Claim Batch Details

Create ClaimBatchDetail

Creates a new ClaimBatchDetail

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

batch_Number required	integer <int32> References the ClaimBatch.Batch_Number value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API.
batch_Claim required	integer <int32> References the ClaimBatch.Batch_Claim value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API.
claim_Seq required	string [ 1 .. 2 ] characters In combination with Adjustment_Seq, creates a unique sequence for each service line on this claim.
adjustment_Seq required	string [ 1 .. 3 ] characters In combination with Claim_Seq, creates a unique sequence for each service line on this claim. Used to note adjustments, cascading, etc. when utlized. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ansI_Code	string or null <= 8 characters No longer in use.
apC_Code	string or null <= 8 characters The APC code applied to this service if identified for calculation during adjudication.
account_Key	integer or null <int32> For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
adjusted_From_Adjustment_Line	string or null <= 3 characters References the Adjustment_Seq value on the original claim that this claim is adjusting.
adjusted_From_Line	string or null <= 2 characters References the Claim_Seq value on the original claim that this claim is adjusting.
auth_Number	string or null <= 20 characters The Auth Number for services that require authorization. References Auth.Auth_Number.
auth_Penalty	number or null <double> If an Auth Penalty is applied during adjudication, that is housed here.
auth_Required	string or null <= 1 characters Notes that this service lines required authorization.
benefit_Code	string or null <= 10 characters This is the benefit code assigned to this service line based on the Plan assigned on the Claim header. References BenefitCodes.Benefit_Code.
benefit_Rate_Applied	number or null <double> Benefit Rate being applied to this detail line.
billed_Price required	number <double> The billed charges assigned by the provider for this service. Note: This field is marked as NOT NULL in the database and therefore required by the API.
brand_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
buccal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cliA_Number	string or null <= 32 characters No longer in use.
coB_Amt required	number <double> Holds the Other Insurance calculated amount that would affect the payable amount for this service (calculated from COB_Hold, COB_Mem_Resp, COB_Savings, and COB_Savings_Used). Note: This field is marked as NOT NULL in the database and therefore required by the API.
coB_Hold	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Mem_Resp	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Savings	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Savings_Used	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
calendar_Year	string or null <= 4 characters Used for Flex Claims to indicate the calendar year this claim applies.
capitation_Claim required	boolean Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API.
check_ID	integer or null <int32> No longer in use.
co_Ins_Amt required	number <double> The co-insurance amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
co_Pay_Amt required	number <double> The co-pay amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
currency_ID	string or null <= 16 characters For currency calculations, this holds the destination currency.
days_Supply	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
ded_Credit_Amt	number or null <double> If the service is eligiblity for deductible credits, they would be stored here.
deductible_Amt required	number <double> The deductible amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
detail_Plan_Year	string or null <= 8 characters Indicates which Plan Year the service line correlates to from GroupPlanYear.Plan_Year
diagnosis_Code	string or null <= 8 characters The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.
discount_Amt required	number <double> The difference between Billed and Allowed is stored as the Discount Amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
dispense_As_Written	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
distal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
drug_Code	string or null <= 20 characters For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code.
drug_Quantity	number or null <double> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
entry_Date	string <date-time> Date when the record was first added to the system.
entry_User	string or null <= 20 characters User that first added the record to the system.
error_Auth	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Benefit	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Count	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Covered	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Dates	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Diagnosis	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_ExCode	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Modifier	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Place	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Price	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Procedure	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
ex_Code	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
ex_Code2	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
ex_Code3	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
fica required	number <double> The FICA tax amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
facial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
federal_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Federal "To Tax" amount for disability claim.
federal_Tax required	number <double> The calculated Federal tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
federal_Tax_Flat	number or null <double> A flat federal tax amount applied in addition to the calculated tax amount.
fill_Date	string or null <date-time> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
flex_Description	string or null <= 128 characters Manually entered description of this flex claim.
formulary_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
incisal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
interest required	number <double> If interest is calculated on a claim, it is stored here and applied to payable amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
labial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
life_Benefit	string or null <= 10 characters The Life Benefit to be applied for Life claims processing.
life_Benefit_Volume	number or null <double> The Life Benefit calculated volume based on benefit definition.
line_Control_Number	string or null <= 64 characters Number added manually to claims and from 837 files and sent outbound on 835 files.
lingual required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
local_Tax	number or null <double> If a locality tax is applicable it would be housed here. Note: The database will apply a default value of `0` for this field if a value is not provided.
mail_Order_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
medicare_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Medicare "To Tax" amount for disability claim.
medicare_Tax	number or null <double> The calculated Medicare tax amount based on the "To Tax" amount.
mesial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
minutes_Per_Unit	number or null <double> This is for anesthesia, each Unit of anesthesia is equal to a specific amount of Minutes.
modifier	string or null <= 8 characters The modifier applied to this service.
modifier_2	string or null <= 8 characters The modifier applied to this service.
modifier_3	string or null <= 8 characters The modifier applied to this service.
modifier_4	string or null <= 8 characters The modifier applied to this service.
modifier_Units	number or null <double> The number of the units from this detail line that comes from the Modifier. This determines pricing for the line.
not_Covered_Amt required	number <double> For not covered services, or partially not covered services, this reflects that deduction. Note: This field is marked as NOT NULL in the database and therefore required by the API.
occlusal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
oral_Cavity_Designation_Code_1	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_2	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_3	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_4	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_5	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
other_Deduction_Amount	number or null <double> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
override_Benefit_Code required	boolean This flag indicates if the benefit code has been overridden. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_COB_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Co_Ins_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Co_Pay_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Ded_Credit_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Deductible_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Federal_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Local_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Medicare_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Not_Covered_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Plan_Price required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Social_Security required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_State_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_With_Hold_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ppO_Price_Plan_Price_Diff	number or null <double> Information field used in custom processing and reporting.
paid_Amt required	number <double> The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: This field is marked as NOT NULL in the database and therefore required by the API.
partial_Loss required	number <double> The partial loss amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
payor_ID	string or null <= 20 characters For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
pharmacy_Name	string or null <= 128 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
place_Of_Service	string or null <= 5 characters The place of service for the services being rendered on this service line.
plan_Price required	number <double> The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: This field is marked as NOT NULL in the database and therefore required by the API.
premium_Deduction required	number <double> The premium deduction amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
prescriber_ID	string or null <= 32 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
prescription_Date	string or null <date-time> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
prescription_Number	string or null <= 50 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
pricing_Method	string or null <= 8 characters For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.
pricing_Rate	number or null <double> The rate associated with the reprice method (Pricing_Method).
principal required	number <double> For life claims, this holds the principal amount for reporting. Note: This field is marked as NOT NULL in the database and therefore required by the API.
procedure_Code	string or null <= 8 characters The service being rendered on this claim.
procedure_Code2	string or null <= 8 characters The secondary service being rendered on this claim.
procedure_Code_Units	number or null <double> The number of th eunits from this detail line that comes from the Prtocedure Code. This determines pricing for the line.
qualifying_Payment_Amount	number or null <double> QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.
reason_Code	integer or null <int32> No longer in use.
refill_Indicator	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
repriced_Savings_Amount	number or null <double> Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.
root required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
service_Date	string or null <date-time> The start date of the services being rendered.
service_Thru	string or null <date-time> The end date of the services being rendered.
socSec_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Social Security "To Tax" amount for disability claim.
social_Security required	number <double> The calculated Social Security tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
state_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the State "To Tax" amount for disability claim.
state_Tax required	number <double> The calculated State tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
state_Tax_Flat	number or null <double> A flat state tax amount applied in addition to the calculated tax amount.
state_Tax_State	string or null <= 2 characters When state taxes are calculated, this indicates the state the tax amount was calculated against.
status_Code	string or null <= 1 characters Holds the individaul status of this service line based on Ex Codes. A - Payable, D - Denied, E - Pended.
svc_Count	number or null <double> The units applied to this service.
taxable_Amount	number or null <double> This holds the starting taxable amount based on pre-tax and pre-gross deductions applied to this service.
tooth_Number	integer or null <int32> For dental claims, this identifies the tooth, quadrant or arch being worked for this service.
ucR_Price required	number <double> No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.
unit_Dose	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
unit_Of_Measure	string or null <= 2 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
update_Date	string <date-time> Date when the record was last updated in the system.
update_User	string or null <= 20 characters User that last updated the record in the system.
with_Hold_Amt required	number <double> For plans that allow withhold, this amount is used to track that amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.

Responses

200

Success

401

Unauthorized

post/claim-batches/{batchNumber}/claims/{batchClaim}/details

Request samples

Payload
C#
JavaScript
curl
Java

{"batch_Number": 0,
"batch_Claim": 0,
"claim_Seq": "st",
"adjustment_Seq": "str",
"ansI_Code": "string",
"apC_Code": "string",
"account_Key": 0,
"adjusted_From_Adjustment_Line": "str",
"adjusted_From_Line": "st",
"auth_Number": "string",
"auth_Penalty": 0.1,
"auth_Required": "s",
"benefit_Code": "string",
"benefit_Rate_Applied": 0.1,
"billed_Price": 0.1,
"brand_Indicator": "s",
"buccal": true,
"cliA_Number": "string",
"coB_Amt": 0.1,
"coB_Hold": 0.1,
"coB_Mem_Resp": 0.1,
"coB_Savings": 0.1,
"coB_Savings_Used": 0.1,
"calendar_Year": "stri",
"capitation_Claim": true,
"check_ID": 0,
"co_Ins_Amt": 0.1,
"co_Pay_Amt": 0.1,
"currency_ID": "string",
"days_Supply": 0,
"ded_Credit_Amt": 0.1,
"deductible_Amt": 0.1,
"detail_Plan_Year": "string",
"diagnosis_Code": "string",
"discount_Amt": 0.1,
"dispense_As_Written": 0,
"distal": true,
"drug_Code": "string",
"drug_Quantity": 0.1,
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"error_Auth": "s",
"error_Benefit": "s",
"error_Count": "s",
"error_Covered": "s",
"error_Dates": "s",
"error_Diagnosis": "s",
"error_ExCode": "s",
"error_Modifier": "s",
"error_Place": "s",
"error_Price": "s",
"error_Procedure": "s",
"ex_Code": "string",
"ex_Code2": "string",
"ex_Code3": "string",
"fica": 0.1,
"facial": true,
"federal_Amount_To_Tax": 0.1,
"federal_Tax": 0.1,
"federal_Tax_Flat": 0.1,
"fill_Date": "2019-08-24T14:15:22Z",
"flex_Description": "string",
"formulary_Indicator": "s",
"incisal": true,
"interest": 0.1,
"labial": true,
"life_Benefit": "string",
"life_Benefit_Volume": 0.1,
"line_Control_Number": "string",
"lingual": true,
"local_Tax": 0.1,
"mail_Order_Indicator": "s",
"medicare_Amount_To_Tax": 0.1,
"medicare_Tax": 0.1,
"mesial": true,
"minutes_Per_Unit": 0.1,
"modifier": "string",
"modifier_2": "string",
"modifier_3": "string",
"modifier_4": "string",
"modifier_Units": 0.1,
"not_Covered_Amt": 0.1,
"occlusal": true,
"oral_Cavity_Designation_Code_1": "str",
"oral_Cavity_Designation_Code_2": "str",
"oral_Cavity_Designation_Code_3": "str",
"oral_Cavity_Designation_Code_4": "str",
"oral_Cavity_Designation_Code_5": "str",
"other_Deduction_Amount": 0.1,
"override_Benefit_Code": true,
"override_COB_Amt": true,
"override_Co_Ins_Amt": true,
"override_Co_Pay_Amt": true,
"override_Ded_Credit_Amt": true,
"override_Deductible_Amt": true,
"override_Federal_Tax": true,
"override_Local_Tax": true,
"override_Medicare_Tax": true,
"override_Not_Covered_Amt": true,
"override_Plan_Price": true,
"override_Social_Security": true,
"override_State_Tax": true,
"override_With_Hold_Amt": true,
"ppO_Price_Plan_Price_Diff": 0.1,
"paid_Amt": 0.1,
"partial_Loss": 0.1,
"payor_ID": "string",
"pharmacy_Name": "string",
"place_Of_Service": "strin",
"plan_Price": 0.1,
"premium_Deduction": 0.1,
"prescriber_ID": "string",
"prescription_Date": "2019-08-24T14:15:22Z",
"prescription_Number": "string",
"pricing_Method": "string",
"pricing_Rate": 0.1,
"principal": 0.1,
"procedure_Code": "string",
"procedure_Code2": "string",
"procedure_Code_Units": 0.1,
"qualifying_Payment_Amount": 0.1,
"reason_Code": 0,
"refill_Indicator": 0,
"repriced_Savings_Amount": 0.1,
"root": true,
"service_Date": "2019-08-24T14:15:22Z",
"service_Thru": "2019-08-24T14:15:22Z",
"socSec_Amount_To_Tax": 0.1,
"social_Security": 0.1,
"state_Amount_To_Tax": 0.1,
"state_Tax": 0.1,
"state_Tax_Flat": 0.1,
"state_Tax_State": "st",
"status_Code": "s",
"svc_Count": 0.1,
"taxable_Amount": 0.1,
"tooth_Number": 0,
"ucR_Price": 0.1,
"unit_Dose": 0,
"unit_Of_Measure": "st",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"with_Hold_Amt": 0.1
}

Response samples

{"data": {"batch_Number": 0,
"batch_Claim": 0,
"claim_Seq": "st",
"adjustment_Seq": "str",
"ansI_Code": "string",
"apC_Code": "string",
"account_Key": 0,
"adjusted_From_Adjustment_Line": "str",
"adjusted_From_Line": "st",
"auth_Number": "string",
"auth_Penalty": 0.1,
"auth_Required": "s",
"benefit_Code": "string",
"benefit_Rate_Applied": 0.1,
"billed_Price": 0.1,
"brand_Indicator": "s",
"buccal": true,
"cliA_Number": "string",
"coB_Amt": 0.1,
"coB_Hold": 0.1,
"coB_Mem_Resp": 0.1,
"coB_Savings": 0.1,
"coB_Savings_Used": 0.1,
"calendar_Year": "stri",
"capitation_Claim": true,
"check_ID": 0,
"co_Ins_Amt": 0.1,
"co_Pay_Amt": 0.1,
"currency_ID": "string",
"days_Supply": 0,
"ded_Credit_Amt": 0.1,
"deductible_Amt": 0.1,
"detail_Plan_Year": "string",
"diagnosis_Code": "string",
"discount_Amt": 0.1,
"dispense_As_Written": 0,
"distal": true,
"drug_Code": "string",
"drug_Quantity": 0.1,
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"error_Auth": "s",
"error_Benefit": "s",
"error_Count": "s",
"error_Covered": "s",
"error_Dates": "s",
"error_Diagnosis": "s",
"error_ExCode": "s",
"error_Modifier": "s",
"error_Place": "s",
"error_Price": "s",
"error_Procedure": "s",
"ex_Code": "string",
"ex_Code2": "string",
"ex_Code3": "string",
"fica": 0.1,
"facial": true,
"federal_Amount_To_Tax": 0.1,
"federal_Tax": 0.1,
"federal_Tax_Flat": 0.1,
"fill_Date": "2019-08-24T14:15:22Z",
"flex_Description": "string",
"formulary_Indicator": "s",
"incisal": true,
"interest": 0.1,
"labial": true,
"life_Benefit": "string",
"life_Benefit_Volume": 0.1,
"line_Control_Number": "string",
"lingual": true,
"local_Tax": 0.1,
"mail_Order_Indicator": "s",
"medicare_Amount_To_Tax": 0.1,
"medicare_Tax": 0.1,
"mesial": true,
"minutes_Per_Unit": 0.1,
"modifier": "string",
"modifier_2": "string",
"modifier_3": "string",
"modifier_4": "string",
"modifier_Units": 0.1,
"not_Covered_Amt": 0.1,
"occlusal": true,
"oral_Cavity_Designation_Code_1": "str",
"oral_Cavity_Designation_Code_2": "str",
"oral_Cavity_Designation_Code_3": "str",
"oral_Cavity_Designation_Code_4": "str",
"oral_Cavity_Designation_Code_5": "str",
"other_Deduction_Amount": 0.1,
"override_Benefit_Code": true,
"override_COB_Amt": true,
"override_Co_Ins_Amt": true,
"override_Co_Pay_Amt": true,
"override_Ded_Credit_Amt": true,
"override_Deductible_Amt": true,
"override_Federal_Tax": true,
"override_Local_Tax": true,
"override_Medicare_Tax": true,
"override_Not_Covered_Amt": true,
"override_Plan_Price": true,
"override_Social_Security": true,
"override_State_Tax": true,
"override_With_Hold_Amt": true,
"ppO_Price_Plan_Price_Diff": 0.1,
"paid_Amt": 0.1,
"partial_Loss": 0.1,
"payor_ID": "string",
"pharmacy_Name": "string",
"place_Of_Service": "strin",
"plan_Price": 0.1,
"premium_Deduction": 0.1,
"prescriber_ID": "string",
"prescription_Date": "2019-08-24T14:15:22Z",
"prescription_Number": "string",
"pricing_Method": "string",
"pricing_Rate": 0.1,
"principal": 0.1,
"procedure_Code": "string",
"procedure_Code2": "string",
"procedure_Code_Units": 0.1,
"qualifying_Payment_Amount": 0.1,
"reason_Code": 0,
"refill_Indicator": 0,
"repriced_Savings_Amount": 0.1,
"root": true,
"service_Date": "2019-08-24T14:15:22Z",
"service_Thru": "2019-08-24T14:15:22Z",
"socSec_Amount_To_Tax": 0.1,
"social_Security": 0.1,
"state_Amount_To_Tax": 0.1,
"state_Tax": 0.1,
"state_Tax_Flat": 0.1,
"state_Tax_State": "st",
"status_Code": "s",
"svc_Count": 0.1,
"taxable_Amount": 0.1,
"tooth_Number": 0,
"ucR_Price": 0.1,
"unit_Dose": 0,
"unit_Of_Measure": "st",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"with_Hold_Amt": 0.1
},
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

List ClaimBatchDetail

Lists all ClaimBatchDetail for the given batchNumber and batchClaim

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim

query Parameters

page	integer <int32> Default: 1 Page
pageSize	integer <int32> Default: 100 Page Size
sortBy	string Comma separated string to sort by. Each sort field can be followed by :asc or :desc to specify sort direction, ascending is default. E.g., 'Property1:desc,Property2:asc,Property3:asc' sorts Property1 in descending order, Property2 in ascending, and Property3 in ascending.

header Parameters

vbasoftware-database

required

string

Target database

Responses

200

Success

401

Unauthorized

get/claim-batches/{batchNumber}/claims/{batchClaim}/details

Request samples

C#
JavaScript
curl
Java

Response samples

No sample

Get ClaimBatchDetail

Gets ClaimBatchDetail

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim
claimSeq required	string Claim Seq
adjustmentSeq required	string Adjustment Seq

header Parameters

vbasoftware-database

required

string

Target database

Responses

200

Success

401

Unauthorized

get/claim-batches/{batchNumber}/claims/{batchClaim}/details/{claimSeq}/{adjustmentSeq}

Request samples

C#
JavaScript
curl
Java

Response samples

No sample

Update ClaimBatchDetail

Updates a specific ClaimBatchDetail.

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim
claimSeq required	string Claim Seq
adjustmentSeq required	string Adjustment Seq

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

batch_Number required	integer <int32> References the ClaimBatch.Batch_Number value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API.
batch_Claim required	integer <int32> References the ClaimBatch.Batch_Claim value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API.
claim_Seq required	string [ 1 .. 2 ] characters In combination with Adjustment_Seq, creates a unique sequence for each service line on this claim.
adjustment_Seq required	string [ 1 .. 3 ] characters In combination with Claim_Seq, creates a unique sequence for each service line on this claim. Used to note adjustments, cascading, etc. when utlized. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ansI_Code	string or null <= 8 characters No longer in use.
apC_Code	string or null <= 8 characters The APC code applied to this service if identified for calculation during adjudication.
account_Key	integer or null <int32> For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
adjusted_From_Adjustment_Line	string or null <= 3 characters References the Adjustment_Seq value on the original claim that this claim is adjusting.
adjusted_From_Line	string or null <= 2 characters References the Claim_Seq value on the original claim that this claim is adjusting.
auth_Number	string or null <= 20 characters The Auth Number for services that require authorization. References Auth.Auth_Number.
auth_Penalty	number or null <double> If an Auth Penalty is applied during adjudication, that is housed here.
auth_Required	string or null <= 1 characters Notes that this service lines required authorization.
benefit_Code	string or null <= 10 characters This is the benefit code assigned to this service line based on the Plan assigned on the Claim header. References BenefitCodes.Benefit_Code.
benefit_Rate_Applied	number or null <double> Benefit Rate being applied to this detail line.
billed_Price required	number <double> The billed charges assigned by the provider for this service. Note: This field is marked as NOT NULL in the database and therefore required by the API.
brand_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
buccal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cliA_Number	string or null <= 32 characters No longer in use.
coB_Amt required	number <double> Holds the Other Insurance calculated amount that would affect the payable amount for this service (calculated from COB_Hold, COB_Mem_Resp, COB_Savings, and COB_Savings_Used). Note: This field is marked as NOT NULL in the database and therefore required by the API.
coB_Hold	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Mem_Resp	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Savings	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Savings_Used	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
calendar_Year	string or null <= 4 characters Used for Flex Claims to indicate the calendar year this claim applies.
capitation_Claim required	boolean Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API.
check_ID	integer or null <int32> No longer in use.
co_Ins_Amt required	number <double> The co-insurance amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
co_Pay_Amt required	number <double> The co-pay amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
currency_ID	string or null <= 16 characters For currency calculations, this holds the destination currency.
days_Supply	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
ded_Credit_Amt	number or null <double> If the service is eligiblity for deductible credits, they would be stored here.
deductible_Amt required	number <double> The deductible amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
detail_Plan_Year	string or null <= 8 characters Indicates which Plan Year the service line correlates to from GroupPlanYear.Plan_Year
diagnosis_Code	string or null <= 8 characters The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.
discount_Amt required	number <double> The difference between Billed and Allowed is stored as the Discount Amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
dispense_As_Written	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
distal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
drug_Code	string or null <= 20 characters For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code.
drug_Quantity	number or null <double> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
entry_Date	string <date-time> Date when the record was first added to the system.
entry_User	string or null <= 20 characters User that first added the record to the system.
error_Auth	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Benefit	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Count	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Covered	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Dates	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Diagnosis	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_ExCode	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Modifier	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Place	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Price	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Procedure	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
ex_Code	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
ex_Code2	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
ex_Code3	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
fica required	number <double> The FICA tax amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
facial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
federal_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Federal "To Tax" amount for disability claim.
federal_Tax required	number <double> The calculated Federal tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
federal_Tax_Flat	number or null <double> A flat federal tax amount applied in addition to the calculated tax amount.
fill_Date	string or null <date-time> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
flex_Description	string or null <= 128 characters Manually entered description of this flex claim.
formulary_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
incisal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
interest required	number <double> If interest is calculated on a claim, it is stored here and applied to payable amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
labial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
life_Benefit	string or null <= 10 characters The Life Benefit to be applied for Life claims processing.
life_Benefit_Volume	number or null <double> The Life Benefit calculated volume based on benefit definition.
line_Control_Number	string or null <= 64 characters Number added manually to claims and from 837 files and sent outbound on 835 files.
lingual required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
local_Tax	number or null <double> If a locality tax is applicable it would be housed here. Note: The database will apply a default value of `0` for this field if a value is not provided.
mail_Order_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
medicare_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Medicare "To Tax" amount for disability claim.
medicare_Tax	number or null <double> The calculated Medicare tax amount based on the "To Tax" amount.
mesial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
minutes_Per_Unit	number or null <double> This is for anesthesia, each Unit of anesthesia is equal to a specific amount of Minutes.
modifier	string or null <= 8 characters The modifier applied to this service.
modifier_2	string or null <= 8 characters The modifier applied to this service.
modifier_3	string or null <= 8 characters The modifier applied to this service.
modifier_4	string or null <= 8 characters The modifier applied to this service.
modifier_Units	number or null <double> The number of the units from this detail line that comes from the Modifier. This determines pricing for the line.
not_Covered_Amt required	number <double> For not covered services, or partially not covered services, this reflects that deduction. Note: This field is marked as NOT NULL in the database and therefore required by the API.
occlusal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
oral_Cavity_Designation_Code_1	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_2	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_3	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_4	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_5	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
other_Deduction_Amount	number or null <double> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
override_Benefit_Code required	boolean This flag indicates if the benefit code has been overridden. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_COB_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Co_Ins_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Co_Pay_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Ded_Credit_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Deductible_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Federal_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Local_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Medicare_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Not_Covered_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Plan_Price required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Social_Security required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_State_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_With_Hold_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ppO_Price_Plan_Price_Diff	number or null <double> Information field used in custom processing and reporting.
paid_Amt required	number <double> The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: This field is marked as NOT NULL in the database and therefore required by the API.
partial_Loss required	number <double> The partial loss amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
payor_ID	string or null <= 20 characters For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
pharmacy_Name	string or null <= 128 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
place_Of_Service	string or null <= 5 characters The place of service for the services being rendered on this service line.
plan_Price required	number <double> The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: This field is marked as NOT NULL in the database and therefore required by the API.
premium_Deduction required	number <double> The premium deduction amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
prescriber_ID	string or null <= 32 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
prescription_Date	string or null <date-time> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
prescription_Number	string or null <= 50 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
pricing_Method	string or null <= 8 characters For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.
pricing_Rate	number or null <double> The rate associated with the reprice method (Pricing_Method).
principal required	number <double> For life claims, this holds the principal amount for reporting. Note: This field is marked as NOT NULL in the database and therefore required by the API.
procedure_Code	string or null <= 8 characters The service being rendered on this claim.
procedure_Code2	string or null <= 8 characters The secondary service being rendered on this claim.
procedure_Code_Units	number or null <double> The number of th eunits from this detail line that comes from the Prtocedure Code. This determines pricing for the line.
qualifying_Payment_Amount	number or null <double> QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.
reason_Code	integer or null <int32> No longer in use.
refill_Indicator	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
repriced_Savings_Amount	number or null <double> Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.
root required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
service_Date	string or null <date-time> The start date of the services being rendered.
service_Thru	string or null <date-time> The end date of the services being rendered.
socSec_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Social Security "To Tax" amount for disability claim.
social_Security required	number <double> The calculated Social Security tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
state_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the State "To Tax" amount for disability claim.
state_Tax required	number <double> The calculated State tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
state_Tax_Flat	number or null <double> A flat state tax amount applied in addition to the calculated tax amount.
state_Tax_State	string or null <= 2 characters When state taxes are calculated, this indicates the state the tax amount was calculated against.
status_Code	string or null <= 1 characters Holds the individaul status of this service line based on Ex Codes. A - Payable, D - Denied, E - Pended.
svc_Count	number or null <double> The units applied to this service.
taxable_Amount	number or null <double> This holds the starting taxable amount based on pre-tax and pre-gross deductions applied to this service.
tooth_Number	integer or null <int32> For dental claims, this identifies the tooth, quadrant or arch being worked for this service.
ucR_Price required	number <double> No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.
unit_Dose	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
unit_Of_Measure	string or null <= 2 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
update_Date	string <date-time> Date when the record was last updated in the system.
update_User	string or null <= 20 characters User that last updated the record in the system.
with_Hold_Amt required	number <double> For plans that allow withhold, this amount is used to track that amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.

Responses

200

Success

401

Unauthorized

put/claim-batches/{batchNumber}/claims/{batchClaim}/details/{claimSeq}/{adjustmentSeq}

Request samples

Payload
C#
JavaScript
curl
Java

{"batch_Number": 0,
"batch_Claim": 0,
"claim_Seq": "st",
"adjustment_Seq": "str",
"ansI_Code": "string",
"apC_Code": "string",
"account_Key": 0,
"adjusted_From_Adjustment_Line": "str",
"adjusted_From_Line": "st",
"auth_Number": "string",
"auth_Penalty": 0.1,
"auth_Required": "s",
"benefit_Code": "string",
"benefit_Rate_Applied": 0.1,
"billed_Price": 0.1,
"brand_Indicator": "s",
"buccal": true,
"cliA_Number": "string",
"coB_Amt": 0.1,
"coB_Hold": 0.1,
"coB_Mem_Resp": 0.1,
"coB_Savings": 0.1,
"coB_Savings_Used": 0.1,
"calendar_Year": "stri",
"capitation_Claim": true,
"check_ID": 0,
"co_Ins_Amt": 0.1,
"co_Pay_Amt": 0.1,
"currency_ID": "string",
"days_Supply": 0,
"ded_Credit_Amt": 0.1,
"deductible_Amt": 0.1,
"detail_Plan_Year": "string",
"diagnosis_Code": "string",
"discount_Amt": 0.1,
"dispense_As_Written": 0,
"distal": true,
"drug_Code": "string",
"drug_Quantity": 0.1,
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"error_Auth": "s",
"error_Benefit": "s",
"error_Count": "s",
"error_Covered": "s",
"error_Dates": "s",
"error_Diagnosis": "s",
"error_ExCode": "s",
"error_Modifier": "s",
"error_Place": "s",
"error_Price": "s",
"error_Procedure": "s",
"ex_Code": "string",
"ex_Code2": "string",
"ex_Code3": "string",
"fica": 0.1,
"facial": true,
"federal_Amount_To_Tax": 0.1,
"federal_Tax": 0.1,
"federal_Tax_Flat": 0.1,
"fill_Date": "2019-08-24T14:15:22Z",
"flex_Description": "string",
"formulary_Indicator": "s",
"incisal": true,
"interest": 0.1,
"labial": true,
"life_Benefit": "string",
"life_Benefit_Volume": 0.1,
"line_Control_Number": "string",
"lingual": true,
"local_Tax": 0.1,
"mail_Order_Indicator": "s",
"medicare_Amount_To_Tax": 0.1,
"medicare_Tax": 0.1,
"mesial": true,
"minutes_Per_Unit": 0.1,
"modifier": "string",
"modifier_2": "string",
"modifier_3": "string",
"modifier_4": "string",
"modifier_Units": 0.1,
"not_Covered_Amt": 0.1,
"occlusal": true,
"oral_Cavity_Designation_Code_1": "str",
"oral_Cavity_Designation_Code_2": "str",
"oral_Cavity_Designation_Code_3": "str",
"oral_Cavity_Designation_Code_4": "str",
"oral_Cavity_Designation_Code_5": "str",
"other_Deduction_Amount": 0.1,
"override_Benefit_Code": true,
"override_COB_Amt": true,
"override_Co_Ins_Amt": true,
"override_Co_Pay_Amt": true,
"override_Ded_Credit_Amt": true,
"override_Deductible_Amt": true,
"override_Federal_Tax": true,
"override_Local_Tax": true,
"override_Medicare_Tax": true,
"override_Not_Covered_Amt": true,
"override_Plan_Price": true,
"override_Social_Security": true,
"override_State_Tax": true,
"override_With_Hold_Amt": true,
"ppO_Price_Plan_Price_Diff": 0.1,
"paid_Amt": 0.1,
"partial_Loss": 0.1,
"payor_ID": "string",
"pharmacy_Name": "string",
"place_Of_Service": "strin",
"plan_Price": 0.1,
"premium_Deduction": 0.1,
"prescriber_ID": "string",
"prescription_Date": "2019-08-24T14:15:22Z",
"prescription_Number": "string",
"pricing_Method": "string",
"pricing_Rate": 0.1,
"principal": 0.1,
"procedure_Code": "string",
"procedure_Code2": "string",
"procedure_Code_Units": 0.1,
"qualifying_Payment_Amount": 0.1,
"reason_Code": 0,
"refill_Indicator": 0,
"repriced_Savings_Amount": 0.1,
"root": true,
"service_Date": "2019-08-24T14:15:22Z",
"service_Thru": "2019-08-24T14:15:22Z",
"socSec_Amount_To_Tax": 0.1,
"social_Security": 0.1,
"state_Amount_To_Tax": 0.1,
"state_Tax": 0.1,
"state_Tax_Flat": 0.1,
"state_Tax_State": "st",
"status_Code": "s",
"svc_Count": 0.1,
"taxable_Amount": 0.1,
"tooth_Number": 0,
"ucR_Price": 0.1,
"unit_Dose": 0,
"unit_Of_Measure": "st",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"with_Hold_Amt": 0.1
}

Response samples

{"data": {"batch_Number": 0,
"batch_Claim": 0,
"claim_Seq": "st",
"adjustment_Seq": "str",
"ansI_Code": "string",
"apC_Code": "string",
"account_Key": 0,
"adjusted_From_Adjustment_Line": "str",
"adjusted_From_Line": "st",
"auth_Number": "string",
"auth_Penalty": 0.1,
"auth_Required": "s",
"benefit_Code": "string",
"benefit_Rate_Applied": 0.1,
"billed_Price": 0.1,
"brand_Indicator": "s",
"buccal": true,
"cliA_Number": "string",
"coB_Amt": 0.1,
"coB_Hold": 0.1,
"coB_Mem_Resp": 0.1,
"coB_Savings": 0.1,
"coB_Savings_Used": 0.1,
"calendar_Year": "stri",
"capitation_Claim": true,
"check_ID": 0,
"co_Ins_Amt": 0.1,
"co_Pay_Amt": 0.1,
"currency_ID": "string",
"days_Supply": 0,
"ded_Credit_Amt": 0.1,
"deductible_Amt": 0.1,
"detail_Plan_Year": "string",
"diagnosis_Code": "string",
"discount_Amt": 0.1,
"dispense_As_Written": 0,
"distal": true,
"drug_Code": "string",
"drug_Quantity": 0.1,
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"error_Auth": "s",
"error_Benefit": "s",
"error_Count": "s",
"error_Covered": "s",
"error_Dates": "s",
"error_Diagnosis": "s",
"error_ExCode": "s",
"error_Modifier": "s",
"error_Place": "s",
"error_Price": "s",
"error_Procedure": "s",
"ex_Code": "string",
"ex_Code2": "string",
"ex_Code3": "string",
"fica": 0.1,
"facial": true,
"federal_Amount_To_Tax": 0.1,
"federal_Tax": 0.1,
"federal_Tax_Flat": 0.1,
"fill_Date": "2019-08-24T14:15:22Z",
"flex_Description": "string",
"formulary_Indicator": "s",
"incisal": true,
"interest": 0.1,
"labial": true,
"life_Benefit": "string",
"life_Benefit_Volume": 0.1,
"line_Control_Number": "string",
"lingual": true,
"local_Tax": 0.1,
"mail_Order_Indicator": "s",
"medicare_Amount_To_Tax": 0.1,
"medicare_Tax": 0.1,
"mesial": true,
"minutes_Per_Unit": 0.1,
"modifier": "string",
"modifier_2": "string",
"modifier_3": "string",
"modifier_4": "string",
"modifier_Units": 0.1,
"not_Covered_Amt": 0.1,
"occlusal": true,
"oral_Cavity_Designation_Code_1": "str",
"oral_Cavity_Designation_Code_2": "str",
"oral_Cavity_Designation_Code_3": "str",
"oral_Cavity_Designation_Code_4": "str",
"oral_Cavity_Designation_Code_5": "str",
"other_Deduction_Amount": 0.1,
"override_Benefit_Code": true,
"override_COB_Amt": true,
"override_Co_Ins_Amt": true,
"override_Co_Pay_Amt": true,
"override_Ded_Credit_Amt": true,
"override_Deductible_Amt": true,
"override_Federal_Tax": true,
"override_Local_Tax": true,
"override_Medicare_Tax": true,
"override_Not_Covered_Amt": true,
"override_Plan_Price": true,
"override_Social_Security": true,
"override_State_Tax": true,
"override_With_Hold_Amt": true,
"ppO_Price_Plan_Price_Diff": 0.1,
"paid_Amt": 0.1,
"partial_Loss": 0.1,
"payor_ID": "string",
"pharmacy_Name": "string",
"place_Of_Service": "strin",
"plan_Price": 0.1,
"premium_Deduction": 0.1,
"prescriber_ID": "string",
"prescription_Date": "2019-08-24T14:15:22Z",
"prescription_Number": "string",
"pricing_Method": "string",
"pricing_Rate": 0.1,
"principal": 0.1,
"procedure_Code": "string",
"procedure_Code2": "string",
"procedure_Code_Units": 0.1,
"qualifying_Payment_Amount": 0.1,
"reason_Code": 0,
"refill_Indicator": 0,
"repriced_Savings_Amount": 0.1,
"root": true,
"service_Date": "2019-08-24T14:15:22Z",
"service_Thru": "2019-08-24T14:15:22Z",
"socSec_Amount_To_Tax": 0.1,
"social_Security": 0.1,
"state_Amount_To_Tax": 0.1,
"state_Tax": 0.1,
"state_Tax_Flat": 0.1,
"state_Tax_State": "st",
"status_Code": "s",
"svc_Count": 0.1,
"taxable_Amount": 0.1,
"tooth_Number": 0,
"ucR_Price": 0.1,
"unit_Dose": 0,
"unit_Of_Measure": "st",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"with_Hold_Amt": 0.1
},
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

Delete ClaimBatchDetail

Deletes an ClaimBatchDetail

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim
claimSeq required	string Claim Seq
adjustmentSeq required	string Adjustment Seq

header Parameters

vbasoftware-database

required

string

Target database

Responses

204

Success

401

Unauthorized

delete/claim-batches/{batchNumber}/claims/{batchClaim}/details/{claimSeq}/{adjustmentSeq}

Request samples

C#
JavaScript
curl
Java

Create or Update Batch ClaimBatchDetail

Create or Update multiple ClaimBatchDetail at once. If the entity exists, it will be updated. If the entity does not exist, it will be created.

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

Array

batch_Number required	integer <int32> References the ClaimBatch.Batch_Number value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API.
batch_Claim required	integer <int32> References the ClaimBatch.Batch_Claim value on the parent record. Note: This field is marked as NOT NULL in the database and therefore required by the API.
claim_Seq required	string [ 1 .. 2 ] characters In combination with Adjustment_Seq, creates a unique sequence for each service line on this claim.
adjustment_Seq required	string [ 1 .. 3 ] characters In combination with Claim_Seq, creates a unique sequence for each service line on this claim. Used to note adjustments, cascading, etc. when utlized. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ansI_Code	string or null <= 8 characters No longer in use.
apC_Code	string or null <= 8 characters The APC code applied to this service if identified for calculation during adjudication.
account_Key	integer or null <int32> For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
adjusted_From_Adjustment_Line	string or null <= 3 characters References the Adjustment_Seq value on the original claim that this claim is adjusting.
adjusted_From_Line	string or null <= 2 characters References the Claim_Seq value on the original claim that this claim is adjusting.
auth_Number	string or null <= 20 characters The Auth Number for services that require authorization. References Auth.Auth_Number.
auth_Penalty	number or null <double> If an Auth Penalty is applied during adjudication, that is housed here.
auth_Required	string or null <= 1 characters Notes that this service lines required authorization.
benefit_Code	string or null <= 10 characters This is the benefit code assigned to this service line based on the Plan assigned on the Claim header. References BenefitCodes.Benefit_Code.
benefit_Rate_Applied	number or null <double> Benefit Rate being applied to this detail line.
billed_Price required	number <double> The billed charges assigned by the provider for this service. Note: This field is marked as NOT NULL in the database and therefore required by the API.
brand_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
buccal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cliA_Number	string or null <= 32 characters No longer in use.
coB_Amt required	number <double> Holds the Other Insurance calculated amount that would affect the payable amount for this service (calculated from COB_Hold, COB_Mem_Resp, COB_Savings, and COB_Savings_Used). Note: This field is marked as NOT NULL in the database and therefore required by the API.
coB_Hold	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Mem_Resp	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Savings	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
coB_Savings_Used	number or null <double> Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
calendar_Year	string or null <= 4 characters Used for Flex Claims to indicate the calendar year this claim applies.
capitation_Claim required	boolean Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: This field is marked as NOT NULL in the database and therefore required by the API.
check_ID	integer or null <int32> No longer in use.
co_Ins_Amt required	number <double> The co-insurance amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
co_Pay_Amt required	number <double> The co-pay amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
currency_ID	string or null <= 16 characters For currency calculations, this holds the destination currency.
days_Supply	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
ded_Credit_Amt	number or null <double> If the service is eligiblity for deductible credits, they would be stored here.
deductible_Amt required	number <double> The deductible amount applied by adjudication based on benefit definition. Note: This field is marked as NOT NULL in the database and therefore required by the API.
detail_Plan_Year	string or null <= 8 characters Indicates which Plan Year the service line correlates to from GroupPlanYear.Plan_Year
diagnosis_Code	string or null <= 8 characters The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.
discount_Amt required	number <double> The difference between Billed and Allowed is stored as the Discount Amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
dispense_As_Written	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
distal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
drug_Code	string or null <= 20 characters For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code.
drug_Quantity	number or null <double> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
entry_Date	string <date-time> Date when the record was first added to the system.
entry_User	string or null <= 20 characters User that first added the record to the system.
error_Auth	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Benefit	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Count	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Covered	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Dates	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Diagnosis	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_ExCode	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Modifier	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Place	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Price	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
error_Procedure	string or null <= 1 characters During adjudication, this holds the results of claim rules associated with this error code. For a list of valid Error Codes, check the ErrorCategoryType table.
ex_Code	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
ex_Code2	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
ex_Code3	string or null <= 6 characters A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
fica required	number <double> The FICA tax amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
facial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
federal_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Federal "To Tax" amount for disability claim.
federal_Tax required	number <double> The calculated Federal tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
federal_Tax_Flat	number or null <double> A flat federal tax amount applied in addition to the calculated tax amount.
fill_Date	string or null <date-time> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
flex_Description	string or null <= 128 characters Manually entered description of this flex claim.
formulary_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
incisal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
interest required	number <double> If interest is calculated on a claim, it is stored here and applied to payable amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
labial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
life_Benefit	string or null <= 10 characters The Life Benefit to be applied for Life claims processing.
life_Benefit_Volume	number or null <double> The Life Benefit calculated volume based on benefit definition.
line_Control_Number	string or null <= 64 characters Number added manually to claims and from 837 files and sent outbound on 835 files.
lingual required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
local_Tax	number or null <double> If a locality tax is applicable it would be housed here. Note: The database will apply a default value of `0` for this field if a value is not provided.
mail_Order_Indicator	string or null <= 1 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
medicare_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Medicare "To Tax" amount for disability claim.
medicare_Tax	number or null <double> The calculated Medicare tax amount based on the "To Tax" amount.
mesial required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
minutes_Per_Unit	number or null <double> This is for anesthesia, each Unit of anesthesia is equal to a specific amount of Minutes.
modifier	string or null <= 8 characters The modifier applied to this service.
modifier_2	string or null <= 8 characters The modifier applied to this service.
modifier_3	string or null <= 8 characters The modifier applied to this service.
modifier_4	string or null <= 8 characters The modifier applied to this service.
modifier_Units	number or null <double> The number of the units from this detail line that comes from the Modifier. This determines pricing for the line.
not_Covered_Amt required	number <double> For not covered services, or partially not covered services, this reflects that deduction. Note: This field is marked as NOT NULL in the database and therefore required by the API.
occlusal required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
oral_Cavity_Designation_Code_1	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_2	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_3	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_4	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
oral_Cavity_Designation_Code_5	string or null <= 3 characters For dental claims this holds the oral cavity designation sent on the 837D.
other_Deduction_Amount	number or null <double> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
override_Benefit_Code required	boolean This flag indicates if the benefit code has been overridden. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_COB_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Co_Ins_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Co_Pay_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Ded_Credit_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Deductible_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Federal_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Local_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Medicare_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Not_Covered_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Plan_Price required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_Social_Security required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_State_Tax required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
override_With_Hold_Amt required	boolean Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ppO_Price_Plan_Price_Diff	number or null <double> Information field used in custom processing and reporting.
paid_Amt required	number <double> The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: This field is marked as NOT NULL in the database and therefore required by the API.
partial_Loss required	number <double> The partial loss amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
payor_ID	string or null <= 20 characters For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
pharmacy_Name	string or null <= 128 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
place_Of_Service	string or null <= 5 characters The place of service for the services being rendered on this service line.
plan_Price required	number <double> The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: This field is marked as NOT NULL in the database and therefore required by the API.
premium_Deduction required	number <double> The premium deduction amount for disability claims. Note: This field is marked as NOT NULL in the database and therefore required by the API.
prescriber_ID	string or null <= 32 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
prescription_Date	string or null <date-time> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
prescription_Number	string or null <= 50 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
pricing_Method	string or null <= 8 characters For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.
pricing_Rate	number or null <double> The rate associated with the reprice method (Pricing_Method).
principal required	number <double> For life claims, this holds the principal amount for reporting. Note: This field is marked as NOT NULL in the database and therefore required by the API.
procedure_Code	string or null <= 8 characters The service being rendered on this claim.
procedure_Code2	string or null <= 8 characters The secondary service being rendered on this claim.
procedure_Code_Units	number or null <double> The number of th eunits from this detail line that comes from the Prtocedure Code. This determines pricing for the line.
qualifying_Payment_Amount	number or null <double> QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.
reason_Code	integer or null <int32> No longer in use.
refill_Indicator	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
repriced_Savings_Amount	number or null <double> Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.
root required	boolean For dental claims, notes if this surface had services rendered. Note: This field is marked as NOT NULL in the database and therefore required by the API.
service_Date	string or null <date-time> The start date of the services being rendered.
service_Thru	string or null <date-time> The end date of the services being rendered.
socSec_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the Social Security "To Tax" amount for disability claim.
social_Security required	number <double> The calculated Social Security tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
state_Amount_To_Tax	number or null <double> Based on taxable amount and various configurations, this holds the State "To Tax" amount for disability claim.
state_Tax required	number <double> The calculated State tax amount based on the "To Tax" amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
state_Tax_Flat	number or null <double> A flat state tax amount applied in addition to the calculated tax amount.
state_Tax_State	string or null <= 2 characters When state taxes are calculated, this indicates the state the tax amount was calculated against.
status_Code	string or null <= 1 characters Holds the individaul status of this service line based on Ex Codes. A - Payable, D - Denied, E - Pended.
svc_Count	number or null <double> The units applied to this service.
taxable_Amount	number or null <double> This holds the starting taxable amount based on pre-tax and pre-gross deductions applied to this service.
tooth_Number	integer or null <int32> For dental claims, this identifies the tooth, quadrant or arch being worked for this service.
ucR_Price required	number <double> No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.
unit_Dose	integer or null <int32> Pharmacy claim information submitted via file submission and used in reporting and interfaces.
unit_Of_Measure	string or null <= 2 characters Pharmacy claim information submitted via file submission and used in reporting and interfaces.
update_Date	string <date-time> Date when the record was last updated in the system.
update_User	string or null <= 20 characters User that last updated the record in the system.
with_Hold_Amt required	number <double> For plans that allow withhold, this amount is used to track that amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.

Responses

207

Success

401

Unauthorized

put/claim-batches/{batchNumber}/claims/{batchClaim}/details-batch

Request samples

Payload
C#
JavaScript
curl
Java

[{"batch_Number": 0,
"batch_Claim": 0,
"claim_Seq": "st",
"adjustment_Seq": "str",
"ansI_Code": "string",
"apC_Code": "string",
"account_Key": 0,
"adjusted_From_Adjustment_Line": "str",
"adjusted_From_Line": "st",
"auth_Number": "string",
"auth_Penalty": 0.1,
"auth_Required": "s",
"benefit_Code": "string",
"benefit_Rate_Applied": 0.1,
"billed_Price": 0.1,
"brand_Indicator": "s",
"buccal": true,
"cliA_Number": "string",
"coB_Amt": 0.1,
"coB_Hold": 0.1,
"coB_Mem_Resp": 0.1,
"coB_Savings": 0.1,
"coB_Savings_Used": 0.1,
"calendar_Year": "stri",
"capitation_Claim": true,
"check_ID": 0,
"co_Ins_Amt": 0.1,
"co_Pay_Amt": 0.1,
"currency_ID": "string",
"days_Supply": 0,
"ded_Credit_Amt": 0.1,
"deductible_Amt": 0.1,
"detail_Plan_Year": "string",
"diagnosis_Code": "string",
"discount_Amt": 0.1,
"dispense_As_Written": 0,
"distal": true,
"drug_Code": "string",
"drug_Quantity": 0.1,
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"error_Auth": "s",
"error_Benefit": "s",
"error_Count": "s",
"error_Covered": "s",
"error_Dates": "s",
"error_Diagnosis": "s",
"error_ExCode": "s",
"error_Modifier": "s",
"error_Place": "s",
"error_Price": "s",
"error_Procedure": "s",
"ex_Code": "string",
"ex_Code2": "string",
"ex_Code3": "string",
"fica": 0.1,
"facial": true,
"federal_Amount_To_Tax": 0.1,
"federal_Tax": 0.1,
"federal_Tax_Flat": 0.1,
"fill_Date": "2019-08-24T14:15:22Z",
"flex_Description": "string",
"formulary_Indicator": "s",
"incisal": true,
"interest": 0.1,
"labial": true,
"life_Benefit": "string",
"life_Benefit_Volume": 0.1,
"line_Control_Number": "string",
"lingual": true,
"local_Tax": 0.1,
"mail_Order_Indicator": "s",
"medicare_Amount_To_Tax": 0.1,
"medicare_Tax": 0.1,
"mesial": true,
"minutes_Per_Unit": 0.1,
"modifier": "string",
"modifier_2": "string",
"modifier_3": "string",
"modifier_4": "string",
"modifier_Units": 0.1,
"not_Covered_Amt": 0.1,
"occlusal": true,
"oral_Cavity_Designation_Code_1": "str",
"oral_Cavity_Designation_Code_2": "str",
"oral_Cavity_Designation_Code_3": "str",
"oral_Cavity_Designation_Code_4": "str",
"oral_Cavity_Designation_Code_5": "str",
"other_Deduction_Amount": 0.1,
"override_Benefit_Code": true,
"override_COB_Amt": true,
"override_Co_Ins_Amt": true,
"override_Co_Pay_Amt": true,
"override_Ded_Credit_Amt": true,
"override_Deductible_Amt": true,
"override_Federal_Tax": true,
"override_Local_Tax": true,
"override_Medicare_Tax": true,
"override_Not_Covered_Amt": true,
"override_Plan_Price": true,
"override_Social_Security": true,
"override_State_Tax": true,
"override_With_Hold_Amt": true,
"ppO_Price_Plan_Price_Diff": 0.1,
"paid_Amt": 0.1,
"partial_Loss": 0.1,
"payor_ID": "string",
"pharmacy_Name": "string",
"place_Of_Service": "strin",
"plan_Price": 0.1,
"premium_Deduction": 0.1,
"prescriber_ID": "string",
"prescription_Date": "2019-08-24T14:15:22Z",
"prescription_Number": "string",
"pricing_Method": "string",
"pricing_Rate": 0.1,
"principal": 0.1,
"procedure_Code": "string",
"procedure_Code2": "string",
"procedure_Code_Units": 0.1,
"qualifying_Payment_Amount": 0.1,
"reason_Code": 0,
"refill_Indicator": 0,
"repriced_Savings_Amount": 0.1,
"root": true,
"service_Date": "2019-08-24T14:15:22Z",
"service_Thru": "2019-08-24T14:15:22Z",
"socSec_Amount_To_Tax": 0.1,
"social_Security": 0.1,
"state_Amount_To_Tax": 0.1,
"state_Tax": 0.1,
"state_Tax_Flat": 0.1,
"state_Tax_State": "st",
"status_Code": "s",
"svc_Count": 0.1,
"taxable_Amount": 0.1,
"tooth_Number": 0,
"ucR_Price": 0.1,
"unit_Dose": 0,
"unit_Of_Measure": "st",
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"with_Hold_Amt": 0.1
}
]

Response samples

{"data": [{"id": [{"key": "string",
"value": "string"
}
],
"status": 0,
"body": "string"
}
],
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

List matching benefit detail Advanced API

List of potential benefit matches along with a match count for a specific claim service line.

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

batchNumber required	integer <int32> Batch Number
batchClaim required	integer <int32> Batch Claim
claimSeq required	string Claim Seq

query Parameters

planId	string Plan ID
providerId	string Provider ID
providerType	string Provider Type

header Parameters

vbasoftware-database

required

string

Target database

Responses

200

Success

401

Unauthorized

get/claim-batches/{batchNumber}/claims/{batchClaim}/details/{claimSeq}/adjudicate-benefit-match

Request samples

C#
JavaScript
curl
Java

Response samples

No sample

Claim Batch Details

Create ClaimBatchDetail

path Parameters

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

List ClaimBatchDetail

path Parameters

query Parameters

header Parameters

Get ClaimBatchDetail

path Parameters

header Parameters

Update ClaimBatchDetail

path Parameters

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

Delete ClaimBatchDetail

path Parameters

header Parameters

Create or Update Batch ClaimBatchDetail

path Parameters

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

List matching benefit detail Advanced API

path Parameters

query Parameters

header Parameters

Request Body schema:
application/json
required

Request Body schema:
application/json
required

Request Body schema:
application/json
required