Claim
A claim (CMS1500) with snapshot data for submitted claims, live data for drafts, and correction tracking
Fields
accept_assignment
· Boolean · Whether assignment is accepted additional_claim_information
· String · Additional claim info from Box 19 amount_paid
· String · Amount paid by the patient billing_provider
· ClaimProvider · Billing provider / organization info claim_codes
· String · Condition codes from Box 10d claim_md_rejection_messages
· [ClaimMdMessage!]!
· required · Most recent Claim MD rejection messages claim_submissions
· ClaimSubmissionPaginationConnection!
· required · Submission history for this claim client_sig_on_file
· Boolean · Whether the client signature is on file coordination_of_benefits
· CoordinationOfBenefits · COB data derived from primary claim ERA and manual overrides has_claim_submission_claim_data
· Boolean!
· required · Whether frozen claim submission data exists for this claim include_referrer_information
· Boolean · Whether referrer information should be included insured_sig_on_file
· Boolean · Whether the insured signature is on file org_info
· OrganizationInfo · The Organization Info in use on this claim original_claim
· Claim · The parent claim if this is a correction original_claim_id
· ID · The ID of the original claim if this is a correction original_reference_number
· String · Original reference number from Box 22 patient
· ClaimPatient · Patient demographics patient_account_num
· String · Patient account number payer_order
· PayerOrder · Whether this is a primary or secondary claim primary_claim
· Claim · The primary claim if this is a secondary claim primary_claim_id
· ID · The ID of the primary claim if this is a secondary claim prior_authorization_number
· String · Prior authorization number from Box 23 referral_info
· ClaimReferralInfo · Referral information referring_provider
· ClaimProvider · Referring provider rendering_provider
· ClaimProvider · Rendering provider resubmission_code
· String · Frequency/resubmission code from Box 22 service_location
· ClaimLocation · Service location submission_method
· String · Submission method (e.g. office_ally, change_health, manual) submitted_at
· ISO8601DateTime · Timestamp when the claim was last submitted use_indiv_npi
· Boolean · Whether the claim uses the individual NPI Used By
Definition
"""A claim (CMS1500) with snapshot data for submitted claims, live data for drafts, and correction tracking"""type Claim { """ Whether assignment is accepted """ accept_assignment: Boolean
""" Additional claim info from Box 19 """ additional_claim_information: String
""" Amount paid by the patient """ amount_paid: String
""" Billing provider / organization info """ billing_provider: ClaimProvider
""" Condition codes from Box 10d """ claim_codes: String
""" Most recent Claim MD rejection messages """ claim_md_rejection_messages: [ClaimMdMessage!]!
""" Submission history for this claim """ claim_submissions( """ Returns the elements in the list that come after the specified cursor. """ after: String
""" Returns the elements in the list that come before the specified cursor. """ before: String
""" Returns the first _n_ elements from the list. """ first: Int
""" Returns the last _n_ elements from the list. """ last: Int ): ClaimSubmissionPaginationConnection!
""" Whether the client signature is on file """ client_sig_on_file: Boolean
""" COB data derived from primary claim ERA and manual overrides """ coordination_of_benefits: CoordinationOfBenefits
""" Child correction claims """ correction_claims( """ Returns the elements in the list that come after the specified cursor. """ after: String
""" Returns the elements in the list that come before the specified cursor. """ before: String
""" Returns the first _n_ elements from the list. """ first: Int
""" Returns the last _n_ elements from the list. """ last: Int ): ClaimPaginationConnection!
""" ICD-10 diagnoses """ diagnoses: [ClaimDiagnosis!]!
""" Whether the claim has been submitted """ has_been_submitted: Boolean!
""" Whether frozen claim submission data exists for this claim """ has_claim_submission_claim_data: Boolean! id: ID!
""" Whether referrer information should be included """ include_referrer_information: Boolean
""" Whether the insured signature is on file """ insured_sig_on_file: Boolean
""" True if this claim is a correction of another claim """ is_correction: Boolean!
""" Whether the claim is in a locked status """ is_locked: Boolean!
""" The Organization Info in use on this claim """ org_info: OrganizationInfo
""" The parent claim if this is a correction """ original_claim: Claim
""" The ID of the original claim if this is a correction """ original_claim_id: ID
""" Original reference number from Box 22 """ original_reference_number: String
""" Patient demographics """ patient: ClaimPatient
""" Patient account number """ patient_account_num: String
""" Whether this is a primary or secondary claim """ payer_order: PayerOrder
""" Insurance policies on this claim """ policies: [ClaimPolicy!]!
""" The primary claim if this is a secondary claim """ primary_claim: Claim
""" The ID of the primary claim if this is a secondary claim """ primary_claim_id: ID
""" Prior authorization number from Box 23 """ prior_authorization_number: String
""" Referral information """ referral_info: ClaimReferralInfo
""" Referring provider """ referring_provider: ClaimProvider
""" Rendering provider """ rendering_provider: ClaimProvider
""" Frequency/resubmission code from Box 22 """ resubmission_code: String
""" CPT service lines """ service_lines: [ClaimServiceLine!]!
""" Service location """ service_location: ClaimLocation
""" Current claim status (live, not from snapshot) """ status: String
""" Submission method (e.g. office_ally, change_health, manual) """ submission_method: String
""" Timestamp when the claim was last submitted """ submitted_at: ISO8601DateTime
""" Whether the claim uses the individual NPI """ use_indiv_npi: Boolean}