers[].Identifiers[]
Array of Objects
ReliableList of IDs and ID Types that identify the concept
Transactions[].Submissions[].Subscribers[].Identifiers[].ID
String
ReliableID for the subscriber
Transactions[].Submissions[].Subscribers[].Identifiers[].IDType
String
ReliableThe type of ID
Transactions[].Submissions[].Subscribers[].Demographics.FirstName
String
PossibleFirst name of the Subscriber
Transactions[].Submissions[].Subscribers[].Demographics.MiddleName
String
PossibleMiddle name of the Subscriber
Transactions[].Submissions[].Subscribers[].Demographics.LastName
String
PossibleLast name of the Subscriber
Transactions[].Submissions[].Subscribers[].Demographics.Address
Object
PossibleAddress of the Subscriber
Transactions[].Submissions[].Subscribers[].Demographics.Address.StreetAddress
String
PossibleStreet address
Transactions[].Submissions[].Subscribers[].Demographics.Address.City
String
PossibleCity
Transactions[].Submissions[].Subscribers[].Demographics.Address.State
String
PossibleState
Transactions[].Submissions[].Subscribers[].Demographics.Address.ZIP
String
PossibleZIP
Transactions[].Submissions[].Subscribers[].Demographics.Address.County
String
PossibleCounty
Transactions[].Submissions[].Subscribers[].Demographics.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Demographics.PhoneNumber.Home
String
PossibleHome phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Demographics.PhoneNumber.Office
String
PossibleOffice phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Demographics.PhoneNumber.Mobile
String
ProbableMobile phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Demographics.DOB
String
ReliableSubscriber's date of birth.
In YYYY-MM-DD format
Transactions[].Submissions[].Subscribers[].Demographics.Sex
String
ReliableValueSetSubscriber's sex
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].OrganizationName
String
ReliableIf the subscriber is not a person, this will contain the organization name
Transactions[].Submissions[].Subscribers[].ResponsibilityLevel
String
ReliableValueSetPayor responsibility level
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Insurance
Array of Objects
Probable
Transactions[].Submissions[].Subscribers[].Insurance.Plan.ID
String
ProbableIdentifier of insurance plan
Transactions[].Submissions[].Subscribers[].Insurance.Plan.IDType
String
ProbableID type of insurance plan
Transactions[].Submissions[].Subscribers[].Insurance.Plan.Name
String
ProbableName of insurance plan
Transactions[].Submissions[].Subscribers[].Insurance.Plan.Type
String
PossibleType of insurance plan
Transactions[].Submissions[].Subscribers[].Insurance.MemberNumber
String
PossiblePatient member number
Transactions[].Submissions[].Subscribers[].Insurance.Company.ID
String
ProbableID of insurance company (payor)
Transactions[].Submissions[].Subscribers[].Insurance.Company.IDType
String
ProbableID type of insurance company (payor)
Transactions[].Submissions[].Subscribers[].Insurance.Company.Name
String
ProbableName of insurance company (payor)
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address
Object
ProbableInsurance company's address
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address.StreetAddress
String
ProbableStreet address
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address.City
String
ProbableCity
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address.State
String
ProbableState
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address.ZIP
String
ProbableZIP
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address.County
String
PossibleCounty
Transactions[].Submissions[].Subscribers[].Insurance.Company.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Insurance.Company.PhoneNumber
String
ProbableInsurance companys phone number.
In E. 164 Format (i.e. +16085551234)
Transactions[].Submissions[].Subscribers[].Insurance.GroupNumber
String
ProbableInsurance policy group number
Transactions[].Submissions[].Subscribers[].Insurance.GroupName
String
ProbableInsurance policy group name
Transactions[].Submissions[].Subscribers[].Insurance.EffectiveDate
String
ProbableEffect date of this insurance policy.
In YYYY-MM-DD format
Transactions[].Submissions[].Subscribers[].Insurance.ExpirationDate
String
ProbableExpiration date of this insurance policy.
In YYYY-MM-DD format
Transactions[].Submissions[].Subscribers[].Insurance.PolicyNumber
String
ProbableInsurance policy number
Transactions[].Submissions[].Subscribers[].Insurance.Priority
String
PossibleValueSetThe insurance priority sequence.
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Insurance.AgreementType
String
ProbableValueSetType of insurance agreement.
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Insurance.CoverageType
String
ProbableValueSetType of insurance agreement.
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Identifiers[]
Array of Objects
ReliableList of IDs and ID types that identify the patient
Transactions[].Submissions[].Subscribers[].Patients[].Identifiers[].ID
String
ReliableID for the patient
Transactions[].Submissions[].Subscribers[].Patients[].Identifiers[].IDType
String
ReliableType of ID.
E.g. MRN, EPI
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.FirstName
String
ReliablePatient's first name
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.MiddleName
String
PossiblePatient's middle name or middle initial. For patients with multiple middle names, all their middle names are included in this field.
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.LastName
String
ReliablePatient's last name
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.DOB
String
ReliablePatient's date of birth.
In ISO 8601 format
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.SSN
String
ProbablePatient's social security number
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Sex
String
ReliableValueSetPatient's sex
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Race
String
PossibleValueSetPatient's race
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.IsHispanic
Boolean
PossibleValueSetIndicates if the patient is of hispanic origin.
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Religion
String
PossibleValueSetPatient's religious affiliation
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.MaritalStatus
String
PossibleValueSetPatient's marital status
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.IsDeceased
Boolean
PossibleIndicates if the patient is deceased
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.DeathDateTime
DateTime
PossibleDate and Time the patient was proclaimed deceased.
ISO 8601 Format
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.PhoneNumber.Home
String
ProbablePatient's home phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.PhoneNumber.Office
String
ProbablePatient's office phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.PhoneNumber.Mobile
String
ProbablePatient's mobile phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.EmailAddresses[]
Array of Strings
ProbablePatient's email address(es)
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Language
String
PossibleValueSetPatient's primary spoken language
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Citizenship[]
Array of strings
PossibleValueSetPatient's nation(s) of citizenship
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address
Object
ProbablePatient's home address
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address.StreetAddress
String
ProbableStreet address
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address.City
String
ProbableCity
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address.State
String
ProbableState
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address.ZIP
String
ProbableZIP
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address.County
String
PossibleCounty
Transactions[].Submissions[].Subscribers[].Patients[].Demographics.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Notes[]
Array of strings
PossiblePatient-level notes
Transactions[].Submissions[].Subscribers[].Patients[].RelationToSubscriber
String
ReliableValueSetRelation to the subscriber
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Claims[]
Array of Object
ReliableArray of claims for the given subscriber/patient.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].SubmissionNumber
String
ReliableThis will generally be the claim number sent on the initial claim submission.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Type
String
ProbableValueSetType of Claim (Institutional only)
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].TotalAmount
String
ProbableTotal amount of all lines on the claim.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].CopayAmount
String
ProbableAmount the patient has paid or still owes.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].IsProviderSignatureOnFile
Boolean
ProbableWhether or not the provider signature is on file for the claim.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].IsReleaseOfInformationOnFile
Boolean
ProbableWhether or not the submitter has a signed ROI form for the patient.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].ProviderAcceptanceCode
String
PossibleCode indicating whether the provider accepts assignment.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].BenefitsAssignmentCode
Boolean
ProbableValueSetCode indicates whether the patient has or has not assigned benefits to the provider.
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].AdditionalDates[]
Array of Objects
ProbableCollection of additional dates related to the claim
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].AdditionalDates[].DateTime
String
Probable
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].AdditionalDates[].Type
String
ProbableType of date value.
e.x. Service Period Start (https://ushik.ahrq.gov/ViewItemDetails?system=sdo&itemKey=133121000)
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].ReferenceNumbers[]
Array of Objects
ProbableReference numbers associated to the claim like Prior Auth Number, Member ID, and Provider IDs
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].ReferenceNumbers[].ID
String
ProbableID for the claim
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].ReferenceNumbers[].IDType
String
ProbableThe type of ID
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Diagnoses[].Code
String
ProbableDiagnosis code.
First index in array indicates primary diagnosis
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Diagnoses[].Codeset
String
ProbableCode set used to identify the diagnosis code.
e.x. ICD-10, ICD-9
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Diagnoses[].Description
String
ProbableDiagnosis name
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Diagnoses[].Type
String
ProbableType of diagnosis.
One of the following: Admitting, Working, or Final
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].DiagnosisRelatedGroup
String
ProbableCMS Diagnosis Related Group for an inpatient admission
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].ID
String
PossibleID of the provider.
This ID is often required for Inpatient Visits.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].IDType
String
PossibleID type of the ID for the provider
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].FirstName
String
PossibleFirst name of the undefined
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].LastName
String
PossibleLast name of the undefined
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Credentials[]
Array of Strings
PossibleList of credentials for the undefined.
e.g. MD, PhD
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address
Object
PossibleProvider's address
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address.StreetAddress
String
PossibleStreet address
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address.City
String
PossibleCity
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address.State
String
PossibleState
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address.ZIP
String
PossibleZIP
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address.County
String
PossibleCounty
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].EmailAddresses[]
Array of Strings
ProbableProvider's email address(es)
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].PhoneNumber.Office
String
PossibleProvider's office phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Location
Object
PossibleProvider's location
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Location.Type
String
PossibleType of location.
Examples: Clinic, Department, Home, Nursing Unit, Provider's Office, Phone
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Location.Facility
String
PossibleFacility.
Example: Community Hospital
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Location.Department
String
PossibleDepartment
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Location.Room
String
PossibleRoom.
Example: 136
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Role
String
ProbableThe role this provider has in patient care.
E.x. Attending, Referring, Operating
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Specialty.ID
String
ProbableID of specialty.
Commonly the taxonomy ID
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Providers[].Specialty.Description
String
ProbableDescription/name of specialty
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[]
Array of Objects
ReliableServices associated with this claim
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Code
String
ProbableCode for the service line
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Codeset
String
ProbableCode set used to identify the service line
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Description
String
ProbableDescription of the service line
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Modifiers[]
String
ProbableArray of service modifiers
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Amount
String
ProbableTotal dollar amount for this line item
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].StartDateTime
String
ProbableWhen the service conveyed began
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].EndDateTime
String
ProbableWhen the service conveyed ended
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].RevenueCode
String
ProbableInstitutional only.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Quantity.Value
String
ProbableService line quantity.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Quantity.Units
String
ProbableAssociated units to the quantity
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].IsEmergency
Boolean
ProbableWhether or not this service was performed in an emergency setting.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].ReferenceNumbers[]
Array of Objects
ProbableReference numbers associated to the claim service line
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].ReferenceNumbers[].ID
String
ProbableID for the service line
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].ReferenceNumbers[].IDType
String
ProbableThe type of ID
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Diagnoses[].Code
String
ProbableDiagnosis code.
First index in array indicates primary diagnosis associated with this service line item.
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Diagnoses[].Codeset
String
ProbableCode set used to identify the diagnosis code.
e.x. ICD-10, ICD-9
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Diagnoses[].Description
String
ProbableDiagnosis name
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Diagnoses[].Type
String
ProbableType of diagnosis.
One of the following: Admitting, Working, or Final
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Drug
Object
ProbableDrug information related to the service of an institutional claim
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Drug.PrescriptionID
String
ProbablePharmacy Prescription ID associated to the the drug
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Drug.NDC
String
ProbableNDC ID
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Drug.Quantity.Value
String
ProbableDrug Quantity
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Drug.Quantity.Units
String
ProbableAssociated Units to the quantity
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Services[].Notes
String
ProbableAdditional notes for this line
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.DateTime
String
ProbableDateTime of admission.
ISO 8601 Format
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.DischargeDateTime
String
ProbableDateTime of discharge.
ISO 8601 Format
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.Location
Object
Probable
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.Location.Type
String
ProbableType of location.
Examples: Clinic, Department, Home, Nursing Unit, Provider's Office, Phone
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.Location.Facility
String
ProbableFacility.
Example: Community Hospital
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.Location.Department
String
ProbableDepartment
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.Location.Room
String
ProbableRoom.
Example: 136
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.PreviousLocation
Object
Probable
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.PreviousLocation.Type
String
ProbableType of location.
Examples: Clinic, Department, Home, Nursing Unit, Provider's Office, Phone
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.PreviousLocation.Facility
String
ProbableFacility.
Example: Community Hospital
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.PreviousLocation.Department
String
ProbableDepartment
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.PreviousLocation.Room
String
ProbableRoom.
Example: 136
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.Type
String
ProbableType of inpatient admission.
Only populated for inpatient admissions. E.x. Elective, Emergency
Transactions[].Submissions[].Subscribers[].Patients[].Claims[].Visit.VisitNumber
String
PossibleVisit Number.
Unique ID of a single visit
{
"Meta": {
"DataModel": "Claim",
"EventType": "SubmissionBatch",
"EventDateTime": "2022-06-30T16:07:58.135Z",
"Test": true,
"Source": {
"ID": "7ce6f387-c33c-417d-8682-81e83628cbd9",
"Name": "Redox Dev Tools"
},
"Destinations": [
{
"ID": "af394f14-b34a-464f-8d24-895f370af4c9",
"Name": "Redox EMR"
}
],
"Logs": [
{
"ID": "d9f5d293-7110-461e-a875-3beb089e79f3",
"AttemptID": "925d1617-2fe0-468c-a14c-f8c04b572c54"
}
],
"Message": {
"ID": 5565
},
"Transmission": {
"ID": 12414
},
"FacilityCode": null
},
"Transactions": [
{
"ID": "000000001",
"IDType": null,
"Type": "Institutional",
"Submitter": {
"Identifiers": [
{
"ID": "8675309",
"IDType": "TIN"
}
],
"Name": "Redox Health System",
"Address": {
"StreetAddress": null,
"City": null,
"State": null,
"ZIP": null,
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Receiver": {
"Identifiers": [
{
"ID": "123456",
"IDType": "TIN"
}
],
"Name": "National Insurance Company of Redox",
"Address": {
"StreetAddress": null,
"City": null,
"State": null,
"ZIP": null,
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Submissions": [
{
"BillingProvider": {
"Identifiers": [],
"Name": null,
"Address": {
"StreetAddress": null,
"City": null,
"State": null,
"ZIP": null,
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
},
"Specialty": {
"ID": null,
"Description": null
}
},
"Subscribers": [
{
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
},
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"DOB": "2008-01-06",
"Sex": "Male"
},
"OrganizationName": null,
"ResponsibilityLevel": "Primary",
"Insurance": {
"Plan": {
"ID": "31572",
"IDType": "Payor ID",
"Name": "HMO Deductible Plan",
"Type": null
},
"MemberNumber": null,
"Company": {
"ID": "60054",
"IDType": null,
"Name": "aetna (60054 0131)",
"Address": {
"StreetAddress": "PO Box 14080",
"City": "Lexington",
"State": "KY",
"ZIP": "40512-4079",
"County": "Fayette",
"Country": "US"
},
"PhoneNumber": "+18089541123"
},
"GroupNumber": "847025-024-0009",
"GroupName": "Accelerator Labs",
"EffectiveDate": "2015-01-01",
"ExpirationDate": "2020-12-31",
"PolicyNumber": "9140860055",
"Priority": null,
"AgreementType": null,
"CoverageType": null
},
"Patients": [
{
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
}
},
"Notes": [],
"RelationToSubscriber": null,
"Claims": [
{
"SubmissionNumber": "66729659983",
"Type": "Admit Through Discharge",
"TotalAmount": "200.00",
"CopayAmount": "10.00",
"IsProviderSignatureOnFile": true,
"IsReleaseOfInformationOnFile": true,
"ProviderAcceptanceCode": null,
"BenefitsAssignmentCode": null,
"AdditionalDates": [
{
"DateTime": "2016-10-08",
"Type": "Service Period Start"
},
{
"DateTime": "2016-10-11",
"Type": "Service Period End"
}
],
"ReferenceNumbers": [
{
"ID": "AUTH000000",
"IDType": "Prior Authorization"
}
],
"Diagnoses": [
{
"Code": "M54.5",
"Codeset": "ICD-10",
"Description": null,
"Type": "Admitting"
},
{
"Code": "J45.909",
"Codeset": "ICD-10",
"Description": null,
"Type": null
}
],
"DiagnosisRelatedGroup": "551",
"Providers": [
{
"ID": "4236464757",
"IDType": "NPI",
"FirstName": "John",
"LastName": "Slate",
"Credentials": [
"DO"
],
"Address": {
"StreetAddress": "500 First St.",
"City": "Clayton",
"State": "MO",
"ZIP": "63105",
"County": "Saint Louis",
"Country": "USA"
},
"EmailAddresses": [],
"PhoneNumber": {
"Office": null
},
"Location": {
"Type": null,
"Facility": null,
"Department": null,
"Room": null
},
"Role": "Attending",
"Specialty": {
"ID": "1223G0001X",
"Description": "General Practice"
}
}
],
"Services": [
{
"Code": "73560",
"Codeset": null,
"Description": "X-Ray knee 1 or 2 views",
"Modifiers": [],
"Amount": "100.00",
"StartDateTime": null,
"EndDateTime": null,
"RevenueCode": null,
"Quantity": {
"Value": 1,
"Units": "Unit"
},
"IsEmergency": false,
"ReferenceNumbers": [
{
"ID": "1",
"IDType": "Control Number"
}
],
"Diagnoses": [],
"Drug": {
"PrescriptionID": null,
"NDC": null,
"Quantity": {
"Value": null,
"Units": null
}
},
"Notes": null
},
{
"Code": "J9202",
"Codeset": "HCPCS",
"Description": "Zoladex",
"Modifiers": [],
"Amount": "3.50",
"StartDateTime": null,
"EndDateTime": null,
"RevenueCode": null,
"Quantity": {
"Value": "1",
"Units": "Unit"
},
"IsEmergency": false,
"ReferenceNumbers": [
{
"ID": "2",
"IDType": "Control Number"
}
],
"Diagnoses": [],
"Drug": {
"PrescriptionID": "ABC123456",
"NDC": "00310095036",
"Quantity": {
"Value": "1",
"Units": "Unit"
}
},
"Notes": null
}
],
"Visit": {
"DateTime": "2016-10-08",
"DischargeDateTime": "2016-10-11",
"Location": {
"Type": "Inpatient",
"Facility": "RES General Hospital",
"Department": "3N",
"Room": "136"
},
"PreviousLocation": {
"Type": "Critical Access Hospital",
"Facility": null,
"Department": null,
"Room": null
},
"Type": "Elective",
"VisitNumber": null
}
}
]
}
]
}
]
}
]
}
]
}
PaymentBatchlink
DEV PREVIEWA PaymentBatch message is used to send a payment notification, typically from a payer to a healthcare provider, but it may be used in other situations where funds are transferred from one party to another. This is functionally identical to the Payment Event, but allows for multiple transactions to be sent in a batch.
Fields
Meta
Meta.DataModel
String
ReliableRequiredClaim
Meta.EventType
String
ReliableRequiredPaymentBatch
Meta.EventDateTime
DateTime
ReliableDateTime of the event.
ISO 8601 Format
Meta.Test
Boolean
ReliableFlag as a test message
Meta.Source
String
ReliableWhere the message originated.
Included in messages from Redox
Meta.Source.ID
String
ReliableID of the source.
UUID
Meta.Source.Name
String
ReliableName of the source
Meta.Destinations[]
Array of Objects
ReliableList of destinations to send your message to. All messages must have at least one destination. Queries accept only one destination.
Required when sending data to Redox
Meta.Destinations[].ID
String
ReliableID of the destination.
UUID
Meta.Destinations[].Name
String
ReliableName of the destination
Meta.Logs[]
Array of Objects
ReliableRequest log identifiers.
Meta.Logs[].ID
String
ReliableID of a request log that corresponds to this request, used for support and reference within the Redox dashboard.
UUID
Meta.Logs[].AttemptID
String
ReliableID of request log attempt. Useful in cases where retries are possible.
UUID
Meta.Message
String
ReliableRecord in Redox that corresponds to the communication sent from the source to Redox.
Included in messages from Redox
Meta.Message.ID
Numeric
ReliableID of the message created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.Transmission
String
ReliableRecord in Redox that corresponds to the communication sent from Redox to your destination.
Included in messages from Redox
Meta.Transmission.ID
Numeric
ReliableID of the transmission created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.FacilityCode
String
PossibleCode for the facility related to the message.
Only use this field if a health system indicates you should. The code is specific to the health system's EHR and might not be unique across health systems. In general, the facility fields within the data models (e.g. OrderingFacility) are more reliable and informative.
Transactions
Transactions[].ID
String
ReliableID used by submitter to reference this Claims
Transactions[].IDType
String
ReliableType of ID
Transactions[].Type
String
ReliableValueSetThe type of Claims, Institutional or Professional
-
Additional values may be added by Redox in the future.
-
Transactions[].TotalPaymentAmount
String
ProbableThe total amount of all of the payments listed in the Payments array.
Redox recommends sending it as an additional layer of validation.
Transactions[].CreditOrDebit
String
ProbableValueSetA flag indicating whether the monetary amount in Transaction.TotalPaymentAmount is a credit or debit.
-
Additional values may be added by Redox in the future.
-
Transactions[].PaymentMethod
String
ProbableValueSetHow the payment was/will be transferred.
-
Additional values may be added by Redox in the future.
-
Transactions[].PaymentDateTime
String
ProbableWhen the transaction should be processed by the destination.
For example, if the "Check" is used in Transaction.PaymentMethod this would be the date on the check. ISO 8601 Format
Transactions[].TrackingNumber
String
ProbableA number used to by the Payer to trace the payment.
For example, if the "Check" is used in Transaction.PaymentMethod this would be the check number.
Transactions[].Submitter
Object
ReliableSubmitter of a Claims
Transactions[].Submitter.Identifiers[]
Array of Objects
ReliableList of IDs and ID Types that identify the concept
Transactions[].Submitter.Identifiers[].ID
String
ReliableID for the submitter
Transactions[].Submitter.Identifiers[].IDType
String
ReliableThe type of ID
Transactions[].Submitter.Name
String
Reliable
Transactions[].Submitter.Address
Object
ProbableAddress of the Submitter
Transactions[].Submitter.Address.StreetAddress
String
ProbableStreet address
Transactions[].Submitter.Address.City
String
ProbableCity
Transactions[].Submitter.Address.State
String
ProbableState
Transactions[].Submitter.Address.ZIP
String
ProbableZIP
Transactions[].Submitter.Address.County
String
PossibleCounty
Transactions[].Submitter.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Submitter.EmailAddress
String
Probable
Transactions[].Submitter.PhoneNumber.Office
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Submitter.PhoneNumber.Fax
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Receiver
Object
ReliableReceiver of a Claims
Transactions[].Receiver.Identifiers[]
Array of Objects
ReliableList of IDs and ID Types that identify the concept
Transactions[].Receiver.Identifiers[].ID
String
ReliableID for the receiver
Transactions[].Receiver.Identifiers[].IDType
String
ReliableThe type of ID
Transactions[].Receiver.Name
String
Reliable
Transactions[].Receiver.Address
Object
ProbableAddress of the Receiver
Transactions[].Receiver.Address.StreetAddress
String
ProbableStreet address
Transactions[].Receiver.Address.City
String
ProbableCity
Transactions[].Receiver.Address.State
String
ProbableState
Transactions[].Receiver.Address.ZIP
String
ProbableZIP
Transactions[].Receiver.Address.County
String
PossibleCounty
Transactions[].Receiver.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Receiver.EmailAddress
String
Probable
Transactions[].Receiver.PhoneNumber.Office
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Receiver.PhoneNumber.Fax
String
ProbableIn E. 164 Format. (e.g. +16085551234)
Transactions[].Payments[]
Array of Objects
Probable
Transactions[].Payments[].DateTime
String
ProbableThe DateTime this payment was processed.
ISO 8601 Format
Transactions[].Payments[].Patient.Identifiers[]
Array of Objects
ReliableList of IDs and ID types that identify the patient
Transactions[].Payments[].Patient.Identifiers[].ID
String
ReliableID for the patient
Transactions[].Payments[].Patient.Identifiers[].IDType
String
ReliableType of ID.
E.g. MRN, EPI
Transactions[].Payments[].Patient.Demographics.FirstName
String
ReliablePatient's first name
Transactions[].Payments[].Patient.Demographics.MiddleName
String
PossiblePatient's middle name or middle initial. For patients with multiple middle names, all their middle names are included in this field.
Transactions[].Payments[].Patient.Demographics.LastName
String
ReliablePatient's last name
Transactions[].Payments[].Patient.Demographics.DOB
String
ReliablePatient's date of birth.
In ISO 8601 format
Transactions[].Payments[].Patient.Demographics.SSN
String
ProbablePatient's social security number
Transactions[].Payments[].Patient.Demographics.Sex
String
ReliableValueSetPatient's sex
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.Race
String
PossibleValueSetPatient's race
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.IsHispanic
Boolean
PossibleValueSetIndicates if the patient is of hispanic origin.
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.Religion
String
PossibleValueSetPatient's religious affiliation
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.MaritalStatus
String
PossibleValueSetPatient's marital status
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.IsDeceased
Boolean
PossibleIndicates if the patient is deceased
Transactions[].Payments[].Patient.Demographics.DeathDateTime
DateTime
PossibleDate and Time the patient was proclaimed deceased.
ISO 8601 Format
Transactions[].Payments[].Patient.Demographics.PhoneNumber.Home
String
ProbablePatient's home phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Payments[].Patient.Demographics.PhoneNumber.Office
String
ProbablePatient's office phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Payments[].Patient.Demographics.PhoneNumber.Mobile
String
ProbablePatient's mobile phone number.
In E. 164 Format. (e.g. +16085551234)
Transactions[].Payments[].Patient.Demographics.EmailAddresses[]
Array of Strings
ProbablePatient's email address(es)
Transactions[].Payments[].Patient.Demographics.Language
String
PossibleValueSetPatient's primary spoken language
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.Citizenship[]
Array of strings
PossibleValueSetPatient's nation(s) of citizenship
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Demographics.Address
Object
ProbablePatient's home address
Transactions[].Payments[].Patient.Demographics.Address.StreetAddress
String
ProbableStreet address
Transactions[].Payments[].Patient.Demographics.Address.City
String
ProbableCity
Transactions[].Payments[].Patient.Demographics.Address.State
String
ProbableState
Transactions[].Payments[].Patient.Demographics.Address.ZIP
String
ProbableZIP
Transactions[].Payments[].Patient.Demographics.Address.County
String
PossibleCounty
Transactions[].Payments[].Patient.Demographics.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Patient.Notes[]
Array of strings
PossiblePatient-level notes
Transactions[].Payments[].Claims[]
Array of Objects
Probable
Transactions[].Payments[].Claims[].ControlNumber
String
ReliableThe Payer's reference number
Transactions[].Payments[].Claims[].SubmissionNumber
String
ReliableThis will generally be the claim number sent on the initial claim submission.
Transactions[].Payments[].Claims[].ReceivedDate
String
ProbableDate the claim was submitted.
ISO 8601 Format
Transactions[].Payments[].Claims[].StartDateTime
String
ProbableDate the statement period started.
ISO 8601 Format
Transactions[].Payments[].Claims[].EndDateTime
String
ProbableDate the statement period ended.
ISO 8601 Format
Transactions[].Payments[].Claims[].Status
String
ReliableValueSetStatus of the claim
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Claims[].ChargedAmount
String
ReliableTotal monetary amount of the claim
Transactions[].Payments[].Claims[].PaymentAmount
String
ProbableMonetary amount of the claim paid
Transactions[].Payments[].Claims[].PatientResponsibilityAmount
String
ReliableMonetary amount of the claim the patient is responsible for
Transactions[].Payments[].Claims[].ReferenceNumbers[]
Array of Objects
ProbableReference numbers associated to the claim like Prior Auth Number, Member ID, and Provider IDs
Transactions[].Payments[].Claims[].ReferenceNumbers[].ID
String
ProbableID for the claim
Transactions[].Payments[].Claims[].ReferenceNumbers[].IDType
String
ProbableThe type of ID
Transactions[].Payments[].Claims[].Adjustments[]
Object
ReliableAdjustments explain why a claim was paid differently than it was billed.
Adjustments may not exist at the claim level if they exist at the service level
Transactions[].Payments[].Claims[].Adjustments[].Amount
String
ProbableMonetary amount of the adjustment.
A negative number indicates a payment increase, while a positive number indicates a payment reduction.
Transactions[].Payments[].Claims[].Adjustments[].Quantity
String
Probable
Transactions[].Payments[].Claims[].Adjustments[].Type
String
ProbableValueSetType of Adjustment
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Claims[].Adjustments[].Reason
String
ProbableValueSetAdjustment reason
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Claims[].Services[]
String
ProbableThis array will provide additional detail for claims processed at the line level.
Transactions[].Payments[].Claims[].Services[].ChargedAmount
String
ProbableThe monetory amount charged
Transactions[].Payments[].Claims[].Services[].PaymentAmount
String
ReliableThe monetory amount paid
Transactions[].Payments[].Claims[].Services[].ChargedUnits
String
ProbableThe number of units of service charged for
Transactions[].Payments[].Claims[].Services[].PaymentUnits
String
ProbableThe number of units of service paid for
Transactions[].Payments[].Claims[].Services[].AllowedAmount
String
ReliableMaximum monetary amount of payment
Transactions[].Payments[].Claims[].Services[].SubmittedService
Object
ProbableSubmitted service information
Transactions[].Payments[].Claims[].Services[].SubmittedService.Code
String
ProbableCode for the submitted service
Transactions[].Payments[].Claims[].Services[].SubmittedService.Codeset
String
ProbableCode set used to identify the submitted service
Transactions[].Payments[].Claims[].Services[].SubmittedService.Description
String
ProbableDescription of the submitted service
Transactions[].Payments[].Claims[].Services[].SubmittedService.Modifiers[]
String
ProbableArray of modifiers
Transactions[].Payments[].Claims[].Services[].AdjudicatedService
Object
ProbableAdjudicated service information
Transactions[].Payments[].Claims[].Services[].AdjudicatedService.Code
String
ProbableCode for the adjudicated service
Transactions[].Payments[].Claims[].Services[].AdjudicatedService.Codeset
String
ProbableCode set used to identify the adjudicated service
Transactions[].Payments[].Claims[].Services[].AdjudicatedService.Description
String
ProbableDescription of the adjudicated service
Transactions[].Payments[].Claims[].Services[].AdjudicatedService.Modifiers[]
String
ProbableArray of modifiers
Transactions[].Payments[].Claims[].Services[].Adjustments[]
Object
ReliableAdjustments explain why a claim was paid differently than it was billed.
Transactions[].Payments[].Claims[].Services[].Adjustments[].Amount
String
ProbableMonetary amount of the adjustment.
A negative number indicates a payment increase, while a positive number indicates a payment reduction.
Transactions[].Payments[].Claims[].Services[].Adjustments[].Quantity
String
Probable
Transactions[].Payments[].Claims[].Services[].Adjustments[].Type
String
ProbableValueSetType of Adjustment
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Claims[].Services[].Adjustments[].Reason
String
ProbableValueSetAdjustment reason
-
Additional values may be added by Redox in the future.
-
Transactions[].Payments[].Claims[].Services[].StartDateTime
String
ProbableDate the claim was submitted.
ISO 8601 Format
Transactions[].Payments[].Claims[].Services[].EndDateTime
String
ProbableDate the statement period started.
ISO 8601 Format
Transactions[].Payments[].Claims[].Services[].ReferenceNumbers[]
Array of Objects
ProbableReference numbers associated to the claim service line
Transactions[].Payments[].Claims[].Services[].ReferenceNumbers[].ID
String
ProbableID for the service line
Transactions[].Payments[].Claims[].Services[].ReferenceNumbers[].IDType
String
ProbableThe type of ID
{
"Meta": {
"DataModel": "Claim",
"EventType": "PaymentBatch",
"EventDateTime": "2022-06-30T16:07:58.135Z",
"Test": true,
"Source": {
"ID": "7ce6f387-c33c-417d-8682-81e83628cbd9",
"Name": "Redox Dev Tools"
},
"Destinations": [
{
"ID": "af394f14-b34a-464f-8d24-895f370af4c9",
"Name": "Redox EMR"
}
],
"Logs": [
{
"ID": "d9f5d293-7110-461e-a875-3beb089e79f3",
"AttemptID": "925d1617-2fe0-468c-a14c-f8c04b572c54"
}
],
"Message": {
"ID": 5565
},
"Transmission": {
"ID": 12414
},
"FacilityCode": null
},
"Transactions": [
{
"ID": "000000001",
"IDType": null,
"Type": "Profressional",
"TotalPaymentAmount": "580.00",
"CreditOrDebit": "Credit",
"PaymentMethod": "Check",
"PaymentDateTime": "2016-11-11T02:11:03.111Z",
"TrackingNumber": "8675309",
"Submitter": {
"Identifiers": [
{
"ID": "123456",
"IDType": "TIN"
}
],
"Name": "National Insurance Company of Redox",
"Address": {
"StreetAddress": null,
"City": null,
"State": null,
"ZIP": null,
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Receiver": {
"Identifiers": [
{
"ID": "8675309",
"IDType": "TIN"
}
],
"Name": "Redox Health System",
"Address": {
"StreetAddress": null,
"City": null,
"State": null,
"ZIP": null,
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Payments": [
{
"DateTime": "2016-11-08T02:11:03.111Z",
"Patient": {
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
}
},
"Notes": []
},
"Claims": [
{
"ControlNumber": "94151100100",
"SubmissionNumber": "66729659983",
"ReceivedDate": "2016-10-31",
"StartDateTime": null,
"EndDateTime": null,
"Status": "Processed as Primary",
"ChargedAmount": "100.00",
"PaymentAmount": "65.00",
"PatientResponsibilityAmount": "20.00",
"ReferenceNumbers": [
{
"ID": "AUTH000000",
"IDType": "Prior Authorization"
}
],
"Adjustments": [],
"Services": [
{
"ChargedAmount": "100.00",
"PaymentAmount": "65.00",
"ChargedUnits": null,
"PaymentUnits": null,
"AllowedAmount": "85.00",
"SubmittedService": {
"Code": null,
"Codeset": null,
"Description": null,
"Modifiers": []
},
"AdjudicatedService": {
"Code": null,
"Codeset": null,
"Description": null,
"Modifiers": []
},
"Adjustments": [
{
"Amount": "20.00",
"Quantity": null,
"Type": "Patient responsibility",
"Reason": "Deductible amount"
},
{
"Amount": "15.00",
"Quantity": null,
"Type": "Contractual obligations",
"Reason": "Claim specific negotiated discount"
}
],
"StartDateTime": null,
"EndDateTime": null,
"ReferenceNumbers": [
{
"ID": "1",
"IDType": "Control Number"
}
]
}
]
}
]
},
{
"DateTime": "2016-11-08T02:11:03.111Z",
"Patient": {
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
}
},
"Notes": []
},
"Claims": [
{
"ControlNumber": "94151100200",
"SubmissionNumber": "774466586",
"ReceivedDate": "2016-10-31",
"StartDateTime": null,
"EndDateTime": null,
"Status": "Processed as Primary",
"ChargedAmount": "100.00",
"PaymentAmount": "75.00",
"PatientResponsibilityAmount": "20.00",
"ReferenceNumbers": [
{
"ID": "AUTH000000",
"IDType": "Prior Authorization"
}
],
"Adjustments": [],
"Services": [
{
"ChargedAmount": "100.00",
"PaymentAmount": "75.00",
"ChargedUnits": null,
"PaymentUnits": null,
"AllowedAmount": "95.00",
"SubmittedService": {
"Code": null,
"Codeset": null,
"Description": null,
"Modifiers": []
},
"AdjudicatedService": {
"Code": null,
"Codeset": null,
"Description": null,
"Modifiers": []
},
"Adjustments": [
{
"Amount": "20.00",
"Quantity": null,
"Type": "Patient responsibility",
"Reason": "Deductible amount"
},
{
"Amount": "5.00",
"Quantity": null,
"Type": "Contractual obligations",
"Reason": "Claim specific negotiated discount"
}
],
"StartDateTime": null,
"EndDateTime": null,
"ReferenceNumbers": [
{
"ID": "1",
"IDType": "Control Number"
}
]
}
]
}
]
}
]
}
]
}
Submissionlink
BETAA Submission message is used to send a payment request, typically from a healthcare provider to an insurer. This is commonly sent as an EDI 837 form by healthcare providers.
Fields
Meta
Meta.DataModel
String
ReliableRequiredClaim
Meta.EventType
String
ReliableRequiredSubmission
Meta.EventDateTime
DateTime
ReliableDateTime of the event.
ISO 8601 Format
Meta.Test
Boolean
ReliableFlag as a test message
Meta.Source
String
ReliableWhere the message originated.
Included in messages from Redox
Meta.Source.ID
String
ReliableID of the source.
UUID
Meta.Source.Name
String
ReliableName of the source
Meta.Destinations[]
Array of Objects
ReliableList of destinations to send your message to. All messages must have at least one destination. Queries accept only one destination.
Required when sending data to Redox
Meta.Destinations[].ID
String
ReliableID of the destination.
UUID
Meta.Destinations[].Name
String
ReliableName of the destination
Meta.Logs[]
Array of Objects
ReliableRequest log identifiers.
Meta.Logs[].ID
String
ReliableID of a request log that corresponds to this request, used for support and reference within the Redox dashboard.
UUID
Meta.Logs[].AttemptID
String
ReliableID of request log attempt. Useful in cases where retries are possible.
UUID
Meta.Message
String
ReliableRecord in Redox that corresponds to the communication sent from the source to Redox.
Included in messages from Redox
Meta.Message.ID
Numeric
ReliableID of the message created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.Transmission
String
ReliableRecord in Redox that corresponds to the communication sent from Redox to your destination.
Included in messages from Redox
Meta.Transmission.ID
Numeric
ReliableID of the transmission created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.FacilityCode
String
PossibleCode for the facility related to the message.
Only use this field if a health system indicates you should. The code is specific to the health system's EHR and might not be unique across health systems. In general, the facility fields within the data models (e.g. OrderingFacility) are more reliable and informative.
Transaction
Transaction.ID
String
ReliableID used by Sender to reference this claim
Transaction.IDType
String
ReliableType of ID
Transaction.Type
String
ReliableThe type of claim, Institutional or Professional.
Transaction.Submitter.ID
String
ReliableID of the submitter
Transaction.Submitter.IDType
String
ReliableType of ID
Transaction.Submitter.Name
String
ReliableName of submitter
Transaction.Submitter.EmailAddress
String
ReliableEmail address
Transaction.Submitter.PhoneNumber.Office
String
ReliableSubmitter's office phone number.
In E. 164 Format. (e.g. +16085551234)
Transaction.Submitter.PhoneNumber.Fax
String
ReliableSubmitter's fax number.
In E. 164 Format. (e.g. +16085551234)
Transaction.Receiver.ID
String
ReliableID of transaction recipient
Transaction.Receiver.IDType
String
ReliableType of ID
Transaction.Receiver.Name
String
ReliableName of transaction recipient
BillingProvider
BillingProvider.ID
String
ReliableID of billing provider
BillingProvider.IDType
String
ReliableType of ID
BillingProvider.TIN
String
PossibleTax Identification Number of Billing Provider
BillingProvider.FirstName
String
Reliable
BillingProvider.MiddleName
String
Reliable
BillingProvider.LastName
String
Reliable
BillingProvider.OrganizationName
String
Reliable
BillingProvider.Specialty.ID
String
ReliableBilling provider's specialty.
Commonly the taxonomy ID
BillingProvider.Specialty.Description
String
ReliableBilling provider's specialty description
BillingProvider.Address
Object
PossibleBilling provider's address
BillingProvider.Address.StreetAddress
String
PossibleStreet address
BillingProvider.Address.City
String
PossibleCity
BillingProvider.Address.State
String
PossibleState
BillingProvider.Address.ZIP
String
PossibleZIP
BillingProvider.Address.County
String
PossibleCounty
BillingProvider.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
BillingProvider.EmailAddress
String
Reliable
BillingProvider.PhoneNumber.Office
String
ReliableBilling provider's office phone number.
In E. 164 Format. (e.g. +16085551234)
BillingProvider.PhoneNumber.Fax
String
ReliableBilling provider's fax number.
In E. 164 Format. (e.g. +16085551234)
Subscriber
Subscriber.ID
String
ReliableID of the subscriber
Subscriber.IDType
String
ReliableType of ID
Subscriber.FirstName
String
Reliable
Subscriber.MiddleName
String
Reliable
Subscriber.LastName
String
Reliable
Subscriber.OrganizationName
String
ReliableIf the subscriber is not a person, this will contain the organization name
Subscriber.Address
Object
PossibleSubscriber's address
Subscriber.Address.StreetAddress
String
PossibleStreet address
Subscriber.Address.City
String
PossibleCity
Subscriber.Address.State
String
PossibleState
Subscriber.Address.ZIP
String
PossibleZIP
Subscriber.Address.County
String
PossibleCounty
Subscriber.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Subscriber.DOB
String
ReliableSubscriber's date of birth.
In YYYY-MM-DD format
Subscriber.Sex
String
ReliableValueSetSubscriber's sex
-
Additional values may be added by Redox in the future.
-
Subscriber.RelationToPatient
String
ReliableRelation to the patient.
E.x. Self, Parent
Subscriber.ResponsibilityLevel
String
ReliablePayor responsibility level.
E.x. Primary, Secondary, Tertiary
Subscriber.Insurance
Array of Objects
Probable
Subscriber.Insurance.Plan.ID
String
ProbableIdentifier of insurance plan
Subscriber.Insurance.Plan.IDType
String
ProbableID type of insurance plan
Subscriber.Insurance.Plan.Name
String
ProbableName of insurance plan
Subscriber.Insurance.Plan.Type
String
PossibleType of insurance plan
Subscriber.Insurance.MemberNumber
String
PossiblePatient member number
Subscriber.Insurance.Company.ID
String
ProbableID of insurance company (payor)
Subscriber.Insurance.Company.IDType
String
ProbableID type of insurance company (payor)
Subscriber.Insurance.Company.Name
String
ProbableName of insurance company (payor)
Subscriber.Insurance.Company.Address
Object
ProbableInsurance company's address
Subscriber.Insurance.Company.Address.StreetAddress
String
ProbableStreet address
Subscriber.Insurance.Company.Address.City
String
ProbableCity
Subscriber.Insurance.Company.Address.State
String
ProbableState
Subscriber.Insurance.Company.Address.ZIP
String
ProbableZIP
Subscriber.Insurance.Company.Address.County
String
PossibleCounty
Subscriber.Insurance.Company.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Subscriber.Insurance.Company.PhoneNumber
String
ProbableInsurance companys phone number.
In E. 164 Format (i.e. +16085551234)
Subscriber.Insurance.GroupNumber
String
ProbableInsurance policy group number
Subscriber.Insurance.GroupName
String
ProbableInsurance policy group name
Subscriber.Insurance.EffectiveDate
String
ProbableEffect date of this insurance policy.
In YYYY-MM-DD format
Subscriber.Insurance.ExpirationDate
String
ProbableExpiration date of this insurance policy.
In YYYY-MM-DD format
Subscriber.Insurance.PolicyNumber
String
ProbableInsurance policy number
Subscriber.Insurance.Priority
String
PossibleValueSetThe insurance priority sequence.
-
Additional values may be added by Redox in the future.
-
Subscriber.Insurance.AgreementType
String
ProbableValueSetType of insurance agreement.
-
Additional values may be added by Redox in the future.
-
Subscriber.Insurance.CoverageType
String
ProbableValueSetType of insurance agreement.
-
Additional values may be added by Redox in the future.
-
Patient
Patient.Identifiers[]
Array of Objects
ReliableList of IDs and ID types that identify the patient
Patient.Identifiers[].ID
String
ReliableID for the patient
Patient.Identifiers[].IDType
String
ReliableType of ID.
E.g. MRN, EPI
Patient.Demographics.FirstName
String
ReliablePatient's first name
Patient.Demographics.MiddleName
String
PossiblePatient's middle name or middle initial. For patients with multiple middle names, all their middle names are included in this field.
Patient.Demographics.LastName
String
ReliablePatient's last name
Patient.Demographics.DOB
String
ReliablePatient's date of birth.
In ISO 8601 format
Patient.Demographics.SSN
String
ProbablePatient's social security number
Patient.Demographics.Sex
String
ReliableValueSetPatient's sex
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.Race
String
PossibleValueSetPatient's race
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.IsHispanic
Boolean
PossibleValueSetIndicates if the patient is of hispanic origin.
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.Religion
String
PossibleValueSetPatient's religious affiliation
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.MaritalStatus
String
PossibleValueSetPatient's marital status
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.IsDeceased
Boolean
PossibleIndicates if the patient is deceased
Patient.Demographics.DeathDateTime
DateTime
PossibleDate and Time the patient was proclaimed deceased.
ISO 8601 Format
Patient.Demographics.PhoneNumber.Home
String
ProbablePatient's home phone number.
In E. 164 Format. (e.g. +16085551234)
Patient.Demographics.PhoneNumber.Office
String
ProbablePatient's office phone number.
In E. 164 Format. (e.g. +16085551234)
Patient.Demographics.PhoneNumber.Mobile
String
ProbablePatient's mobile phone number.
In E. 164 Format. (e.g. +16085551234)
Patient.Demographics.EmailAddresses[]
Array of Strings
ProbablePatient's email address(es)
Patient.Demographics.Language
String
PossibleValueSetPatient's primary spoken language
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.Citizenship[]
Array of strings
PossibleValueSetPatient's nation(s) of citizenship
-
Additional values may be added by Redox in the future.
-
Patient.Demographics.Address
Object
ProbablePatient's home address
Patient.Demographics.Address.StreetAddress
String
ProbableStreet address
Patient.Demographics.Address.City
String
ProbableCity
Patient.Demographics.Address.State
String
ProbableState
Patient.Demographics.Address.ZIP
String
ProbableZIP
Patient.Demographics.Address.County
String
PossibleCounty
Patient.Demographics.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Patient.Notes[]
Array of strings
PossiblePatient-level notes
Patient.Weight
String
ProbableOne of the following: "Patient", "Clinic", "Insurance", "Other". Indicates who will be receiving the bill for the service.
Patient.IsPregnant
String
ProbableOne of the following: "Yes", "No", "Not Specified"
Claims
Claims[]
Array of Object
ProbableArray of claims on this transaction.
Claims[].ID
String
ProbableIdentifier for this particular claim.
Claims[].Type
String
ProbableType of Claim (Institutional only).
E.x. 'Admit thru Discharge Claim', 'Replacement of Prior Claim ', Void/Cancel of Prior Claim '. May be referred to as the Bill Type Frequency
Claims[].TotalAmount
String
ProbableTotal amount of all lines on the claim.
Claims[].CopayAmount
String
ProbableAmount the patient has paid or still owes.
Claims[].IsProviderSignatureOnFile
Boolean
ProbableWhether or not the provider signature is on file for the claim.
Claims[].IsReleaseOfInformationOnFile
Boolean
ProbableWhether or not the submitter has a signed ROI form for the patient.
Claims[].ReferenceNumbers[].ID
String
ProbableMay include Prior Auth numbers, CLIA numbers, etc
Claims[].ReferenceNumbers[].Type
String
Probable
Claims[].Visit.VisitNumber
String
ReliableVisit Number.
Unique ID of a single visit
Claims[].Visit.DateTime
String
ProbableDateTime of admission.
ISO 8601 Format
Claims[].Visit.DischargeDateTime
String
ProbableDateTime of discharge.
ISO 8601 Format
Claims[].Visit.Type
String
ProbableType of inpatient admission.
Only populated for inpatient admissions. E.x. Elective, Emergency
Claims[].Visit.Location
Object
Probable
Claims[].Visit.Location.Type
String
ProbableType of location.
Examples: Clinic, Department, Home, Nursing Unit, Provider's Office, Phone
Claims[].Visit.Location.Facility
String
ProbableFacility.
Example: Community Hospital
Claims[].Visit.Location.Department
String
ProbableDepartment
Claims[].Visit.Location.Room
String
ProbableRoom.
Example: 136
Claims[].Visit.PreviousLocation
Object
Probable
Claims[].Visit.PreviousLocation.Type
String
ProbableType of location.
Examples: Clinic, Department, Home, Nursing Unit, Provider's Office, Phone
Claims[].Visit.PreviousLocation.Facility
String
ProbableFacility.
Example: Community Hospital
Claims[].Visit.PreviousLocation.Department
String
ProbableDepartment
Claims[].Visit.PreviousLocation.Room
String
ProbableRoom.
Example: 136
Claims[].AdditionalDates[].Type
String
ProbableType of date value.
e.x. Service Period Start (https://ushik.ahrq.gov/ViewItemDetails?system=sdo&itemKey=133121000)
Claims[].AdditionalDates[].DateTime
String
Probable
Claims[].Diagnoses[].Code
String
ProbableDiagnosis code.
First index in array indicates primary diagnosis
Claims[].Diagnoses[].Codeset
String
ProbableCode set used to identify the diagnosis code.
e.x. ICD-10, ICD-9
Claims[].Diagnoses[].Name
String
ProbableDiagnosis name
Claims[].Diagnoses[].Type
String
ProbableType of diagnosis.
One of the following: Admitting, Working, or Final
Claims[].DiagnosisRelatedGroup
String
ProbableCMS Diagnosis Related Group for an inpatient admission
Claims[].Procedures[].Code
String
ProbableProcedure codes associated with this claim
Claims[].Procedures[].CodeSet
String
ProbableCode set used to identify the procedure code.
e.x. CPT, HCPCS, SNOMED, or LOINC
Claims[].Procedures[].Name
String
ProbableName of procedure
Claims[].Procedures[].Modifiers[]
String
ProbableArray of procedure modifiers
Claims[].Lines[]
String
Probable
Claims[].Lines[].ID
String
ProbableIdentifier for the line item.
Claims[].Lines[].Amount
String
ProbableTotal dollar amount for this line item.
Claims[].Lines[].Diagnoses[].Code
String
ProbableDiagnosis code.
First index in array indicates primary diagnosis associated with this service line item.
Claims[].Lines[].Diagnoses[].Codeset
String
ProbableCode set used to identify the diagnosis code.
e.x. ICD-10, ICD-9
Claims[].Lines[].Diagnoses[].Name
String
ProbableDiagnosis name
Claims[].Lines[].Diagnoses[].Type
String
ProbableType of diagnosis.
One of the following: Admitting, Working, or Final
Claims[].Lines[].Procedure.Code
String
ProbableProcedure codes associated with this service line item.
Claims[].Lines[].Procedure.CodeSet
String
ProbableCode set used to identify the procedure code.
e.x. CPT, HCPCS, SNOMED, or LOINC
Claims[].Lines[].Procedure.Name
String
ProbableName of procedure
Claims[].Lines[].Procedure.Modifiers[]
String
ProbableArray of procedure modifiers
Claims[].Lines[].ServiceDateTime
String
ProbableWhen the procedure conveyed in this line item began.
Claims[].Lines[].ServiceEndDateTime
String
ProbableWhen the procedure conveyed in this line item ended.
Claims[].Lines[].RevenueCode
String
ProbableInstitutional only.
Claims[].Lines[].UnitCount
String
ProbableNumeric value for units of service rendered.
Claims[].Lines[].Units
String
ProbableUnits corresponding to UnitCount, (days, units, etc.)
Claims[].Lines[].IsEmergency
Boolean
ProbableWhether or not this service was performed in an emergency setting.
Claims[].Lines[].Notes
String
ProbableAdditional notes for this line
Claims[].Providers[].ID
String
ProbableID of billing provider
Claims[].Providers[].IDType
String
ProbableType of ID.
Commonly 'NPI'
Claims[].Providers[].Role
String
ProbableThe role this provider has in patient care.
E.x. Attending, Referring, Operating
Claims[].Providers[].FirstName
String
Probable
Claims[].Providers[].MiddleName
String
Probable
Claims[].Providers[].LastName
String
Probable
Claims[].Providers[].Specialty.ID
String
ProbableID of specialty.
Commonly the taxonomy ID
Claims[].Providers[].Specialty.Description
String
ProbableDescription/name of specialty
{
"Meta": {
"DataModel": "Claim",
"EventType": "Submission",
"EventDateTime": "2022-06-30T16:07:58.135Z",
"Test": true,
"Source": {
"ID": "7ce6f387-c33c-417d-8682-81e83628cbd9",
"Name": "Redox Dev Tools"
},
"Destinations": [
{
"ID": "af394f14-b34a-464f-8d24-895f370af4c9",
"Name": "Redox EMR"
}
],
"Logs": [
{
"ID": "d9f5d293-7110-461e-a875-3beb089e79f3",
"AttemptID": "925d1617-2fe0-468c-a14c-f8c04b572c54"
}
],
"Message": {
"ID": 5565
},
"Transmission": {
"ID": 12414
},
"FacilityCode": null
},
"Transaction": {
"ID": "94151100100",
"IDType": null,
"Type": "Professional",
"Submitter": {
"ID": null,
"IDType": null,
"Name": null,
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Receiver": {
"ID": null,
"IDType": null,
"Name": null
}
},
"BillingProvider": {
"ID": "4356789876",
"IDType": "NPI",
"TIN": null,
"FirstName": "Pat",
"MiddleName": null,
"LastName": "Granite",
"OrganizationName": null,
"Specialty": {
"ID": null,
"Description": null
},
"Address": {
"StreetAddress": "123 Main St.",
"City": "Madison",
"State": "WI",
"ZIP": "53703",
"County": "Dane",
"Country": "USA"
},
"EmailAddress": null,
"PhoneNumber": {
"Office": "+16085551234",
"Fax": null
}
},
"Subscriber": {
"ID": null,
"IDType": null,
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"OrganizationName": null,
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
},
"DOB": "2008-01-06",
"Sex": "Male",
"RelationToPatient": "Self",
"ResponsibilityLevel": "Primary",
"Insurance": {
"Plan": {
"ID": "31572",
"IDType": "Payor ID",
"Name": "HMO Deductible Plan",
"Type": null
},
"MemberNumber": null,
"Company": {
"ID": "60054",
"IDType": null,
"Name": "aetna (60054 0131)",
"Address": {
"StreetAddress": "PO Box 14080",
"City": "Lexington",
"State": "KY",
"ZIP": "40512-4079",
"County": "Fayette",
"Country": "US"
},
"PhoneNumber": "+18089541123"
},
"GroupNumber": "847025-024-0009",
"GroupName": "Accelerator Labs",
"EffectiveDate": "2015-01-01",
"ExpirationDate": "2020-12-31",
"PolicyNumber": "9140860055",
"Priority": null,
"AgreementType": null,
"CoverageType": null
}
},
"Patient": {
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
}
},
"Notes": [],
"Weight": null,
"IsPregnant": null
},
"Claims": [
{
"ID": "123456789",
"Type": "Admit thru Discharge Claim",
"TotalAmount": "200.00",
"CopayAmount": "10.00",
"IsProviderSignatureOnFile": true,
"IsReleaseOfInformationOnFile": true,
"ReferenceNumbers": [
{
"ID": "AUTH000000",
"Type": null
}
],
"Visit": {
"VisitNumber": null,
"DateTime": "2016-10-08",
"DischargeDateTime": null,
"Type": null,
"Location": {
"Type": "Outpatient Clinic",
"Facility": "RHS Vista Oaks Clinic",
"Department": "Vista Oaks Clinic",
"Room": null
},
"PreviousLocation": {
"Type": null,
"Facility": null,
"Department": null,
"Room": null
}
},
"AdditionalDates": [
{
"Type": "Service Period Start",
"DateTime": "2016-10-08"
}
],
"Diagnoses": [
{
"Code": "M54.5",
"Codeset": "ICD-10",
"Name": "Lower back pain",
"Type": null
},
{
"Code": "J45.909",
"Codeset": "ICD-10",
"Name": "Unspecified asthma, uncomplicated",
"Type": null
}
],
"DiagnosisRelatedGroup": null,
"Procedures": [],
"Lines": [
{
"ID": "12345678",
"Amount": "100.00",
"Diagnoses": [],
"Procedure": {
"Code": "73560",
"CodeSet": "CPT",
"Name": null,
"Modifiers": []
},
"ServiceDateTime": "2016-10-5",
"ServiceEndDateTime": null,
"RevenueCode": null,
"UnitCount": "1",
"Units": "Units",
"IsEmergency": false,
"Notes": null
}
],
"Providers": [
{
"ID": "4236464757",
"IDType": "NPI",
"Role": "Attending",
"FirstName": "John",
"MiddleName": null,
"LastName": "Slate",
"Specialty": {
"ID": "1223G0001X",
"Description": "General Practice"
}
}
]
}
]
}
Paymentlink
BETAA Payment message is used to send a payment notification, typically from a payer to a healthcare provider, but it may be used in other situations where funds are transferred from one party to another. This is commonly sent as an EDI 835.
Fields
Meta
Meta.DataModel
String
ReliableRequiredClaim
Meta.EventType
String
ReliableRequiredPayment
Meta.EventDateTime
DateTime
ReliableDateTime of the event.
ISO 8601 Format
Meta.Test
Boolean
ReliableFlag as a test message
Meta.Source
String
ReliableWhere the message originated.
Included in messages from Redox
Meta.Source.ID
String
ReliableID of the source.
UUID
Meta.Source.Name
String
ReliableName of the source
Meta.Destinations[]
Array of Objects
ReliableList of destinations to send your message to. All messages must have at least one destination. Queries accept only one destination.
Required when sending data to Redox
Meta.Destinations[].ID
String
ReliableID of the destination.
UUID
Meta.Destinations[].Name
String
ReliableName of the destination
Meta.Logs[]
Array of Objects
ReliableRequest log identifiers.
Meta.Logs[].ID
String
ReliableID of a request log that corresponds to this request, used for support and reference within the Redox dashboard.
UUID
Meta.Logs[].AttemptID
String
ReliableID of request log attempt. Useful in cases where retries are possible.
UUID
Meta.Message
String
ReliableRecord in Redox that corresponds to the communication sent from the source to Redox.
Included in messages from Redox
Meta.Message.ID
Numeric
ReliableID of the message created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.Transmission
String
ReliableRecord in Redox that corresponds to the communication sent from Redox to your destination.
Included in messages from Redox
Meta.Transmission.ID
Numeric
ReliableID of the transmission created in Redox.
(Deprecated. Slated for removal on or after Nov. 1, 2022. Use Meta.Logs[].ID instead)
Meta.FacilityCode
String
PossibleCode for the facility related to the message.
Only use this field if a health system indicates you should. The code is specific to the health system's EHR and might not be unique across health systems. In general, the facility fields within the data models (e.g. OrderingFacility) are more reliable and informative.
Transaction
Transaction.ID
String
ReliableID used by Sender to reference this claim
Transaction.IDType
String
ReliableType of ID
Transaction.Type
String
ReliableThe type of claim, Institutional or Professional.
Transaction.Submitter.ID
String
ReliableID of the submitter
Transaction.Submitter.IDType
String
ReliableType of ID
Transaction.Submitter.Name
String
ReliableName of submitter
Transaction.Submitter.EmailAddress
String
ReliableEmail address
Transaction.Submitter.PhoneNumber.Office
String
ReliableSubmitter's office phone number.
In E. 164 Format. (e.g. +16085551234)
Transaction.Submitter.PhoneNumber.Fax
String
ReliableSubmitter's fax number.
In E. 164 Format. (e.g. +16085551234)
Transaction.Receiver.ID
String
ReliableID of transaction recipient
Transaction.Receiver.IDType
String
ReliableType of ID
Transaction.Receiver.Name
String
ReliableName of transaction recipient
Transaction.TotalPaymentAmount
String
ProbableThe total amount of all of the payments listed in the Payments array.
Redox can calculate this for you, but we recommend sending it as an additional layer of validation.
Transaction.CreditOrDebit
String
ProbableA flag indicating whether the monetary amount in Transaction.TotalPaymentAmount is a credit or debit.
Send either "Credit" or "Debit" in this field.
Transaction.PaymentMethod
String
ProbableHow the payment was/will be transferred.
We currently support "Check" and "ACH".
Transaction.PaymentDateTime
DateTime
ProbableWhen the transaction should be processed by the destination.
For example, if the "Check" is used in Transaction.PaymentMethod this would be the date on the check.
Transaction.TrackingNumber
String
ProbableA number used to by the Payer to trace the payment.
For example, if the "Check" is used in Transaction.PaymentMethod this would be the check number.
Payer
Payer
String
Probable
Payer.ID
String
Probable
Payer.IDType
String
Probable
Payer.Name
String
Probable
Payer.Address
String
Probable
Payer.Address.StreetAddress
String
ProbableStreet address
Payer.Address.City
String
ProbableCity
Payer.Address.State
String
ProbableState
Payer.Address.ZIP
String
ProbableZIP
Payer.Address.County
String
ProbableCounty
Payer.Address.Country
String
ProbableCountry
Payer.EmailAddress
String
ProbableEmail address
Payer.PhoneNumber.Office
String
ProbableSubmitter's office phone number.
In E. 164 Format. (e.g. +16085551234)
Payer.PhoneNumber.Fax
String
ProbableSubmitter's fax number.
In E. 164 Format. (e.g. +16085551234)
Payee
Payee
String
Probable
Payee.ID
String
Probable
Payee.IDType
String
Probable
Payee.Name
String
Probable
Payee.Address
String
Probable
Payee.Address.StreetAddress
String
ProbableStreet address
Payee.Address.City
String
ProbableCity
Payee.Address.State
String
ProbableState
Payee.Address.ZIP
String
ProbableZIP
Payee.Address.County
String
ProbableCounty
Payee.Address.Country
String
ProbableCountry
Payee.EmailAddress
String
ProbableEmail address
Payee.PhoneNumber.Office
String
ProbableSubmitter's office phone number.
In E. 164 Format. (e.g. +16085551234)
Payee.PhoneNumber.Fax
String
ProbableSubmitter's fax number.
In E. 164 Format. (e.g. +16085551234)
Payments
Payments[]
String
Probable
Payments[].DateTime
DateTime
ProbableThe DateTime this payment was processed
Payments[].Patient.Identifiers[]
Array of Objects
ReliableList of IDs and ID types that identify the patient
Payments[].Patient.Identifiers[].ID
String
ReliableRequiredID for the patient
Payments[].Patient.Identifiers[].IDType
String
ReliableRequiredType of ID.
E.g. MRN, EPI
Payments[].Patient.Demographics.FirstName
String
ReliablePatient's first name
Payments[].Patient.Demographics.MiddleName
String
PossiblePatient's middle name or middle initial. For patients with multiple middle names, all their middle names are included in this field.
Payments[].Patient.Demographics.LastName
String
ReliablePatient's last name
Payments[].Patient.Demographics.DOB
String
ReliablePatient's date of birth.
In ISO 8601 format
Payments[].Patient.Demographics.SSN
String
ProbablePatient's social security number
Payments[].Patient.Demographics.Sex
String
ReliableValueSetPatient's sex
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.Race
String
PossibleValueSetPatient's race
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.IsHispanic
Boolean
PossibleValueSetIndicates if the patient is of hispanic origin.
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.Religion
String
PossibleValueSetPatient's religious affiliation
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.MaritalStatus
String
PossibleValueSetPatient's marital status
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.IsDeceased
Boolean
PossibleIndicates if the patient is deceased
Payments[].Patient.Demographics.DeathDateTime
DateTime
PossibleDate and Time the patient was proclaimed deceased.
ISO 8601 Format
Payments[].Patient.Demographics.PhoneNumber.Home
String
ProbablePatient's home phone number.
In E. 164 Format. (e.g. +16085551234)
Payments[].Patient.Demographics.PhoneNumber.Office
String
ProbablePatient's office phone number.
In E. 164 Format. (e.g. +16085551234)
Payments[].Patient.Demographics.PhoneNumber.Mobile
String
ProbablePatient's mobile phone number.
In E. 164 Format. (e.g. +16085551234)
Payments[].Patient.Demographics.EmailAddresses[]
Array of Strings
ProbablePatient's email address(es)
Payments[].Patient.Demographics.Language
String
PossibleValueSetPatient's primary spoken language
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.Citizenship[]
Array of strings
PossibleValueSetPatient's nation(s) of citizenship
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Demographics.Address
Object
ProbablePatient's home address
Payments[].Patient.Demographics.Address.StreetAddress
String
ProbableStreet address
Payments[].Patient.Demographics.Address.City
String
ProbableCity
Payments[].Patient.Demographics.Address.State
String
ProbableState
Payments[].Patient.Demographics.Address.ZIP
String
ProbableZIP
Payments[].Patient.Demographics.Address.County
String
PossibleCounty
Payments[].Patient.Demographics.Address.Country
String
PossibleValueSetCountry
-
Additional values may be added by Redox in the future.
-
Payments[].Patient.Notes[]
Array of strings
PossiblePatient-level notes
Payments[].Claim.Number
String
ProbableThe Payer's reference number
Payments[].Claim.SubmissionNumber
String
ProbableThis will generally be the claim number sent on the Submission (837).
Payments[].Claim.ReceivedDate
String
ProbableDate the claim was submitted
Payments[].Claim.ServiceDateTime
DateTime
ProbableDate the statement period started
Payments[].Claim.ServiceEndDateTime
DateTime
ProbableDate the statement period ended
Payments[].Claim.Status
String
ProbableStatus of the claim
Payments[].Claim.ChargedAmount
String
ProbableTotal monetary amount of the claim
Payments[].Claim.PaymentAmount
String
ProbableMonetary amount of the claim paid
Payments[].Claim.PatientResponsibilityAmount
String
ProbableMonetary amount of the claim the patient is responsible for
Payments[].Claim.Adjustments[]
String
ProbableAdjustments explain why a claim was paid differently than it was billed.
Payments[].Claim.Adjustments[].Amount
String
ProbableMonetary amount of the adjustment.
A negative number indicates a payment increase, while a positive number indicates a payment reduction.
Payments[].Claim.Adjustments[].ReasonGroup
String
ProbableAdjustment group.
E.x. Contractual Obligation, Other Adjustments, Payer Initiated Reductions, Patient Responsibility
Payments[].Claim.Adjustments[].Quantity
String
Probable
Payments[].Claim.Adjustments[].Reason
String
ProbableAdjustment reason
Payments[].Claim.ReferenceNumbers[].ID
String
ProbableMay include Prior Auth numbers, CLIA numbers, etc
Payments[].Claim.ReferenceNumbers[].IDType
String
Probable
Payments[].Claim.Services[]
String
ProbableThis array will provide additional detail for claims processed at the line level.
Payments[].Claim.Services[].ChargedAmount
String
ProbableThe monetory amount charged
Payments[].Claim.Services[].PaymentAmount
String
ProbableThe monetory amount paid
Payments[].Claim.Services[].ChargedUnits
String
ProbableThe number of units of service charged for
Payments[].Claim.Services[].PaymentUnits
String
ProbableThe number of units of service paid for
Payments[].Claim.Services[].AllowedAmount
String
ProbableMaximum monetary amount of payment
Payments[].Claim.Services[].DeductibleAmount
String
ProbableMonetary amount of patient deductible
Payments[].Claim.Services[].SubmittedProcedure.Code
String
ProbableProcedure codes associated with this service.
Payments[].Claim.Services[].SubmittedProcedure.CodeSet
String
ProbableCode set used to identify the procedure code
Payments[].Claim.Services[].SubmittedProcedure.Name
String
ProbableName of procedure
Payments[].Claim.Services[].SubmittedProcedure.Modifiers[]
String
ProbableArray of procedure modifiers
Payments[].Claim.Services[].AdjudicatedProcedure.Code
String
ProbableAdjudicated procedure codes associated with this service.
Payments[].Claim.Services[].AdjudicatedProcedure.CodeSet
String
ProbableCode set used to identify the procedure code
Payments[].Claim.Services[].AdjudicatedProcedure.Name
String
ProbableName of procedure
Payments[].Claim.Services[].AdjudicatedProcedure.Modifiers[]
String
ProbableArray of procedure modifiers
Payments[].Claim.Services[].ServiceDateTime
DateTime
ProbableDate the claim was submitted
Payments[].Claim.Services[].ServiceEndDateTime
DateTime
ProbableDate the statement period started
Payments[].Claim.Services[].ReferenceNumbers[].ID
String
ProbableMay include Prior Auth numbers, CLIA numbers, etc
Payments[].Claim.Services[].ReferenceNumbers[].IDType
String
Probable
{
"Meta": {
"DataModel": "Claim",
"EventType": "Payment",
"EventDateTime": "2022-06-30T16:07:58.135Z",
"Test": true,
"Source": {
"ID": "7ce6f387-c33c-417d-8682-81e83628cbd9",
"Name": "Redox Dev Tools"
},
"Destinations": [
{
"ID": "af394f14-b34a-464f-8d24-895f370af4c9",
"Name": "Redox EMR"
}
],
"Logs": [
{
"ID": "d9f5d293-7110-461e-a875-3beb089e79f3",
"AttemptID": "925d1617-2fe0-468c-a14c-f8c04b572c54"
}
],
"Message": {
"ID": 5565
},
"Transmission": {
"ID": 12414
},
"FacilityCode": null
},
"Transaction": {
"ID": "000000001",
"IDType": null,
"Type": null,
"Submitter": {
"ID": null,
"IDType": null,
"Name": "National Insurance Company of Redox",
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Receiver": {
"ID": null,
"IDType": null,
"Name": "Redox Health System"
},
"TotalPaymentAmount": "580.00",
"CreditOrDebit": "Credit",
"PaymentMethod": "Check",
"PaymentDateTime": "2016-11-11T02:11:03.111Z",
"TrackingNumber": "8675309"
},
"Payer": {
"ID": "999999999",
"IDType": "HPID",
"Name": "Cherdabee Insurance Corp",
"Address": {
"StreetAddress": "123 fake street",
"City": "Los Angeles",
"State": "CA",
"ZIP": "90210",
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Payee": {
"ID": "51531312",
"IDType": null,
"Name": "Redox Health System",
"Address": {
"StreetAddress": "2020 Eastwood Drive",
"City": "Madison",
"State": "WI",
"ZIP": "53704",
"County": null,
"Country": null
},
"EmailAddress": null,
"PhoneNumber": {
"Office": null,
"Fax": null
}
},
"Payments": [
{
"DateTime": "2016-11-08T02:11:03.111Z",
"Patient": {
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
}
},
"Notes": []
},
"Claim": {
"Number": "94151100100",
"SubmissionNumber": null,
"ReceivedDate": "2016-10-31",
"ServiceDateTime": "2016-10-08T08:58:03.125Z",
"ServiceEndDateTime": "2016-10-11T14:58:03.532Z",
"Status": "Processed as Primary",
"ChargedAmount": "100.00",
"PaymentAmount": "65.00",
"PatientResponsibilityAmount": "20.00",
"Adjustments": [],
"ReferenceNumbers": [
{
"ID": "AUTH000000",
"IDType": "Prior Authorization"
}
],
"Services": [
{
"ChargedAmount": "100.00",
"PaymentAmount": "65.00",
"ChargedUnits": null,
"PaymentUnits": null,
"AllowedAmount": "85.00",
"DeductibleAmount": null,
"SubmittedProcedure": {
"Code": "55454-3",
"CodeSet": "LOINC",
"Name": null,
"Modifiers": []
},
"AdjudicatedProcedure": {
"Code": "55454-3",
"CodeSet": "LOINC",
"Name": null,
"Modifiers": []
},
"ServiceDateTime": "2016-10-08T08:58:03.624Z",
"ServiceEndDateTime": "2016-10-08T14:58:03.263Z",
"ReferenceNumbers": []
}
]
}
},
{
"DateTime": "2016-11-08T02:11:03.111Z",
"Patient": {
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
"IDType": "EHRID"
},
{
"ID": "a1d4ee8aba494ca",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "Timothy",
"MiddleName": "Paul",
"LastName": "Bixby",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18088675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "4762 Hickory Street",
"City": "Monroe",
"State": "WI",
"ZIP": "53566",
"County": "Green",
"Country": "US"
}
},
"Notes": []
},
"Claim": {
"Number": "94151100100",
"SubmissionNumber": null,
"ReceivedDate": "2016-10-31",
"ServiceDateTime": "2016-10-08T08:58:03.125Z",
"ServiceEndDateTime": "2016-10-11T14:58:03.532Z",
"Status": "Processed as Primary",
"ChargedAmount": "100.00",
"PaymentAmount": "75.00",
"PatientResponsibilityAmount": "20.00",
"Adjustments": [],
"ReferenceNumbers": [
{
"ID": "AUTH000000",
"IDType": "Prior Authorization"
}
],
"Services": [
{
"ChargedAmount": "100.00",
"PaymentAmount": "75.00",
"ChargedUnits": null,
"PaymentUnits": null,
"AllowedAmount": "95.00",
"DeductibleAmount": null,
"SubmittedProcedure": {
"Code": "99211",
"CodeSet": "LOINC",
"Name": null,
"Modifiers": []
},
"AdjudicatedProcedure": {
"Code": "99211",
"CodeSet": "LOINC",
"Name": null,
"Modifiers": []
},
"ServiceDateTime": "2016-10-08T08:58:03.624Z",
"ServiceEndDateTime": "2016-10-08T14:58:03.263Z",
"ReferenceNumbers": [
{
"ID": "1",
"IDType": "Control Number"
}
]
}
]
}
}
]
}