API reference

Every endpoint is under https://sandbox.myclaimhouse.com/api/v1, takes and returns JSON with snake_case fields, and needs an API key sent as Authorization: Bearer <key>. See Authentication and keys for keys, Errors, retries and idempotency for the shared error shape, and the OpenAPI document to generate a client.

Account#

The API key making the request and the organization it belongs to.

Endpoint	Request	Permission
Get the current API key	`GET /api/v1/me`	`read`

Payers#

The payer directory: which payers Claim House reaches, and for what.

Endpoint	Request	Permission
List payers	`GET /api/v1/payers`	`read`
Search payers	`GET /api/v1/payers/search`	`read`
Get a payer	`GET /api/v1/payers/{id}`	`read`

Offices#

The offices of your organization. An office is who a check is made for.

Endpoint	Request	Permission
List offices	`GET /api/v1/offices`	`read`
Get an office	`GET /api/v1/offices/{id}`	`read`
Register an office for attachments	`POST /api/v1/offices/{id}/register_attachments`	`submit`

Providers#

The dentists who render treatment: add them, keep their NPIs, licenses and taxonomy codes current, and name one on each claim.

Endpoint	Request	Permission
List providers	`GET /api/v1/providers`	`read`
Add a provider	`POST /api/v1/providers`	`submit`
Get a provider	`GET /api/v1/providers/{id}`	`read`
Update a provider	`PATCH /api/v1/providers/{id}`	`submit`

Eligibility#

Check a patient's dental coverage and benefits.

Endpoint	Request	Permission
List eligibility checks	`GET /api/v1/eligibility`	`read`
Check eligibility	`POST /api/v1/eligibility`	`submit`
Get an eligibility check	`GET /api/v1/eligibility/{id}`	`read`

Claims#

Send dental claims: validated before anything is sent, batched into 837D files, and followed through the 997 and 277 responses on their timeline.

Endpoint	Request	Permission
List claims	`GET /api/v1/claims`	`read`
Create a claim	`POST /api/v1/claims`	`submit`
Validate a claim	`POST /api/v1/claims/validate`	`submit`
Get a claim	`GET /api/v1/claims/{id}`	`read`
Get a claim's timeline	`GET /api/v1/claims/{id}/timeline`	`read`
Get a claim's 837D	`GET /api/v1/claims/{id}/x12`	`read`
Update a claim	`PATCH /api/v1/claims/{id}`	`submit`
Submit a claim	`POST /api/v1/claims/{id}/submit`	`submit`
Correct and resubmit a claim	`POST /api/v1/claims/{id}/resubmit`	`submit`
Void a claim	`POST /api/v1/claims/{id}/void`	`submit`
Reconcile a claim	`POST /api/v1/claims/{id}/reconcile`	`submit`
Convert a predetermination into a claim	`POST /api/v1/claims/{id}/convert`	`submit`
Cancel a correction	`POST /api/v1/claims/{id}/cancel_correction`	`submit`

Attachments#

X-rays, charts and narratives for a payer: upload JPEG images to an attachment, close it to get its number, and put it on a claim, whose 837D then carries it.

Endpoint	Request	Permission
List attachments	`GET /api/v1/attachments`	`read`
Create an attachment	`POST /api/v1/attachments`	`submit`
List document types	`GET /api/v1/attachments/document_types`	`read`
Get an attachment	`GET /api/v1/attachments/{id}`	`read`
Change an open attachment	`PATCH /api/v1/attachments/{id}`	`submit`
Discard an open attachment	`DELETE /api/v1/attachments/{id}`	`submit`
Upload a document	`POST /api/v1/attachments/{id}/documents`	`submit`
Remove a document	`DELETE /api/v1/attachments/{id}/documents/{document_id}`	`submit`
Get a preview link	`GET /api/v1/attachments/{id}/documents/{document_id}/url`	`read`
Close an attachment	`POST /api/v1/attachments/{id}/close`	`submit`

ERAs#

Remittances (835) as JSON: what each payer paid on each claim and line, and why it adjusted the rest; each payment matched to its claim, posted when you have posted it.

Endpoint	Request	Permission
List ERAs	`GET /api/v1/eras`	`read`
Get an ERA	`GET /api/v1/eras/{id}`	`read`
Get an ERA's 835	`GET /api/v1/eras/{id}/x12`	`read`
Post an ERA	`POST /api/v1/eras/{id}/post`	`submit`
Match a payment to a claim	`POST /api/v1/eras/{id}/claims/{era_claim_id}/match`	`submit`

Patients#

The people in your checks and claims, one record each, with coverage as last verified, open claims and open charges. Kept by Claim House from what you send; your practice management system stays the system of record.

Endpoint	Request	Permission
List patients	`GET /api/v1/patients`	`read`
Search patients	`POST /api/v1/patients/search`	`read`
Get a patient	`GET /api/v1/patients/{id}`	`read`

Enrollments#

The payer paperwork each provider needs before some payers take claims or send ERAs and EFT: start one per provider, payer and type, with the method from the payer directory, and track its status and dates.

Endpoint	Request	Permission
List enrollments	`GET /api/v1/enrollments`	`read`
Start an enrollment	`POST /api/v1/enrollments`	`submit`
Get an enrollment	`GET /api/v1/enrollments/{id}`	`read`
Update an enrollment	`PATCH /api/v1/enrollments/{id}`	`submit`

Payer requests#

A payer asking for more about a claim it has: list them, record a paper one, and answer with a solicited attachment.

Endpoint	Request	Permission
List payer requests	`GET /api/v1/payer_requests`	`read`
Record a payer request	`POST /api/v1/payer_requests`	`submit`
Get a payer request	`GET /api/v1/payer_requests/{id}`	`read`
Answer a payer request	`POST /api/v1/payer_requests/{id}/answer`	`submit`

Sandbox#

The scripted payer scenarios available to test keys.

Endpoint	Request	Permission
List sandbox scenarios	`GET /api/v1/sandbox/scenarios`	`read`

Events#

Everything Claim House emits: read an event, list events, and replay one to your endpoints.

Endpoint	Request	Permission
List events	`GET /api/v1/events`	`read`
Get an event	`GET /api/v1/events/{id}`	`read`
Replay an event	`POST /api/v1/events/{id}/replay`	`submit`

Webhook endpoints#

Where Claim House sends events: add, list and remove endpoints, and replace a signing secret.

Endpoint	Request	Permission
List webhook endpoints	`GET /api/v1/webhook_endpoints`	`read`
Add a webhook endpoint	`POST /api/v1/webhook_endpoints`	`submit`
Get a webhook endpoint	`GET /api/v1/webhook_endpoints/{id}`	`read`
Delete a webhook endpoint	`DELETE /api/v1/webhook_endpoints/{id}`	`submit`
Rotate a signing secret	`POST /api/v1/webhook_endpoints/{id}/rotate_secret`	`submit`
Disable a webhook endpoint	`POST /api/v1/webhook_endpoints/{id}/disable`	`submit`
Enable a webhook endpoint	`POST /api/v1/webhook_endpoints/{id}/enable`	`submit`

Reports#

Figures computed from your claims and remittances for a period: what was billed and paid, how fast, what was rejected and adjusted, and why.

Endpoint	Request	Permission
Get a report	`GET /api/v1/reports/summary`	`read`

Usage and statements#

What your organization used this month, priced by your agreement: the month summary, every usage record, and the monthly statements.

Endpoint	Request	Permission
Get a month of usage	`GET /api/v1/usage`	`read`
List usage records	`GET /api/v1/usage/units`	`read`
List statements	`GET /api/v1/statements`	`read`
Get a statement	`GET /api/v1/statements/{id}`	`read`