API ClaimProcs

See API Specification

ClaimProcs GET

Version Added: 22.2.33

Get a list of ClaimProcs for a patient or claim.

Parameters:

PatNum:This or ClaimNum is required. Get all ClaimProcs for a single patient.
ClaimNum: This or PatNum is required. Get all ClaimProcs for a single claim.

Example Request:
GET /claimprocs?PatNum=1337
GET /claimprocs?ClaimNum=98567
GET /claimprocs?PatNum=1337&ClaimNum=98567

Example Response:

[
{
"ClaimProcNum": 151,
"ProcNum": 32,
"ClaimNum": 98567,
"PatNum": 1337,
"ProvNum": 1,
"FeeBilled": 328.0,
"InsPayEst": 300.0,
"DedApplied": 0.0,
"Status": "Received",
"InsPayAmt": 300.0,
"Remarks": "",
"PlanNum": 151,
"WriteOff": 0.0,
"CodeSent": "D0272",
"DateCP": "2021-03-23",
"DateEntry": "0001-01-01",
"DedEst": 0.0,
"ClinicNum": 2,
"InsSubNum": 9,
"PayPlanNum": 0,
"SecDateEntry": "2021-03-23",
"DateSuppReceived": "2021-03-23"
},
{
"ClaimProcNum": 153,
"ProcNum": 32,
"ClaimNum": 98567,
"PatNum": 1337,
"ProvNum": 1,
"FeeBilled": 570.0,
"InsPayEst": 200.0,
"DedApplied": 0.0,
"Status": "Supplemental",
"InsPayAmt": 200.0,
"Remarks": "",
"PlanNum": 151,
"WriteOff": 0.0,
"CodeSent": "D0272",
"DateCP": "2021-03-23",
"DateEntry": "2021-03-23",
"DedEst": 0.0,
"ClinicNum": 2,
"InsSubNum": 9,
"PayPlanNum": 0,
"SecDateEntry": "2021-03-23",
"DateSuppReceived": "2021-03-23"
}
]

200 OK
400 BadRequest (Patient is deleted, etc)
404 NotFound (Patient not found, Claim not found)

ClaimProcs PUT InsAdjust

Version Added: 21.1

This adds or changes a claimproc that is acting as an insurance adjustment. PatPlanNum is required. You can obtain the PatPlanNum from FamilyModules GET Insurance. "date" is optional and defaults to today. It should be a date within the benefit year that you are interested in. Any adjustment that is created will also use that date. Either insUsed or deductibleUsed is Required. Pass in the total insurance and/or deductible used. The logic will take into consideration existing paid claims. For example, if payments of $200 are already entered into Open Dental, and you pass in insUsed of $300, then it will result in a $100 adjustment so that it will properly show the $300. If the insUsed passed in exactly equals payments already in Open Dental, then any existing adjustment will be deleted. The calculations do not distinguish family or lifetime benefits.

PatPlanNum: Required.
insUsed: This or deductibleUsed is required.
deductibleUsed: This or insUsed is required.
date: Optional. String in "yyyy-MM-dd" format. Default today's date.

Example Request:
PUT /claimprocs/InsAdjust

{
"PatPlanNum": 123,
"date": "2020-01-01",
"insUsed":"300",
"deductibleUsed":"25"
}

Example Response:
200 OK (Regardless of how the math worked out. ClaimProcs could have been added or deleted.)