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Complete a claim after service is rendered

Once a service has been rendered, you file a claim — the record of what actually happened, which the sponsor uses to pay the provider. This guide covers the outpatient-care claim, which is the most common shape. The medical-procedure claim follows the same pattern but with a narrower scope (one procedure, one authorization).

Before starting, make sure you understand Claims — this guide shows how; the concept page explains why.

Prerequisites​

  • A completed pre-authorization (authorization_id) for the service just rendered. You can also file a claim without an authorization for some countries — the sponsor's rules apply.
  • The provider products for the line items are already registered.
  • Access to an OAuth token with arc:write scope.

1. Create the claim shell​

curl -X POST "https://sandbox.osigu.com/arc/v1/outpatient-care-claim" \
  -H "Authorization: Bearer $TOKEN" \
  -H "Content-Type: application/json" \
  -d '{
    "beneficiary_id": "bnf_01HW8GQ2KMNP3F4R5T6Y7U8I9O",
    "sponsor_slug": "sponsor-sandbox",
    "authorization_id": "auth_01HXA...",
    "diagnosis_code": "R51",
    "line_items": [
      { "product_code": "CONS-GEN", "product_type": "PROCEDURE", "quantity": 1 },
      { "product_code": "LAB-HEMO",  "product_type": "LAB",       "quantity": 1 }
    ]
  }'

Response (201):

{
  "claim_id": "clm_01HXBFP...",
  "status": "OPEN",
  "created_at": "2026-06-25T14:00:12Z"
}

The claim is now OPEN — you can still modify it, add attachments, or void.

2. Retrieve to inspect​

curl "https://sandbox.osigu.com/arc/v1/outpatient-care-claim/clm_01HXBFP..." \
  -H "Authorization: Bearer $TOKEN"

Verify each line item is what you meant. The response also lists any authorization files inherited from the pre-authorization step — those follow the claim automatically.

3. Attach any additional evidence (optional)​

If the sponsor accepts post-service evidence — a signed patient discharge note, an itemised invoice — list attached files with getClaimAuthorizationFiles. Additional documents are usually uploaded via the settlement-batch flow (for Dominican Republic) or via the pre-authorization step (for real-time sponsors).

4. Complete the claim​

Signal Osigu the claim is closed and ready to be included in the next settlement / real-time submission:

curl -X POST "https://sandbox.osigu.com/arc/v1/providers/$PROVIDER_SLUG/outpatient-care-claim/clm_01HXBFP.../complete" \
  -H "Authorization: Bearer $TOKEN"

Response (200):

{
  "claim_id": "clm_01HXBFP...",
  "status": "COMPLETED",
  "completed_at": "2026-06-25T14:10:44Z"
}

Once COMPLETED you can no longer edit line items. To fix a mistake, void and re-create.

5. Void if you need to unwind​

Before the claim reaches SETTLED, you can cancel it:

curl -X POST "https://sandbox.osigu.com/arc/v1/outpatient-care-claim/clm_01HXBFP.../void" \
  -H "Authorization: Bearer $TOKEN" \
  -H "Content-Type: application/json" \
  -d '{"reason":"Wrong diagnosis code"}'

After it's in SETTLED, void isn't allowed — you'd have to work with sponsor operations to reverse.

Medical-procedure claim variant​

Same pattern, different endpoint:

Single line item, always tied to an authorization. No complete call — it goes straight to COMPLETED on creation because there are no line items to add later.