Pathology Claims #

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

Set referral.date
Set referral.provider
Set referral.referralType to “P”
Set flags.serviceType to “P”

`POST` - Submit a Pathology claim #

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

{{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": "P"
    },
    "items": [
        {
            "chargeAmount": "17.40",
            "date": "{{today}}",
            "itemNumber": "65111",
            "scpId": "00001",
            "accessionDateTime": "{{today-1}} 12:45",
            "collectionDateTime": "{{today-1}} 12:30",
            "time": "09:00"
        },
        {
            "chargeAmount": "12.75",
            "date": "{{today}}",
            "itemNumber": "65070",
            "scpId": "00001",
            "accessionDateTime": "{{today-1}} 13:00",
            "collectionDateTime": "{{today-1}} 12:45",
            "rule3Exempt": "Y",
            "time": "09:00"
        },
        {
            "chargeAmount": "10.30",
            "date": "{{today}}",
            "itemNumber": "65120",
            "s4b3Exempt": "Y",
            "scpId": "00001",
            "accessionDateTime": "{{today-1}} 14:00",
            "collectionDateTime": "{{today-1}} 13:45",
            "time": "09:00"
        }
    ],
    "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": "P"
    }
}

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": "P"
    },
    "items": [
        {
            "chargeAmount": "17.40",
            "date": "{{today}}",
            "itemNumber": "65111",
            "scpId": "00001",
            "accessionDateTime": "{{today-1}} 12:45",
            "collectionDateTime": "{{today-1}} 12:30",
            "time": "09:00"
        },
        {
            "chargeAmount": "12.75",
            "date": "{{today}}",
            "itemNumber": "65070",
            "scpId": "00001",
            "accessionDateTime": "{{today-1}} 13:00",
            "collectionDateTime": "{{today-1}} 12:45",
            "rule3Exempt": "Y",
            "time": "09:00"
        },
        {
            "chargeAmount": "10.30",
            "date": "{{today}}",
            "itemNumber": "65120",
            "s4b3Exempt": "Y",
            "scpId": "00001",
            "accessionDateTime": "{{today-1}} 14:00",
            "collectionDateTime": "{{today-1}} 13:45",
            "time": "09:00"
        }
    ],
    "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": "P"
    }
}'

Example Response:

Body:

{
  "claimId": 182858,
  "medicareClaimId": "182858",
  "message": "Claim queued for sending",
  "status": "OK",
  "transactionId": "SAP00000DylpBQHcX9O01MEe"
}

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

Pathology Claims #

POST - Submit a Pathology claim #

`POST` - Submit a Pathology claim #