Skip to main content


         This documentation site is for previous versions. Visit our new documentation site for current releases.      
 

Claims Inquiry API Details

Updated on March 12, 2022

Pega Smart Claims Engine for Healthcare supports two API’s.

POST Claims Inquiry API: The POST Claims Inquiry API accepts set of claims inquiry search parameters as request json. On receiving the request Smart Claims Engine creates a claim inquiry case with respective claims search criteria results and routes it to claims inquiry work basket with “Pending-review” status. Response includes claims inquiry meta data returned as json.

GET Claims Inquiry API: The GET Claims Inquiry API accepts claims inquiry case ID as input request path parameter and returns claims inquiry meta data.

Signature Details:

Post Claims Inquiry APIGet Claims Inquiry API
http://<<URL>>/prweb/PRRestService/
healthcareapi/v1/ClaimsInquiry/{ID}
http://<<URL>>/prweb/PRRestService/
healthcareapi/v1/ClaimsInquiry/{ID}

Service package: healthcareapi

Have a question? Get answers now.

Visit the Support Center to ask questions, engage in discussions, share ideas, and help others.

Did you find this content helpful?

Want to help us improve this content?

We'd prefer it if you saw us at our best.

Pega.com is not optimized for Internet Explorer. For the optimal experience, please use:

Close Deprecation Notice
Contact us