Check claim status #
After a claim is submitted, it progresses through a number of states in the Claiming.com.au server and with medicare. Some claims will be assessed by a Medicare operator, and will take longer to process.
These are the possible statuses of a claim:
NEW Default status, we have received and validated the claim, but have not yet attempted to submit to Medicare
DELAYED We have attempted delivery to Medicare, but an error has occurred. Some errors are automatically re-tried, the remainder are left for manual processing
CANCELLED The cancel_reason has been set on the claim record in note
WITH_MEDICARE We have submitted the claim, and no reports have been received yet.
MEDICARE_ASSESSING An interim claim status, check again in 24 hours
HEALTH_FUND_ASSESSING An interim claim status, check again in 24 hours
PROCESSED There is a processing report, there is not yet a payment report
COMPLETE There is a processing and payment report for this claim.
LOST A claim has been submitted, but no report has been retrieved after trying for 17 days.
REJECTED, REJECTED_FUND, REJECTED_MEDICARE There is something wrong with the claim causing it to be rejected, see the assessment notes in the response
NOTE: Processing by Medicare and the Funds can take anywhere between a few hours and a few days. The API has a facility to check on the progress of individual claims or to request all processing status reports that have changed since a given date/time
You should check daily on the status of each active claim and display the current status to your end users. The response object will contain all of the original data, plus additional data on the progress of the claim.
Where a claim has been rejected the response will include claim and item level rejection information where this has been provided by Medicare or the Fund.
Where a claim has been fully or partially paid, the response will include the ID of the relevant payment report.
NOTE: To get the response as an array of claim objects, add the array=true parameter to the call.
GET - Get a list of claims
#
The claims endpoint without parameters will return an array of claims in a block of 10.
You can use the offset parameter to fetch subsequent blocks.
{{base_url}}/{{version}}/claims
Headers
| Header | Value |
|---|---|
| Accept | application/json |
| Content-Type | application/json |
| Authorization | Bearer {{oauth_token}} |
Example Request:
curl --location 'https://sandbox.claiming.com.au/v2/claims' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer '
Example Response:
Body:
{
"status": "OK",
"total": 2909,
"records": 10,
"offset": 0,
"results": [
{
"type": "InPatientMedical",
"_queueDateTime": "2021-04-06 12:28",
"_invoiceNumber": 33278,
"provider": {
"payee": "2433411Y",
"principal": "2433411Y",
"servicing": "2433411Y"
},
"location": {
"name": "St Elsewhere's Hospital",
"provider": "9988770W",
"type": "H"
},
"patient": {
"dateOfBirth": "1951-04-24",
"fund": {
"eclipseId": "TST",
"number": "12345678"
},
"gender": "F",
"medicare": {
"number": "5950969521",
"ref": "1"
},
"name": {
"family": "POST",
"first": "Jamee"
}
},
"flags": {
"hospitalInd": true,
"accountPaid": false,
"imcClaimType": "SC",
"isAccident": false,
"financialInterestDisclosureInd": true,
"ifc": "W",
"serviceType": "S"
},
"referral": {
"overrideCode": "H"
},
"items": [
{
"itemNumber": "17610",
"date": "2021-03-30",
"chargeAmount": 100.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0001"
},
{
"itemNumber": "20142",
"date": "2021-03-30",
"chargeAmount": 250.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0002"
},
{
"itemNumber": "23045",
"date": "2021-03-30",
"duration": "60",
"serviceText": "START TIME 07:35 - END TIME 08:35",
"chargeAmount": 200.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0003"
},
{
"itemNumber": "25000",
"date": "2021-03-30",
"chargeAmount": 44.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0004"
},
{
"itemNumber": "25014",
"date": "2021-03-30",
"chargeAmount": 44.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0005"
}
],
"claimId": 4897,
"transactionId": null,
"medicareClaimId": "4897",
"timeReceived": 1618009996,
"status": "INVALID"
},
{
"type": "InPatientMedical",
"_queueDateTime": "2021-04-06 12:28",
"_invoiceNumber": 33278,
"provider": {
"payee": "2433411Y",
"principal": "2433411Y",
"servicing": "2433411Y"
},
"location": {
"name": "St Elsewhere's Hospital",
"provider": "9988770W",
"type": "H"
},
"patient": {
"dateOfBirth": "1951-04-24",
"fund": {
"eclipseId": "TST",
"number": "12345678"
},
"gender": "F",
"medicare": {
"number": "5950969521",
"ref": "1"
},
"name": {
"family": "POST",
"first": "Jamee"
}
},
"flags": {
"hospitalInd": true,
"accountPaid": false,
"imcClaimType": "SC",
"isAccident": false,
"financialInterestDisclosureInd": true,
"ifc": "W",
"serviceType": "S"
},
"referral": {
"overrideCode": "H"
},
"items": [
{
"itemNumber": "17610",
"date": "2021-03-30",
"chargeAmount": 100.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0001"
},
{
"itemNumber": "20142",
"date": "2021-03-30",
"chargeAmount": 250.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0002"
},
{
"itemNumber": "23045",
"date": "2021-03-30",
"duration": "060",
"serviceText": "START TIME 07:35 - END TIME 08:35",
"chargeAmount": 200.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0003"
},
{
"itemNumber": "25000",
"date": "2021-03-30",
"chargeAmount": 44.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0004"
},
{
"itemNumber": "25014",
"date": "2021-03-30",
"chargeAmount": 44.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0005"
}
],
"claimId": 4898,
"transactionId": "SAP00000v1SaNAuockVwY8th",
"medicareClaimId": "",
"timeReceived": 1618261859,
"medicareError": 0,
"status": "MEDICARE_ASSESSING"
},
{
"type": "InPatientMedical",
"_queueDateTime": "2021-04-06 12:28",
"_invoiceNumber": 33278,
"provider": {
"payee": "2433411Y",
"principal": "2433411Y",
"servicing": "2433411Y"
},
"location": {
"name": "St Elsewhere's Hospital",
"provider": "9988770W",
"type": "H"
},
"patient": {
"dateOfBirth": "1951-04-24",
"fund": {
"eclipseId": "TST",
"number": "12345678"
},
"gender": "F",
"medicare": {
"number": "5950969521",
"ref": "1"
},
"name": {
"family": "POST",
"first": "Jamee"
}
},
"flags": {
"hospitalInd": true,
"accountPaid": false,
"imcClaimType": "SC",
"isAccident": false,
"financialInterestDisclosureInd": true,
"ifc": "W",
"serviceType": "S"
},
"referral": {
"overrideCode": "H"
},
"items": [
{
"itemNumber": "17610",
"date": "2021-03-30",
"chargeAmount": 100.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0001"
},
{
"itemNumber": "20142",
"date": "2021-03-30",
"chargeAmount": 250.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0002"
},
{
"itemNumber": "23045",
"date": "2021-03-30",
"duration": "060",
"time": "13:45",
"chargeAmount": 200.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0003"
},
{
"itemNumber": "25000",
"date": "2021-03-30",
"chargeAmount": 44.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0004"
},
{
"itemNumber": "25014",
"date": "2021-03-30",
"chargeAmount": 44.0,
"MedicareVoucherId": "01",
"MedicareServiceId": "0005"
}
],
"claimId": 4899,
"transactionId": "SAP00000KGCn1oJmTsMG7Rdq",
"medicareClaimId": "",
"timeReceived": 1618261928,
"medicareError": 0,
"status": "MEDICARE_ASSESSING"
},
{
"_NOITestCase": "5.1.1.1",
"type": "BulkBill",
"flags": {
"serviceType": "O"
},
"patient": {
"dateOfBirth": "1982-10-24",
"medicare": {
"number": "49513067311",
"ref": 0
},
"gender": "F",
"name": {
"first": "TALIA",
"family": "SIMKINS"
}
},
"provider": {
"servicing": "2433411Y"
},
"items": [
{
"chargeAmount": 38.2,
"date": "2021-05-17",
"itemNumber": "23",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001",
"assessmentNotes": [
{
"assessor": "Medicare",
"code": "255",
"note": "Benefit assigned has been increased"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 38.75
}
]
}
],
"claimId": 4903,
"transactionId": "SAP00000FlW4czQo3gyWHExl",
"medicareClaimId": "A0002@",
"timeReceived": 1621203920,
"medicareError": 0,
"assessmentNotes": [],
"paymentId": 587,
"status": "COMPLETE"
},
{
"_NOITestCase": "10.2.3.1",
"type": "DVA",
"flags": {
"serviceType": "S"
},
"location": {
"name": "St Elsewhere's Hospital",
"type": "R"
},
"patient": {
"dateOfBirth": "1965-07-10",
"dva": {
"number": "QX901548"
},
"gender": "M",
"name": {
"family": "EMMA",
"first": "GERALD"
}
},
"provider": {
"servicing": "2433421X"
},
"referral": {
"overrideCode": "N"
},
"items": [
{
"chargeAmount": 28.4,
"date": "2021-05-31",
"itemNumber": "55029",
"lspNumber": "000014",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001",
"assessmentNotes": [
{
"assessor": "DVA",
"code": "514",
"note": "Required equipment type code not on LSPN register"
}
],
"benefit": [
{
"assessor": "DVA",
"benefitPaid": 0.0
}
]
}
],
"claimId": 5101,
"transactionId": "SAP00000uWAUMly7gPjklXv4",
"medicareClaimId": "D0001@",
"timeReceived": 1622581519,
"medicareError": 0,
"assessmentNotes": [],
"status": "REJECTED"
},
{
"_NOITestCase": "10.2.3.1a",
"type": "DVA",
"flags": {
"serviceType": "S"
},
"location": {
"name": "St Elsewhere's Hospital",
"type": "R"
},
"patient": {
"dateOfBirth": "1965-07-10",
"dva": {
"number": "QX901548"
},
"gender": "M",
"name": {
"family": "EMMA",
"first": "GERALD"
}
},
"provider": {
"servicing": "2433421X"
},
"referral": {
"overrideCode": "N"
},
"items": [
{
"chargeAmount": 50.0,
"date": "2021-05-31",
"itemNumber": "104",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001",
"assessmentNotes": [
{
"assessor": "DVA",
"code": "611",
"note": "Valid referral details not supplied - no fee is payable"
}
],
"benefit": [
{
"assessor": "DVA",
"benefitPaid": 0.0
}
]
},
{
"chargeAmount": 28.4,
"date": "2021-05-31",
"itemNumber": "55029",
"lspNumber": "000014",
"MedicareVoucherId": "01",
"MedicareServiceId": "0002",
"assessmentNotes": [
{
"assessor": "DVA",
"code": "514",
"note": "Required equipment type code not on LSPN register"
}
],
"benefit": [
{
"assessor": "DVA",
"benefitPaid": 0.0
}
]
}
],
"claimId": 5102,
"transactionId": "SAP00000MW9rXz2gEYJejDW5",
"medicareClaimId": "D0002@",
"timeReceived": 1622581571,
"medicareError": 0,
"assessmentNotes": [],
"status": "REJECTED"
},
{
"_NOITestCase": "10.2.3.1b",
"type": "DVA",
"flags": {
"serviceType": "O"
},
"location": {
"name": "St Elsewhere's Hospital",
"type": "R"
},
"patient": {
"dateOfBirth": "1965-07-10",
"dva": {
"number": "QX901548"
},
"gender": "M",
"name": {
"family": "EMMA",
"first": "GERALD"
}
},
"provider": {
"servicing": "2433421X"
},
"items": [
{
"chargeAmount": 50.0,
"date": "2021-05-31",
"itemNumber": "104",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001",
"assessmentNotes": [
{
"assessor": "DVA",
"code": "611",
"note": "Valid referral details not supplied - no fee is payable"
}
],
"benefit": [
{
"assessor": "DVA",
"benefitPaid": 0.0
}
]
},
{
"chargeAmount": 28.4,
"date": "2021-05-31",
"itemNumber": "55029",
"lspNumber": "000014",
"MedicareVoucherId": "01",
"MedicareServiceId": "0002",
"assessmentNotes": [
{
"assessor": "DVA",
"code": "514",
"note": "Required equipment type code not on LSPN register"
}
],
"benefit": [
{
"assessor": "DVA",
"benefitPaid": 0.0
}
]
}
],
"claimId": 5103,
"transactionId": "SAP00000DX0ETRgS1qEZqXqi",
"medicareClaimId": "D0003@",
"timeReceived": 1622581597,
"medicareError": 0,
"assessmentNotes": [],
"status": "REJECTED"
},
{
"_NOITestCase": "5.1.2.2",
"type": "BulkBill",
"flags": {
"serviceType": "S",
"hospitalInd": true
},
"patient": {
"dateOfBirth": "1982-10-24",
"medicare": {
"number": "4951306731",
"ref": "1"
},
"name": {
"first": "Talia",
"family": "Simkins"
}
},
"provider": {
"servicing": "2433411Y"
},
"referral": {
"overrideCode": "H"
},
"location": {
"name": "St Elsewheres Hospital",
"provider": "9988770W",
"type": "H"
},
"items": [
{
"chargeAmount": 37.7,
"date": "2021-06-01",
"itemNumber": "119",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001"
}
],
"claimId": 5104,
"transactionId": "SAP00000rGhoPPm9sdXUB5vm",
"medicareClaimId": "#0001@",
"timeReceived": 1622582465,
"medicareError": 0,
"status": "WITH MEDICARE"
},
{
"_NOITestCase": "5.1.2.2a",
"type": "BulkBill",
"flags": {
"serviceType": "S",
"hospitalInd": true
},
"patient": {
"dateOfBirth": "1982-10-24",
"medicare": {
"number": "4951306731",
"ref": "1"
},
"name": {
"first": "Talia",
"family": "Simkins"
}
},
"provider": {
"servicing": "2433411Y"
},
"referral": {
"overrideCode": "H"
},
"location": {
"name": "St Elsewheres Hospital",
"provider": "9988770W",
"type": "H"
},
"items": [
{
"chargeAmount": 37.7,
"date": "2021-06-01",
"itemNumber": "119",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001"
},
{
"chargeAmount": 28.4,
"date": "2021-06-01",
"itemNumber": "55029",
"lspNumber": "000014",
"MedicareVoucherId": "01",
"MedicareServiceId": "0002"
}
],
"claimId": 5105,
"transactionId": "SAP00000DaF0ay8SsQYoj4Ko",
"medicareClaimId": "#0002@",
"timeReceived": 1622582500,
"medicareError": 0,
"status": "WITH MEDICARE"
},
{
"_NOITestCase": "5.1.2.2b",
"type": "BulkBill",
"flags": {
"serviceType": "O",
"hospitalInd": true
},
"patient": {
"dateOfBirth": "1982-10-24",
"medicare": {
"number": "49513067311",
"ref": 0
},
"name": {
"first": "TALIA",
"family": "SIMKINS"
}
},
"provider": {
"servicing": "2433411Y"
},
"location": {
"name": "St Elsewheres Hospital",
"provider": "9988770W",
"type": "H"
},
"items": [
{
"chargeAmount": 37.7,
"date": "2021-06-01",
"itemNumber": "119",
"MedicareVoucherId": "01",
"MedicareServiceId": "0001",
"assessmentNotes": [
{
"assessor": "Medicare",
"code": "350",
"note": "Hospital referral - paid at specialist/consultant rate"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 33.75
}
]
},
{
"chargeAmount": 28.4,
"date": "2021-06-01",
"itemNumber": "55029",
"lspNumber": "000014",
"MedicareVoucherId": "01",
"MedicareServiceId": "0002",
"assessmentNotes": [
{
"assessor": "Medicare",
"code": "514",
"note": "Required equipment type code not on lspn register"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 0.0
}
]
}
],
"claimId": 5106,
"transactionId": "SAP00000cYnMuelmyAyQBho9",
"medicareClaimId": "#0003@",
"timeReceived": 1622582521,
"medicareError": 0,
"assessmentNotes": [],
"paymentId": 589,
"status": "COMPLETE"
}
]
}
Headers:
| Header | Value |
|---|---|
| Server | nginx/1.19.3 |
| Date | Tue, 08 Jun 2021 04:49:28 GMT |
| Content-Type | application/json |
| Content-Length | 183 |
| Connection | keep-alive |
| Access-Control-Allow-Origin | * |
| Access-Control-Allow-Methods | GET, POST, OPTIONS |
GET - Check the status of a range of claims
#
You can change the page limit and offset with parameters. Large blocks should be requested with caution, we recommend max of 100.
{{base_url}}/{{version}}/claims?limit=50&offset=10&since=2021-05-01
Headers
| Header | Value |
|---|---|
| Accept | application/json |
| Content-Type | application/json |
| Authorization | Bearer {{oauth_token}} |
Params
| Param | value |
|---|---|
| limit | 50 |
| offset | 10 |
| since | 2021-05-01 |
Example Request:
curl --location 'https://sandbox.claiming.com.au/v2/claims?limit=50&offset=10' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer '
Example Response:
Body:
{
"status": "OK",
"total": 2909,
"records": 50,
"offset": 10,
"results": [
{
"flags": {
"serviceType": "O"
},
"items": [
{
"MedicareServiceId": "0001",
"MedicareVoucherId": "01",
"chargeAmount": 50.5,
"date": "2018-10-02",
"itemNumber": "00104",
"assessmentNotes": [
{
"assessor": "Medicare",
"code": "103",
"note": "Letter of explanation is being sent separately"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 25.5
}
]
}
],
"patient": {
"dateOfBirth": "1974-02-28",
"gender": "M",
"medicare": {
"number": "0",
"ref": 0
},
"name": {
"family": "",
"first": ""
}
},
"provider": {
"servicing": "2408271B"
},
"type": "BulkBill",
"claimId": 18,
"transactionId": "SAP00003261a5bef5ba81103",
"medicareClaimId": "A0018@",
"timeReceived": 1542566954,
"assessmentNotes": [],
"paymentId": 2,
"status": "COMPLETE"
},
{
"flags": {
"accountPaid": false,
"financialInterestDisclosureInd": true,
"hospitalInd": true,
"ifc": "X",
"imcClaimType": "AG",
"isAccident": false,
"serviceType": "S"
},
"items": [
{
"MedicareServiceId": "0001",
"MedicareVoucherId": "01",
"chargeAmount": 84.45,
"date": "2018-01-01",
"itemNumber": "00001",
"assessmentNotes": [
{
"assessor": "Fund",
"code": "100",
"note": "Lorem ipsum, Dolor sit amet"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 0.0
},
{
"assessor": "Fund",
"benefitPaid": 0.0
}
]
},
{
"MedicareServiceId": "0002",
"MedicareVoucherId": "01",
"chargeAmount": 153.2,
"date": "2018-01-01",
"itemNumber": "00002",
"assessmentNotes": [
{
"assessor": "Fund",
"code": "200",
"note": "Lorem ipsum, Dolor sit amet"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 0.0
},
{
"assessor": "Fund",
"benefitPaid": 0.0
}
]
},
{
"MedicareServiceId": "0003",
"MedicareVoucherId": "01",
"chargeAmount": 229.8,
"date": "2018-01-01",
"duration": 85,
"itemNumber": "00003",
"serviceText": "START TIME 00:00 - END TIME 00:00",
"assessmentNotes": [
{
"assessor": "Fund",
"code": "50",
"note": "Lorem ipsum, Dolor sit amet"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 0.0
},
{
"assessor": "Fund",
"benefitPaid": 0.0
}
]
},
{
"MedicareServiceId": "0004",
"MedicareVoucherId": "01",
"chargeAmount": 76.6,
"date": "2018-01-01",
"itemNumber": "00004",
"assessmentNotes": [
{
"assessor": "Fund",
"code": "25",
"note": "Lorem ipsum, Dolor sit amet"
}
],
"benefit": [
{
"assessor": "Medicare",
"benefitPaid": 0.0
},
{
"assessor": "Fund",
"benefitPaid": 0.0
}
]
}
],
"location": {
"name": "UNIT TEST HOSPITAL",
"provider": "0075200T",
"type": "H"
},
"patient": {
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