POST API Request Mapping
The following table shows the POST API Request Fields and Corresponding SCE Class and Property Mapping.
Request Parameter | SCE Class | SCE Property | Property Type | API Class | Api Property | Data Type | Is Mandatory |
Claims inquiry reason code | PegaHC-CLM-Work-Claimsinquiry | ReasonForInquiry | Text | PegaHC-API | claimsInquiry.reasonForInquiry | String | Yes |
PegaHC-CLM-Work-Claimsinquiry | ReasonForInquiryOther | Text | PegaHC-API | claimsInquiry.reasonForInquiryOther | String | No | |
Claims Inquiry type | PegaHC-CLM-Work-Claimsinquiry | InquiryTypeSelect | Text | PegaHC-API | claimsInquiry.inquiryTypeSelect | String | Yes |
PegaHC-CLM-Work-Claimsinquiry | InquiryTypeSelectOther | Text | PegaHC-API | claimsInquiry.inquiryTypeSelectOther | String | No | |
Inquiry Notes | PegaHC-CLM-Work-Claimsinquiry | ClaimsInquiryNotes | Text | PegaHC-API | claimsInquiry.claimsInquiryNotes | String | No |
ICN's | PegaHC-CLM-Work-Claimsinquiry | ICNList().ID | Pagelist | PegaHC-API | claimsInquiry.icnList().ID | String | Conditional |
BillingProviderNPI | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.NationalProviderIdentifier | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.nationalProviderIdentifier | String | Conditional |
BillingProviderTaxID | PegaHC-CLM-Work | BillingProviderNumber | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.taxIdentificationNumber | String | Conditional |
BillingProviderLastName | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.pyLastName | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.lastName | String | No |
BillingProviderAddressLine1 | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.PracticeAddress().AddressLine1 | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.address().addressLine1 | String | No |
BillingProviderAddressLine2 | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.PracticeAddress().AddressLine2 | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.address().addressLine2 | String | No |
BillingProviderCity | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.PracticeAddress().City | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.address().city | String | No |
BillingProviderState | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.PracticeAddress().State | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.address().state | String | No |
BillingProviderZip | PegaHC-CLM-Work-Claimsinquiry | Claim.BillingEntity.PracticeAddress().PostalCode | Text | PegaHC-API | claimsInquiry.claimHeader.billingProvider.address().postalCode | String | No |
SubscriberID | PegaHC-CLM-Work | SubscriberNumber | Text | PegaHC-API | claimsInquiry.claimHeader.subscriber.ID | String | Conditional |
SubscriberFirstName | PegaHC-CLM-Work-Claimsinquiry | Claim.Subscriber.pyFirstName | Text | PegaHC-API | claimsInquiry.claimHeader.subscriber.firstName | String | No |
SubscriberLastName | PegaHC-CLM-Work-Claimsinquiry | Claim.Subscriber.pyLastName | Text | PegaHC-API | claimsInquiry.claimHeader.subscriber.lastName | String | No |
PatientID | PegaHC-CLM-Work | PatientNumber | Text | PegaHC-API | claimsInquiry.claimHeader.patient.ID | String | Conditional |
PatientFirstName | PegaHC-CLM-Work-Claimsinquiry | Claim.Patient.pyFirstName | Text | PegaHC-API | claimsInquiry.claimHeader.patient.firstName | String | No |
PatientLastName | PegaHC-CLM-Work-Claimsinquiry | Claim.Patient.pyLastName | Text | PegaHC-API | claimsInquiry.claimHeader.patient.lastName | String | No |
Claim type | PegaHC-CLM-Work-Claimsinquiry | Claim.ClaimType | Text | PegaHC-API | claimsInquiry.claimHeader.claimType | String | No |
Claim total charge amount | PegaHC-CLM-Work-Claimsinquiry | Claim.TotalClaimChargeAmount | Decimal | PegaHC-API | claimsInquiry.claimHeader.totalChargeAmount | String | No |
Claim total paid amount | PegaHC-CLM-Work-Claimsinquiry | Claim.TotalClaimPaidAmount | Decimal | PegaHC-API | claimsInquiry.claimHeader.paidAmount | String | No |
Status | PegaHC-CLM-Work-Claimsinquiry | Claim.ClaimStatus | Text | PegaHC-API | claimsInquiry.claimHeader.claimStatus | String | No |
ServiceDateFrom | PegaHC-CLM-Work-Claimsinquiry | Claim.ServiceFromDate | Date | PegaHC-API | claimsInquiry.claimHeader.serviceFromDate | String | No |
ServiceDateTo | PegaHC-CLM-Work-Claimsinquiry | Claim.ServiceToDate | Date | PegaHC-API | claimsInquiry.claimHeader.serviceEndDate | String | No |
Submission date | PegaHC-CLM-Work-Claimsinquiry | Claim.SubmittedDate | Date | PegaHC-API | claimsInquiry.claimHeader.submittedDate | String | No |
Rendering provider NPI | PegaHC-CLM-Work | RenderingProviderNumber | Text | PegaHC-API | claimsInquiry.claimHeader.renderingProvider.ID | String | No |
Plan ID | PegaHC-CLM-Work-Claimsinquiry | Claim.Patient.PlanName | Text | PegaHC-API | claimsInquiry.claimHeader.planID | String | No |
Contract ID | PegaHC-CLM-Work | ContractID | Text | PegaHC-API | claimsInquiry.claimHeader.contractInformation.ID | String | No |
Attachment URL | Work- | pyURL | String | PegaHC-API | claimsInquiry.attachmentURL | String | No |
Group Number | PegaHC-CLM-Work | GroupNumber | Text | PegaHC-API | claimsInquiry.groupNumber | String | No |
Exchange Indicator | PegaHC-CLM-Work-Claimsinquiry | ExchangeIndicator | Text | PegaHC-API | claimsInquiry.exchangeIndicator | String | No |
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