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MedicalProcedureClaimResource

Medical-procedure claim retrieved from OSIGU.

claim_idinteger<int64>

Claim identifier. Long integer.

sponsor_transaction_idstring

Transaction identifier assigned by the sponsor for this claim.

amountnumber

Total claim amount. Decimal number.

copaymentnumber

Amount the beneficiary must pay out-of-pocket. Decimal number.

coinsurancenumber

Coinsurance portion of the claim. Decimal number.

products object[]

Product lines included in the claim.

  • Array [
    • product_idinteger<int64>required

    OSIGU product identifier.

    actionstring

    Update action to apply to this line. Values include ADD, REMOVE, UPDATE.

    provider_slugstring

    Slug of the provider that will dispense this product.

    provider_product_codestring

    Provider-side SKU or code for this product.

    authorized_quantityinteger<int32>

    Number of units the sponsor has authorized.

    statusstring

    Line status after the update (for example, APPROVED, REJECTED).

    reasonstring

    Free-text explanation of the current status.

  • ]
    • additional_notesstring

    Free-text notes recorded with the claim.

    statusstring

    Current lifecycle status of the medical-procedure claim.

    Possible values: [IN_PROGRESS, UPDATE_IN_PROGRESS, EXPIRATION_IN_PROGRESS, EXPIRED, CANCELED, READY, COMPLETED, VOIDED, ERROR, FAILED, PAID]