APIs for VBASoftware
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Delete ClaimCustomExCodeR...
VBASoftware (v1)
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VBAPI VBASoftware
https://vbapi.vbasoftware.com/vbasoftware/
Bodyrequired
- application/json
- text/json
- application/*+json
Unique identifier for each custom Ex Code rule. This takes the combination of fields on this table and, if a claim fits in the configuration, assigns an ex code. Note: This field is marked as NOT NULL in the database and therefore required by the API.
Benefit code associated with the selected custom ExCode rule.
The Date Type (service date, received date, etc.) to use in combination with effective dates to deterine if this rule applies.
The amount you want this edit to compare against. For example, if you wanted to apply a custom ex code for any claim with a Co Insurance greater than $50, you would set Detail_Amount_Field = "co_ins_amt", set the Detail_Amount_Field_Operator to ">", then set the Detail_Amount field to 50.00.
The detail amount field drives the logic for what the Field Operator and Amount are compared against on the Service line: payable_amount: The amount payable based on rules applied (Allowed - (copay, coins, deductible, not covered, etc.). billed_price: The amount billed, represented by the Billed_Price field. plan_price: The price associated with the plan, represented by the Plan_Price field. deductible_amt: The deductible amount, represented by the Deductible_Amt field. co_pay_amt: The co-payment amount, represented by the Co_Pay_Amt field. co_ins_amt: The co-insurance amount, represented by the Co_Ins_Amt field. cob_amt: The coordination of benefits amount, represented by the COB_Amt field. cob_hold: The coordination of benefits hold amount, represented by the COB_Hold field. cob_mem_resp: The coordination of benefits member responsibility, represented by the COB_Mem_Resp field. mem_resp: The total member responsibility, calculated as the sum of Co_Ins_Amt, Co_Pay_Amt, and Deductible_Amt.
Simple operator (Greater than, less than, or equal). This compares the value identified in Detail_Amount_Field against the value in the Detail_Amount field based on this opeator.
The Ex Code that is applied if the identified criteria matched a claim during adjudication.
Option that allows custom claim rules to be applied in network, out of network or in all cases
Indicates that this Custom Ex Code rule is going to apply the resulting Ex Code to the Service Line rather than the header. This assumes the use of Benefit_Code and the Detail_Amount fields. Note: This field is marked as NOT NULL in the database and therefore required by the API.
- VBAPI VBASoftwarehttps://vbapi.vbasoftware.com/vbasoftware/claim-custom-ex-code-rules/{customExCodeRuleKey}
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X PUT \
'https://vbapi.vbasoftware.com/vbasoftware/claim-custom-ex-code-rules/{customExCodeRuleKey}' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>' \
-H 'Content-Type: application/json' \
-H 'vbasoftware-database: string' \
-H 'x-api-key: YOUR_API_KEY_HERE' \
-d '{
"claimCustomExCodeRule_Key": 0,
"benefit_Code": "string",
"claim_Type": "string",
"date_Type": "string",
"detail_Amount": 0.1,
"detail_Amount_Field": "string",
"detail_Amount_Field_Operator": "string",
"division_ID": "string",
"effective_Date": "2019-08-24T14:15:22Z",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"ex_Code": "string",
"federal_ID": "string",
"from_Diag_Code": "string",
"from_Procedure": "string",
"group_ID": "string",
"member_Seq": "st",
"network_Option": "string",
"plan_ID": "string",
"provider_ID": "string",
"subscriber_ID": "string",
"term_Date": "2019-08-24T14:15:22Z",
"thru_Diag_Code": "string",
"thru_Procedure": "string",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_Detail_Ex_Code": true
}'Response
No response example- VBAPI VBASoftwarehttps://vbapi.vbasoftware.com/vbasoftware/claim-custom-ex-code-rules/{customExCodeRuleKey}
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X DELETE \
'https://vbapi.vbasoftware.com/vbasoftware/claim-custom-ex-code-rules/{customExCodeRuleKey}' \
-H 'Authorization: Bearer <YOUR_JWT_HERE>' \
-H 'vbasoftware-database: string' \
-H 'x-api-key: YOUR_API_KEY_HERE'Body
- application/json
- text/json
- application/*+json
Unique identifier for each custom Ex Code rule. This takes the combination of fields on this table and, if a claim fits in the configuration, assigns an ex code. Note: This field is marked as NOT NULL in the database and therefore required by the API.
Benefit code associated with the selected custom ExCode rule.
The Date Type (service date, received date, etc.) to use in combination with effective dates to deterine if this rule applies.
The amount you want this edit to compare against. For example, if you wanted to apply a custom ex code for any claim with a Co Insurance greater than $50, you would set Detail_Amount_Field = "co_ins_amt", set the Detail_Amount_Field_Operator to ">", then set the Detail_Amount field to 50.00.
The detail amount field drives the logic for what the Field Operator and Amount are compared against on the Service line: payable_amount: The amount payable based on rules applied (Allowed - (copay, coins, deductible, not covered, etc.). billed_price: The amount billed, represented by the Billed_Price field. plan_price: The price associated with the plan, represented by the Plan_Price field. deductible_amt: The deductible amount, represented by the Deductible_Amt field. co_pay_amt: The co-payment amount, represented by the Co_Pay_Amt field. co_ins_amt: The co-insurance amount, represented by the Co_Ins_Amt field. cob_amt: The coordination of benefits amount, represented by the COB_Amt field. cob_hold: The coordination of benefits hold amount, represented by the COB_Hold field. cob_mem_resp: The coordination of benefits member responsibility, represented by the COB_Mem_Resp field. mem_resp: The total member responsibility, calculated as the sum of Co_Ins_Amt, Co_Pay_Amt, and Deductible_Amt.
Simple operator (Greater than, less than, or equal). This compares the value identified in Detail_Amount_Field against the value in the Detail_Amount field based on this opeator.
The Ex Code that is applied if the identified criteria matched a claim during adjudication.
Option that allows custom claim rules to be applied in network, out of network or in all cases
Indicates that this Custom Ex Code rule is going to apply the resulting Ex Code to the Service Line rather than the header. This assumes the use of Benefit_Code and the Detail_Amount fields. Note: This field is marked as NOT NULL in the database and therefore required by the API.
- VBAPI VBASoftwarehttps://vbapi.vbasoftware.com/vbasoftware/claim-custom-ex-code-rules-batch
- curl
- JavaScript
- Node.js
- Python
- Java
- C#
- PHP
- Go
- Ruby
- R
- Payload
curl -i -X PUT \
https://vbapi.vbasoftware.com/vbasoftware/claim-custom-ex-code-rules-batch \
-H 'Authorization: Bearer <YOUR_JWT_HERE>' \
-H 'Content-Type: application/json' \
-H 'vbasoftware-database: string' \
-H 'x-api-key: YOUR_API_KEY_HERE' \
-d '[
{
"claimCustomExCodeRule_Key": 0,
"benefit_Code": "string",
"claim_Type": "string",
"date_Type": "string",
"detail_Amount": 0.1,
"detail_Amount_Field": "string",
"detail_Amount_Field_Operator": "string",
"division_ID": "string",
"effective_Date": "2019-08-24T14:15:22Z",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"ex_Code": "string",
"federal_ID": "string",
"from_Diag_Code": "string",
"from_Procedure": "string",
"group_ID": "string",
"member_Seq": "st",
"network_Option": "string",
"plan_ID": "string",
"provider_ID": "string",
"subscriber_ID": "string",
"term_Date": "2019-08-24T14:15:22Z",
"thru_Diag_Code": "string",
"thru_Procedure": "string",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_Detail_Ex_Code": true
}
]'Response
No response example