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ProviderClaimResourceV2

idinteger<int64>
beneficiary_idinteger<int64>
sponsor_slugstring
sponsor_transaction_idstring
amountnumber
copaymentnumber
doctor_medical_license_numberstring
doctor_country_codestring
doctor_specialty_namestring
doctor_namestring
provider_transaction_idstring
biometric_reading_idstring
diagnoses object[]
  • Array [
  • coding_systemstringrequired

    Coding system used for the diagnosis (for example, ICD-10, CIE-10).

    codestringrequired

    Diagnosis code within the coding system.

    typestring

    Diagnosis type as a free-form string.

    type_enumstring

    Diagnosis type. One of CHIEF_COMPLAINT, DIFFERENTIAL_DIAGNOSIS, MEDICAL_DIAGNOSIS.

    Role of the diagnosis in the encounter.

    • CHIEF_COMPLAINT: the primary reason the beneficiary sought care.
    • DIFFERENTIAL_DIAGNOSIS: an alternative diagnosis being considered.
    • MEDICAL_DIAGNOSIS: the confirmed medical diagnosis.

    Possible values: [CHIEF_COMPLAINT, DIFFERENTIAL_DIAGNOSIS, MEDICAL_DIAGNOSIS]

  • ]
  • statusstring
    beneficiary_namestring
    beneficiary_member_codestring
    sponsor_namestring
    transaction_typestring
    product_typestring
    settlement_idstring
    sponsor_product_codestring
    satisfies_document_policyboolean
    authorization_request_idinteger<int64>
    authorization_idinteger<int64>
    files object[]
  • Array [
  • idstring
    original_namestring
    extensionstring
    file_pathstring
    fallback_namestring
    slugstring
  • ]
  • products object[]
  • 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.

  • ]
  • is_required_external_sponsor_validationsboolean
    treatments object[]
  • Array [
  • brandstring
    compositionstring
    indicationstring[]
  • ]