Endpoints for claim submission and dispatch.
Close a virtual claim
Closes an existing claim, marking it complete and preventing further modifications. The request body carries a superset of fields; OTP and biometrics are alternative authorization paths, so supply the OTP for the OTP flow or the biometric fields for the biometrics flow.
Related documentation: Close Claim, Understanding Claim Statuses
Headers
X-Facility-IdFacility Registry (FR) code identifying the facility. Required when authenticating with a service-account token.
X-Facility-Id-TypeType of identifier supplied in X-Facility-Id. Currently only fr-code is supported.
Close a virtual claim › Request Body
cancel_reason_textFree-text explanation for closing/cancelling the claim.
cancel_reason_typeconsent_tokenPatient consent token authorising the claim closure.
Close a virtual claim › Responses
Claim closed successfully
admitted_onappointment_numberattributesauthorization_codeauthorization_guidbeneficiary_guidbeneficiary_idbeneficiary_is_fuzzy_matchedcancel_reason_textcancel_reason_typeclaim_attachments_countclaim_auth_statusclaim_idcreated_by_namecurrencydiagnoses_countdischarge_cancel_datedischarge_cancel_remarksdischarge_reasondischarged_onedi_claim_guidemergency_visit_expiryestimate_ip_daysexpected_discharge_datehas_reviewed_claimidinitial_interventioninvoice_attachments_countinvoice_idinvoice_numberis_charge_master_mappedis_negativeis_resubmittedis_zerolast_retrylocation_codelocation_namemember_namemember_numbermember_number_has_tokenmode_of_arrivalnhif_numbernotesnumber_of_invoicespatient_namepatient_numberpayer_codepayer_namepayer_slade_codepolicy_numberpolicy_valid_frompolicy_valid_toprovider_nameprovider_slade_codereason_for_unknown_patientreference_numberresubmission_workflow_stateretry_countscheme_codescheme_nameservice_typetotal_claim_amounttotal_claim_copaytotal_claim_discounttotal_claim_net_amounttotal_claim_splitsupdated_by_namevisit_endvisit_numbervisit_startworkflow_stateDischarge a patient
Discharges a patient, signifying the end of treatment. The request body carries a superset of fields; OTP and biometric/discharge-auth-guid are alternative authorization paths, so supply the OTP for the OTP flow or the biometric fields / discharge authorization guid for the biometrics flow.
Related documentation: Inpatient Claim Dispatch, Understanding Claim Statuses
Headers
X-Facility-IdFacility Registry (FR) code identifying the facility. Required when authenticating with a service-account token.
X-Facility-Id-TypeType of identifier supplied in X-Facility-Id. Currently only fr-code is supported.
Discharge a patient › Request Body
consent_tokenPatient consent token authorising the discharge.
discharge_auth_guidIdentifier of the discharge authorisation associated with the request.
discharge_dateDate and time the patient was discharged.
discharge_reasoninvoice_numberFacility invoice number for the inpatient episode.
otpOne-time password used to verify the request where required.
Discharge a patient › Responses
Patient discharged successfully
admitted_onappointment_numberattributesauthorization_codeauthorization_guidbeneficiary_guidbeneficiary_idbeneficiary_is_fuzzy_matchedcancel_reason_textcancel_reason_typeclaim_attachments_countclaim_auth_statusclaim_idcreated_by_namecurrencydiagnoses_countdischarge_cancel_datedischarge_cancel_remarksdischarge_reasondischarged_onedi_claim_guidemergency_visit_expiryestimate_ip_daysexpected_discharge_datehas_reviewed_claimidinitial_interventioninvoice_attachments_countinvoice_idinvoice_numberis_charge_master_mappedis_negativeis_resubmittedis_zerolast_retrylocation_codelocation_namemember_namemember_numbermember_number_has_tokenmode_of_arrivalnhif_numbernotesnumber_of_invoicespatient_namepatient_numberpayer_codepayer_namepayer_slade_codepolicy_numberpolicy_valid_frompolicy_valid_toprovider_nameprovider_slade_codereason_for_unknown_patientreference_numberresubmission_workflow_stateretry_countscheme_codescheme_nameservice_typetotal_claim_amounttotal_claim_copaytotal_claim_discounttotal_claim_net_amounttotal_claim_splitsupdated_by_namevisit_endvisit_numbervisit_startworkflow_stateSubmit a virtual claim
Submits a virtual claim. This endpoint serves outpatient and emergency claims. Inpatient claims are
dispatched through POST /claims/discharge instead.
The request body takes one of four shapes:
- Standard Claim - an ordinary outpatient claim for an identified patient. The visit end is
authorised either by OTP (
otp) or by biometrics (discharge_auth_guid), which are alternative paths: supply one, not both. - Emergency - Identified Patient - an emergency claim for a patient who has been identified. The
visit-end authorisation fields are not read for emergency claims. The precondition is doctor consent
instead: the claim's doctor consent status must be
APPROVEDor the submission is rejected. - Emergency - Unidentified Patient - as above, plus a mandatory
reason_for_unknown_patient. - Finalise a Partial Discharge - the second call that submits a claim previously discharged with
discharge_status: PARTIAL. It needs onlyconsent_tokenanddischarge_status: FULL.
discharge_status defaults to FULL, which discharges the patient and submits the claim in one call,
so omitting it behaves exactly as before.
Related documentation: Outpatient Claim Dispatch, Partial and Full Discharge, Submit Emergency Claim, Adding a Claim Doctor
Headers
X-Facility-IdFacility Registry (FR) code identifying the facility. Required when authenticating with a service-account token.
X-Facility-Id-TypeType of identifier supplied in X-Facility-Id. Currently only fr-code is supported.
Submit a virtual claim › Request Body
Decision Table
| Variant | Matching Criteria |
|---|---|
| type = object · requires: consent_token, invoice_number, discharge_reason | |
| type = object · requires: consent_token, invoice_number, discharge_reason | |
| type = object · requires: consent_token, invoice_number, discharge_reason +1 more | |
| type = object · requires: consent_token, discharge_status |
consent_tokenConsent token authorising submission of the virtual claim.
invoice_numberProvider invoice number for the claim. Required on every submission, including the first call of a partial discharge.
discharge_reasonReason the outpatient is being discharged. DECEASED is not valid here - it is an inpatient discharge reason, supplied on POST /claims/discharge.
discharge_statusWhether this call completes the visit or only discharges the patient. FULL (the default) discharges the patient and immediately submits the claim to SHA, running all submission validations. PARTIAL takes consent and records the discharge reason so the patient can leave, but holds the claim back so the facility can finish assembling documentation, then submit it with a second call carrying FULL.
notesFree-text notes accompanying the claim submission. Recorded only on the authorised (non-emergency) submission path.
otpOne-time password used to confirm the patient's consent to close the visit. Use this on the OTP authorisation path.
beneficiary_contact_idIdentifier of the beneficiary contact the discharge OTP was sent to (the id from Get OTP Contacts, not a phone number). Optional even on the OTP path. Omit it on the biometrics path, where discharge_auth_guid is used instead.
discharge_auth_guidGUID of the discharge authorisation associated with the visit. Use this on the biometrics authorisation path, in place of otp.
Submit a virtual claim › Responses
Claim submitted successfully
admitted_onappointment_numberattributesauthorization_codeauthorization_guidbeneficiary_guidbeneficiary_idbeneficiary_is_fuzzy_matchedcancel_reason_textcancel_reason_typeclaim_attachments_countclaim_auth_statusclaim_idcreated_by_namecurrencydiagnoses_countdischarge_cancel_datedischarge_cancel_remarksdischarge_reasondischarged_onedi_claim_guidemergency_visit_expiryestimate_ip_daysexpected_discharge_datehas_reviewed_claimidinitial_interventioninvoice_attachments_countinvoice_idinvoice_numberis_charge_master_mappedis_negativeis_resubmittedis_zerolast_retrylocation_codelocation_namemember_namemember_numbermember_number_has_tokenmode_of_arrivalnhif_numbernotesnumber_of_invoicespatient_namepatient_numberpayer_codepayer_namepayer_slade_codepolicy_numberpolicy_valid_frompolicy_valid_toprovider_nameprovider_slade_codereason_for_unknown_patientreference_numberresubmission_workflow_stateretry_countscheme_codescheme_nameservice_typetotal_claim_amounttotal_claim_copaytotal_claim_discounttotal_claim_net_amounttotal_claim_splitsupdated_by_namevisit_endvisit_numbervisit_startworkflow_state