eClaims and Preauth APIs

Emergency

Endpointhttps://ilm-dev.dha.go.ke/uat-middleware

Endpoints for emergency case claims and protocols.

Add Emergency Case Claim Doctor

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/doctors

Adds a doctor to an existing emergency case claim using their registration or identification details.

Add Emergency Case Claim Doctor › Request Body

consent_token

string · required

identification_number

string · required

identification_type

string · enum · required

Enum values:

registration_number

National ID

Alien ID

Refugee ID

regulation_body

string · enum · required

Enum values:

KMPDC

COC

NCK

Add Emergency Case Claim Doctor › Responses

Doctor successfully added to claim

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

POST/api/v1/claims/doctors

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/doctors \
  --header 'Content-Type: application/json' \
  --data '
{
  "consent_token": "consent_token",
  "identification_number": "identification_number",
  "identification_type": "registration_number",
  "regulation_body": "KMPDC"
}
'

shell

Example Request Body

{
  "consent_token": "consent_token",
  "identification_number": "identification_number",
  "identification_type": "registration_number",
  "regulation_body": "KMPDC"
}

json

Example Responses

{
  "data": {},
  "message": "message"
}

json

application/json

Remove doctor from claim

DELETE

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/doctors

Removes a doctor from an authorized claim

Remove doctor from claim › Request Body

consent_token

string · required

Remove doctor from claim › Responses

No Content

No data returned

DELETE/api/v1/claims/doctors

curl --request DELETE \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/doctors \
  --header 'Content-Type: application/json' \
  --data '
{
  "consent_token": "consent_token"
}
'

shell

Example Request Body

{
  "consent_token": "consent_token"
}

json

Example Responses

No example specified for this content type

Create Emergency Case Claim

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/emergency

This endpoint allows facilities to create a new virtual emergency case claim. Depending on the patient type, the request can be for either an identified or unidentified patient.

Create Emergency Case Claim › Request Body

brought_by

string · enum · required

Enum values:

RELATIVE

UNKNOWN

SAMARITAN

PARAMEDICS

identification_number

string · required

identification_type

string · enum · required

Enum values:

registration_number

National ID

Alien ID

Refugee ID

interventions

string[] · required

mode_of_arrival

string · enum · required

Enum values:

AMBULANCE

WALK-IN

OTHER

reference_number

string · required

regulation_body

string · enum · required

Enum values:

KMPDC

COC

NCK

beneficiary_cr_id

string

notes

string

otp

string

Create Emergency Case Claim › Responses

Emergency claim created successfully

admitted_on

string

appointment_number

string

attributes

string

authorization_code

string

authorization_guid

string

beneficiary_guid

string

beneficiary_id

integer

beneficiary_is_fuzzy_matched

boolean

cancel_reason_text

string

cancel_reason_type

string

claim_attachments_count

integer

claim_auth_status

string

object[]

claim_id

integer

created_by_name

string

currency

string

diagnoses_count

integer

discharge_cancel_date

string

discharge_cancel_remarks

string

discharge_reason

string

discharged_on

string

edi_claim_guid

string

emergency_visit_expiry

string

estimate_ip_days

integer

expected_discharge_date

string

has_reviewed_claim

boolean

id

string

initial_intervention

string

intervention_copay_data

string[]

object[]

invoice_attachments_count

integer

invoice_id

string

invoice_number

string

object[]

is_charge_master_mapped

boolean

is_negative

boolean

is_resubmitted

boolean

is_zero

boolean

last_retry

string

location_code

string

location_name

string

member_name

string

member_number

string

member_number_has_token

boolean

mode_of_arrival

string

nhif_number

string

notes

string

number_of_invoices

integer

patient_name

string

patient_number

string

payer_code

string

payer_name

string

payer_slade_code

string

policy_number

string

policy_valid_from

string

policy_valid_to

string

provider_name

string

provider_slade_code

string

reason_for_unknown_patient

string

reference_number

string

resubmission_workflow_state

string

retry_count

integer

scheme_code

string

scheme_name

string

service_type

string

total_claim_amount

number

total_claim_copay

number

total_claim_discount

number

total_claim_net_amount

number

total_claim_splits

number

updated_by_name

string

visit_end

string

visit_number

string

visit_start

string

workflow_state

string

POST/api/v1/claims/emergency

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/emergency \
  --header 'Content-Type: application/json' \
  --data '
{
  "beneficiary_cr_id": "beneficiary_cr_id",
  "brought_by": "RELATIVE",
  "identification_number": "identification_number",
  "identification_type": "registration_number",
  "interventions": [
    "string"
  ],
  "mode_of_arrival": "AMBULANCE",
  "notes": "notes",
  "otp": "otp",
  "reference_number": "reference_number",
  "regulation_body": "KMPDC"
}
'

shell

Example Request Body

{
  "beneficiary_cr_id": "beneficiary_cr_id",
  "brought_by": "RELATIVE",
  "identification_number": "identification_number",
  "identification_type": "registration_number",
  "interventions": [
    "string"
  ],
  "mode_of_arrival": "AMBULANCE",
  "notes": "notes",
  "otp": "otp",
  "reference_number": "reference_number",
  "regulation_body": "KMPDC"
}

json

Example Responses

{
  "admitted_on": "admitted_on",
  "appointment_number": "appointment_number",
  "attributes": "attributes",
  "authorization_code": "authorization_code",
  "authorization_guid": "authorization_guid",
  "beneficiary_guid": "beneficiary_guid",
  "beneficiary_id": 0,
  "beneficiary_is_fuzzy_matched": true,
  "cancel_reason_text": "cancel_reason_text",
  "cancel_reason_type": "cancel_reason_type",
  "claim_attachments_count": 0,
  "claim_auth_status": "claim_auth_status",
  "claim_diagnoses": [
    {
      "claim": "claim",
      "claim_diagnosis_id": 0,
      "diagnosis": "diagnosis",
      "diagnosis_code": "diagnosis_code",
      "diagnosis_name": "diagnosis_name",
      "edi_claim_diagnosis_guid": "edi_claim_diagnosis_guid",
      "edi_claim_diagnosis_replicated": "edi_claim_diagnosis_replicated",
      "intervention_code": "intervention_code",
      "is_flagged_diagnosis": true,
      "is_inpatient": true,
      "original_visit_date": "original_visit_date",
      "patient_number": "patient_number",
      "recorded_on": "recorded_on",
      "site_code": "site_code",
      "site_code_type": "site_code_type",
      "visit_number": "visit_number"
    }
  ],
  "claim_id": 0,
  "created_by_name": "created_by_name",
  "currency": "currency",
  "diagnoses_count": 0,
  "discharge_cancel_date": "discharge_cancel_date",
  "discharge_cancel_remarks": "discharge_cancel_remarks",
  "discharge_reason": "discharge_reason",
  "discharged_on": "discharged_on",
  "edi_claim_guid": "edi_claim_guid",
  "emergency_visit_expiry": "emergency_visit_expiry",
  "estimate_ip_days": 0,
  "expected_discharge_date": "expected_discharge_date",
  "has_reviewed_claim": true,
  "id": "id",
  "initial_intervention": "initial_intervention",
  "intervention_copay_data": [
    "string"
  ],
  "interventions": [
    {
      "accrued_per_diem_amount": 0,
      "accrued_per_diem_days": 0,
      "active_for_uhc": true,
      "bill_from": "bill_from",
      "bill_to": "bill_to",
      "id": "id",
      "intervention_code": "intervention_code",
      "intervention_fund": "intervention_fund",
      "intervention_name": "intervention_name",
      "intervention_overall_tariff": 0,
      "intervention_payment_mechanism": "intervention_payment_mechanism",
      "is_switched_intervention": true,
      "keph_level_tarrif": 0,
      "preauth_exist": true,
      "requires_surgical_preauth": true,
      "sub_benefit_code": "sub_benefit_code",
      "supported_scheme": "supported_scheme",
      "switched_intervention_id": 0,
      "switched_lines_retained": true,
      "workflow_state": "workflow_state"
    }
  ],
  "invoice_attachments_count": 0,
  "invoice_id": "invoice_id",
  "invoice_number": "invoice_number",
  "invoices": [
    {
      "created_by_name": "created_by_name",
      "department": "department",
      "discount_amount": 0,
      "dispatch_batch_number": "dispatch_batch_number",
      "dispatch_status": "dispatch_status",
      "doctors": [
        {
          "doctor_request_status": "PENDING",
          "slade_code": "slade_code"
        }
      ],
      "edi_invoice_id": "edi_invoice_id",
      "id": "id",
      "invoice_copays": [
        {
          "charge_date": "charge_date",
          "copay_amount": 0,
          "copay_type": "copay_type",
          "description": "description",
          "edi_invoice_copay_guid": "edi_invoice_copay_guid",
          "edi_invoice_copay_id": 0,
          "intervention_code": "intervention_code",
          "invoice": 0,
          "provider_copay_no": "provider_copay_no"
        }
      ],
      "invoice_date": "invoice_date",
      "invoice_flags": [
        {
          "code": "code",
          "description": "description",
          "edi_flag_guid": "edi_flag_guid",
          "edi_flag_id": 0,
          "existing": "existing",
          "flag_type": "flag_type",
          "invoice": "invoice",
          "is_resolved": true,
          "message": "message",
          "payload": "payload",
          "response": "response",
          "timestamp": "timestamp",
          "traceback": "traceback"
        }
      ],
      "invoice_number": "invoice_number",
      "invoice_type": "invoice_type",
      "lines": [
        {
          "attributes": "attributes",
          "bill_from": "bill_from",
          "bill_to": "bill_to",
          "charge_date": "charge_date",
          "discount": 0,
          "discount_reason": "discount_reason",
          "doctor_code": "doctor_code",
          "doctor_name": "doctor_name",
          "id": "id",
          "intervention_code": "intervention_code",
          "invoice": "invoice",
          "is_active": true,
          "is_cancellation": true,
          "is_return": true,
          "item_code": "item_code",
          "item_name": "item_name",
          "line_copay": 0,
          "line_net_amount": 0,
          "line_number": "line_number",
          "line_total_amount": 0,
          "linked_invoice_line": "linked_invoice_line",
          "map_request": "map_request",
          "map_request_description": "map_request_description",
          "mapped_slade_code": "mapped_slade_code",
          "nhif_rebate_amount": 0,
          "patient_discount_amount": 0,
          "patient_net_price": 0,
          "pmf_line_status": "pmf_line_status",
          "quantity": 0,
          "scheme_code": "scheme_code",
          "scheme_name": "scheme_name",
          "sponsor_net_price": 0,
          "uhc_exceeded": true,
          "unit": "unit",
          "unit_price": 0
        }
      ],
      "linked_invoice": "linked_invoice",
      "linked_invoice_line": "linked_invoice_line",
      "member_name": "member_name",
      "patient_name": "patient_name",
      "patient_number": "patient_number",
      "provider_invoice_ref": "provider_invoice_ref",
      "provider_name": "provider_name",
      "scheme_code": "scheme_code",
      "scheme_name": "scheme_name",
      "scu_branch_id": "scu_branch_id",
      "scu_dispatch_timestamp": "scu_dispatch_timestamp",
      "scu_receipt_signature": "scu_receipt_signature",
      "service_type": "service_type",
      "total_inv_amount": 0,
      "total_inv_copay": 0,
      "total_inv_discount": 0,
      "total_inv_net_amount": 0,
      "visit_end": "visit_end",
      "visit_start": "visit_start",
      "workflow_state": "workflow_state"
    }
  ],
  "is_charge_master_mapped": true,
  "is_negative": true,
  "is_resubmitted": true,
  "is_zero": true,
  "last_retry": "last_retry",
  "location_code": "location_code",
  "location_name": "location_name",
  "member_name": "member_name",
  "member_number": "member_number",
  "member_number_has_token": true,
  "mode_of_arrival": "mode_of_arrival",
  "nhif_number": "nhif_number",
  "notes": "notes",
  "number_of_invoices": 0,
  "patient_name": "patient_name",
  "patient_number": "patient_number",
  "payer_code": "payer_code",
  "payer_name": "payer_name",
  "payer_slade_code": "payer_slade_code",
  "policy_number": "policy_number",
  "policy_valid_from": "policy_valid_from",
  "policy_valid_to": "policy_valid_to",
  "provider_name": "provider_name",
  "provider_slade_code": "provider_slade_code",
  "reason_for_unknown_patient": "reason_for_unknown_patient",
  "reference_number": "reference_number",
  "resubmission_workflow_state": "resubmission_workflow_state",
  "retry_count": 0,
  "scheme_code": "scheme_code",
  "scheme_name": "scheme_name",
  "service_type": "service_type",
  "total_claim_amount": 0,
  "total_claim_copay": 0,
  "total_claim_discount": 0,
  "total_claim_net_amount": 0,
  "total_claim_splits": 0,
  "updated_by_name": "updated_by_name",
  "visit_end": "visit_end",
  "visit_number": "visit_number",
  "visit_start": "visit_start",
  "workflow_state": "workflow_state"
}

json

application/json

Get Emergency Protocols

GET

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/emergency/protocols

Retrieve a list of emergency protocols from the ILM Adapter API. These define the applicable clinical or management procedures for emergency cases filtered by status, intervention code, and facility details.

Get Emergency Protocols › query Parameters

active

string · required

Filter intervention if it is still active

intervention_code

string · required

Intervention applicable to a protocol

Get Emergency Protocols › Responses

Emergency protocol retrieved successfully

count

integer

currentPage

integer

endIndex

integer

next

string

pageSize

integer

previous

string

object[]

startIndex

integer

totalPages

integer

GET/api/v1/claims/emergency/protocols

curl --request GET \
  --url 'https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/emergency/protocols?active=%3Cstring%3E&intervention_code=%3Cstring%3E'

shell

Example Responses

{
  "count": 0,
  "currentPage": 0,
  "endIndex": 0,
  "next": "next",
  "pageSize": 0,
  "previous": "previous",
  "results": [
    {
      "applicableTariff": "applicableTariff",
      "guid": "guid",
      "id": 0,
      "intervention": [
        {
          "accessPoint": "accessPoint",
          "active": true,
          "annualQuantityLimit": 0,
          "annualQuantityLimitChoice": "annualQuantityLimitChoice",
          "annualQuantityLimitType": "annualQuantityLimitType",
          "applicableFacilityOwnership": "applicableFacilityOwnership",
          "applicableGender": "applicableGender",
          "benefit": 0,
          "code": "code",
          "comment": "comment",
          "complexity": "complexity",
          "coverageLevel": "coverageLevel",
          "diagnosisBlock": [
            "string"
          ],
          "diagnosisList": [
            "string"
          ],
          "guid": "guid",
          "id": 0,
          "investigationTariffHasLimit": true,
          "isIntraMetro": true,
          "kephLevelTarrif": 0,
          "levelsApplicable": [
            "string"
          ],
          "lowerAgeLimit": 0,
          "managementTariffHasLimit": true,
          "name": "name",
          "needApprovalBeforeClaimSubmission": true,
          "needsDoctorAuthorization": true,
          "needsManualPreauthApproval": true,
          "needsMemberAuthorization": true,
          "needsPreauth": true,
          "overallTariff": 0,
          "overallTariffHasLimit": true,
          "paymentMechanism": "paymentMechanism",
          "preauthFinalised": true,
          "protocolUsed": "protocolUsed",
          "status": "status",
          "upperAgeLimit": 0,
          "usageFrequencyLimit": 0,
          "usageFrequencyType": "usageFrequencyType"
        }
      ],
      "name": "name",
      "protocolClassificationType": "protocolClassificationType",
      "protocolCode": "protocolCode",
      "protocolType": "protocolType",
      "status": "status"
    }
  ],
  "startIndex": 0,
  "totalPages": 0
}

json

application/json

Add Emergency Case Protocol

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/emergency/protocols

This endpoint allows adding a treatment protocol to an existing emergency case claim.

Add Emergency Case Protocol › Request Body

consent_token

string · required

intervention_code

string · required

protocol_code

string · required

quantity

integer · required

unit_price

number · required

object[]

diagnoses

string[]

Add Emergency Case Protocol › Responses

Emergency protocol added successfully

attributes

string

bill_from

string

bill_to

string

charge_date

string

discount

number

discount_reason

string

doctor_code

string

doctor_name

string

id

string

intervention_code

string

invoice

string

is_active

boolean

is_cancellation

boolean

is_return

boolean

item_code

string

item_name

string

line_copay

number

line_net_amount

number

line_number

string

line_total_amount

number

linked_invoice_line

string

map_request

string

map_request_description

string

mapped_slade_code

string

nhif_rebate_amount

number

patient_discount_amount

number

patient_net_price

number

pmf_line_status

string

quantity

number

scheme_code

string

scheme_name

string

sponsor_net_price

number

uhc_exceeded

boolean

unit

string

unit_price

number

POST/api/v1/claims/emergency/protocols

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/emergency/protocols \
  --header 'Content-Type: application/json' \
  --data '
{
  "attachments": [
    {
      "document_title": "document_title",
      "document_type": "DISCHARGE_SUMMARY",
      "file_field_name": "file_field_name"
    }
  ],
  "consent_token": "consent_token",
  "diagnoses": [
    "string"
  ],
  "intervention_code": "intervention_code",
  "protocol_code": "protocol_code",
  "quantity": 0,
  "unit_price": 0
}
'

shell

Example Request Body

{
  "attachments": [
    {
      "document_title": "document_title",
      "document_type": "DISCHARGE_SUMMARY",
      "file_field_name": "file_field_name"
    }
  ],
  "consent_token": "consent_token",
  "diagnoses": [
    "string"
  ],
  "intervention_code": "intervention_code",
  "protocol_code": "protocol_code",
  "quantity": 0,
  "unit_price": 0
}

json

Example Responses

{
  "attributes": "attributes",
  "bill_from": "bill_from",
  "bill_to": "bill_to",
  "charge_date": "charge_date",
  "discount": 0,
  "discount_reason": "discount_reason",
  "doctor_code": "doctor_code",
  "doctor_name": "doctor_name",
  "id": "id",
  "intervention_code": "intervention_code",
  "invoice": "invoice",
  "is_active": true,
  "is_cancellation": true,
  "is_return": true,
  "item_code": "item_code",
  "item_name": "item_name",
  "line_copay": 0,
  "line_net_amount": 0,
  "line_number": "line_number",
  "line_total_amount": 0,
  "linked_invoice_line": "linked_invoice_line",
  "map_request": "map_request",
  "map_request_description": "map_request_description",
  "mapped_slade_code": "mapped_slade_code",
  "nhif_rebate_amount": 0,
  "patient_discount_amount": 0,
  "patient_net_price": 0,
  "pmf_line_status": "pmf_line_status",
  "quantity": 0,
  "scheme_code": "scheme_code",
  "scheme_name": "scheme_name",
  "sponsor_net_price": 0,
  "uhc_exceeded": true,
  "unit": "unit",
  "unit_price": 0
}

json

application/json

Creates an EMT claim

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/emt

Creates an EMT claim

Creates an EMT claim › Request Body

case_number

string · required

diagnoses

string[] · required

interventions

string[] · required

practitioner_reg_number

string · required

protocol_code

string · required

provider_registration_number

string · required

object[]

beneficiary_cr_id

string

consent_token

string

otp

string

Creates an EMT claim › Responses

EMT claim created successfully

admitted_on

string

appointment_number

string

attributes

string

authorization_code

string

authorization_guid

string

beneficiary_guid

string

beneficiary_id

integer

beneficiary_is_fuzzy_matched

boolean

cancel_reason_text

string

cancel_reason_type

string

claim_attachments_count

integer

claim_auth_status

string

object[]

claim_id

integer

created_by_name

string

currency

string

diagnoses_count

integer

discharge_cancel_date

string

discharge_cancel_remarks

string

discharge_reason

string

discharged_on

string

edi_claim_guid

string

emergency_visit_expiry

string

estimate_ip_days

integer

expected_discharge_date

string

has_reviewed_claim

boolean

id

string

initial_intervention

string

intervention_copay_data

string[]

object[]

invoice_attachments_count

integer

invoice_id

string

invoice_number

string

object[]

is_charge_master_mapped

boolean

is_negative

boolean

is_resubmitted

boolean

is_zero

boolean

last_retry

string

location_code

string

location_name

string

member_name

string

member_number

string

member_number_has_token

boolean

mode_of_arrival

string

nhif_number

string

notes

string

number_of_invoices

integer

patient_name

string

patient_number

string

payer_code

string

payer_name

string

payer_slade_code

string

policy_number

string

policy_valid_from

string

policy_valid_to

string

provider_name

string

provider_slade_code

string

reason_for_unknown_patient

string

reference_number

string

resubmission_workflow_state

string

retry_count

integer

scheme_code

string

scheme_name

string

service_type

string

total_claim_amount

number

total_claim_copay

number

total_claim_discount

number

total_claim_net_amount

number

total_claim_splits

number

updated_by_name

string

visit_end

string

visit_number

string

visit_start

string

workflow_state

string

POST/api/v1/claims/emt

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/emt \
  --header 'Content-Type: application/json' \
  --data '
{
  "attachments": [
    {
      "document_title": "document_title",
      "document_type": "DISCHARGE_SUMMARY",
      "file_field_name": "file_field_name"
    }
  ],
  "beneficiary_cr_id": "beneficiary_cr_id",
  "case_number": "case_number",
  "consent_token": "consent_token",
  "diagnoses": [
    "string"
  ],
  "interventions": [
    "string"
  ],
  "otp": "otp",
  "practitioner_reg_number": "practitioner_reg_number",
  "protocol_code": "protocol_code",
  "provider_registration_number": "provider_registration_number"
}
'

shell

Example Request Body

{
  "attachments": [
    {
      "document_title": "document_title",
      "document_type": "DISCHARGE_SUMMARY",
      "file_field_name": "file_field_name"
    }
  ],
  "beneficiary_cr_id": "beneficiary_cr_id",
  "case_number": "case_number",
  "consent_token": "consent_token",
  "diagnoses": [
    "string"
  ],
  "interventions": [
    "string"
  ],
  "otp": "otp",
  "practitioner_reg_number": "practitioner_reg_number",
  "protocol_code": "protocol_code",
  "provider_registration_number": "provider_registration_number"
}

json

Example Responses

{
  "admitted_on": "admitted_on",
  "appointment_number": "appointment_number",
  "attributes": "attributes",
  "authorization_code": "authorization_code",
  "authorization_guid": "authorization_guid",
  "beneficiary_guid": "beneficiary_guid",
  "beneficiary_id": 0,
  "beneficiary_is_fuzzy_matched": true,
  "cancel_reason_text": "cancel_reason_text",
  "cancel_reason_type": "cancel_reason_type",
  "claim_attachments_count": 0,
  "claim_auth_status": "claim_auth_status",
  "claim_diagnoses": [
    {
      "claim": "claim",
      "claim_diagnosis_id": 0,
      "diagnosis": "diagnosis",
      "diagnosis_code": "diagnosis_code",
      "diagnosis_name": "diagnosis_name",
      "edi_claim_diagnosis_guid": "edi_claim_diagnosis_guid",
      "edi_claim_diagnosis_replicated": "edi_claim_diagnosis_replicated",
      "intervention_code": "intervention_code",
      "is_flagged_diagnosis": true,
      "is_inpatient": true,
      "original_visit_date": "original_visit_date",
      "patient_number": "patient_number",
      "recorded_on": "recorded_on",
      "site_code": "site_code",
      "site_code_type": "site_code_type",
      "visit_number": "visit_number"
    }
  ],
  "claim_id": 0,
  "created_by_name": "created_by_name",
  "currency": "currency",
  "diagnoses_count": 0,
  "discharge_cancel_date": "discharge_cancel_date",
  "discharge_cancel_remarks": "discharge_cancel_remarks",
  "discharge_reason": "discharge_reason",
  "discharged_on": "discharged_on",
  "edi_claim_guid": "edi_claim_guid",
  "emergency_visit_expiry": "emergency_visit_expiry",
  "estimate_ip_days": 0,
  "expected_discharge_date": "expected_discharge_date",
  "has_reviewed_claim": true,
  "id": "id",
  "initial_intervention": "initial_intervention",
  "intervention_copay_data": [
    "string"
  ],
  "interventions": [
    {
      "accrued_per_diem_amount": 0,
      "accrued_per_diem_days": 0,
      "active_for_uhc": true,
      "bill_from": "bill_from",
      "bill_to": "bill_to",
      "id": "id",
      "intervention_code": "intervention_code",
      "intervention_fund": "intervention_fund",
      "intervention_name": "intervention_name",
      "intervention_overall_tariff": 0,
      "intervention_payment_mechanism": "intervention_payment_mechanism",
      "is_switched_intervention": true,
      "keph_level_tarrif": 0,
      "preauth_exist": true,
      "requires_surgical_preauth": true,
      "sub_benefit_code": "sub_benefit_code",
      "supported_scheme": "supported_scheme",
      "switched_intervention_id": 0,
      "switched_lines_retained": true,
      "workflow_state": "workflow_state"
    }
  ],
  "invoice_attachments_count": 0,
  "invoice_id": "invoice_id",
  "invoice_number": "invoice_number",
  "invoices": [
    {
      "created_by_name": "created_by_name",
      "department": "department",
      "discount_amount": 0,
      "dispatch_batch_number": "dispatch_batch_number",
      "dispatch_status": "dispatch_status",
      "doctors": [
        {
          "doctor_request_status": "PENDING",
          "slade_code": "slade_code"
        }
      ],
      "edi_invoice_id": "edi_invoice_id",
      "id": "id",
      "invoice_copays": [
        {
          "charge_date": "charge_date",
          "copay_amount": 0,
          "copay_type": "copay_type",
          "description": "description",
          "edi_invoice_copay_guid": "edi_invoice_copay_guid",
          "edi_invoice_copay_id": 0,
          "intervention_code": "intervention_code",
          "invoice": 0,
          "provider_copay_no": "provider_copay_no"
        }
      ],
      "invoice_date": "invoice_date",
      "invoice_flags": [
        {
          "code": "code",
          "description": "description",
          "edi_flag_guid": "edi_flag_guid",
          "edi_flag_id": 0,
          "existing": "existing",
          "flag_type": "flag_type",
          "invoice": "invoice",
          "is_resolved": true,
          "message": "message",
          "payload": "payload",
          "response": "response",
          "timestamp": "timestamp",
          "traceback": "traceback"
        }
      ],
      "invoice_number": "invoice_number",
      "invoice_type": "invoice_type",
      "lines": [
        {
          "attributes": "attributes",
          "bill_from": "bill_from",
          "bill_to": "bill_to",
          "charge_date": "charge_date",
          "discount": 0,
          "discount_reason": "discount_reason",
          "doctor_code": "doctor_code",
          "doctor_name": "doctor_name",
          "id": "id",
          "intervention_code": "intervention_code",
          "invoice": "invoice",
          "is_active": true,
          "is_cancellation": true,
          "is_return": true,
          "item_code": "item_code",
          "item_name": "item_name",
          "line_copay": 0,
          "line_net_amount": 0,
          "line_number": "line_number",
          "line_total_amount": 0,
          "linked_invoice_line": "linked_invoice_line",
          "map_request": "map_request",
          "map_request_description": "map_request_description",
          "mapped_slade_code": "mapped_slade_code",
          "nhif_rebate_amount": 0,
          "patient_discount_amount": 0,
          "patient_net_price": 0,
          "pmf_line_status": "pmf_line_status",
          "quantity": 0,
          "scheme_code": "scheme_code",
          "scheme_name": "scheme_name",
          "sponsor_net_price": 0,
          "uhc_exceeded": true,
          "unit": "unit",
          "unit_price": 0
        }
      ],
      "linked_invoice": "linked_invoice",
      "linked_invoice_line": "linked_invoice_line",
      "member_name": "member_name",
      "patient_name": "patient_name",
      "patient_number": "patient_number",
      "provider_invoice_ref": "provider_invoice_ref",
      "provider_name": "provider_name",
      "scheme_code": "scheme_code",
      "scheme_name": "scheme_name",
      "scu_branch_id": "scu_branch_id",
      "scu_dispatch_timestamp": "scu_dispatch_timestamp",
      "scu_receipt_signature": "scu_receipt_signature",
      "service_type": "service_type",
      "total_inv_amount": 0,
      "total_inv_copay": 0,
      "total_inv_discount": 0,
      "total_inv_net_amount": 0,
      "visit_end": "visit_end",
      "visit_start": "visit_start",
      "workflow_state": "workflow_state"
    }
  ],
  "is_charge_master_mapped": true,
  "is_negative": true,
  "is_resubmitted": true,
  "is_zero": true,
  "last_retry": "last_retry",
  "location_code": "location_code",
  "location_name": "location_name",
  "member_name": "member_name",
  "member_number": "member_number",
  "member_number_has_token": true,
  "mode_of_arrival": "mode_of_arrival",
  "nhif_number": "nhif_number",
  "notes": "notes",
  "number_of_invoices": 0,
  "patient_name": "patient_name",
  "patient_number": "patient_number",
  "payer_code": "payer_code",
  "payer_name": "payer_name",
  "payer_slade_code": "payer_slade_code",
  "policy_number": "policy_number",
  "policy_valid_from": "policy_valid_from",
  "policy_valid_to": "policy_valid_to",
  "provider_name": "provider_name",
  "provider_slade_code": "provider_slade_code",
  "reason_for_unknown_patient": "reason_for_unknown_patient",
  "reference_number": "reference_number",
  "resubmission_workflow_state": "resubmission_workflow_state",
  "retry_count": 0,
  "scheme_code": "scheme_code",
  "scheme_name": "scheme_name",
  "service_type": "service_type",
  "total_claim_amount": 0,
  "total_claim_copay": 0,
  "total_claim_discount": 0,
  "total_claim_net_amount": 0,
  "total_claim_splits": 0,
  "updated_by_name": "updated_by_name",
  "visit_end": "visit_end",
  "visit_number": "visit_number",
  "visit_start": "visit_start",
  "workflow_state": "workflow_state"
}

json

application/json

Eligibility Start Visit Consent