Diagnostic Imaging Claims #

Diagnostic Imaging claims are a type of specialist claim and require the following:

Set referral.date
Set referral.provider
Set referral.referralType to “D”
Set flags.serviceType to “S”

`POST` - Submit a Diagnostic Imaging claim #

This example is for an IMC DI claim. You can also use the same format for the referral section for other DI claim types.

NOTE: DI items in the range 55028 to 61499, MRI items and Radiation Oncology items require the LSPN for the equipment to be set. If you don’t know the appropriate LSPN you can search for it here. https://www2.medicareaustralia.gov.au/pext/pdsPortal/pub/lspnSearch.faces

{{base_url}}/{{version}}/claim?location={{location_id}}

Headers

Header	Value
Content-Type	application/json
Authorization	Bearer {{oauth_token}}

Params

Param	value
location	{{location_id}}

Body

{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "28.80",
            "date": "{{today}}",
            "itemNumber": "55028",
            "lspNumber": "000014"
        }
    ],
    "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"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "provider": "2054781W",
        "referralType": "D"
    }
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/claim?location=25' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "type": "InPatientMedical",
    "flags": {
        "accountPaid": "N",
        "ifc": "W",
        "imcClaimType": "AG",
        "isAccident": "N",
        "serviceType": "S"
    },
    "items": [
        {
            "chargeAmount": "28.80",
            "date": "{{today}}",
            "itemNumber": "55028",
            "lspNumber": "000014"
        }
    ],
    "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"
        }
    },
    "provider": {
        "principal": "2433411Y",
        "servicing": "2433411Y"
    },
    "referral": {
        "date": "{{today-4}}",
        "provider": "2054781W",
        "referralType": "D"
    }
}'

Example Response:

Body:

{
  "claimId": 182859,
  "medicareClaimId": "182859",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000t5gWbS7CmcJSLyds"
}

Headers:

Header	Value
Server	nginx/1.19.3
Date	Tue, 08 Jun 2021 04:49:28 GMT
Content-Type	application/json
Content-Length	149
Connection	keep-alive
Access-Control-Allow-Origin	*
Access-Control-Allow-Methods	GET, POST, OPTIONS

Diagnostic Imaging Claims #

POST - Submit a Diagnostic Imaging claim #

`POST` - Submit a Diagnostic Imaging claim #