Supported integrations
For now, claims are only supported for Open Dental, Dentrix, Dentrix Enterprise, and Eaglesoft.
Overview
The claims endpoints let you access insurance claims for patient services. Practices use claims to get insurance reimbursements and share key information with insurance providers. Claims typically include line items for each procedure performed, along with essential billing information. A claim can be sent to more than one insurance provider.
Example use cases
-
Display real-time insurance claim statuses in a patient portal. Patients can see which claims have been submitted, paid, or denied, reducing confusion and inbound support calls
-
Identify claims that have been outstanding for over 30 days and automatically trigger follow-up tasks for billing teams. This helps practices reduce insurance aging and accelerate cash flow.
Sample response
{
"code": false,
"description": "Description",
"error": "Error",
"data": {
"id": 10,
"location_id": 1,
"patient_id": 1002,
"provider_id": 101,
"guarantor_id": 1001,
"status": "sent",
"received_at": "2024-06-10T15:16:57.000Z",
"sent_at": "2024-06-03T11:23:12.000Z",
"note": "Claim was sent to the insurance company",
"primary_insurance_plan_id": 10021,
"secondary_insurance_plan_id": 10021,
"date_of_service": "2024-06-03",
"totals": {
"amount_billed_to_insurance": {
"amount": "62.00",
"currency": "USD"
},
"estimated_insurance_payment": {
"amount": "62.00",
"currency": "USD"
},
"insurance_payment": {
"amount": "62.00",
"currency": "USD"
},
"write_off": {
"amount": "62.00",
"currency": "USD"
}
},
"deleted_at": "2022-01-01T00:00:00Z",
"patient": {
...
},
"provider": {
...
},
"guarantor": {
...
},
"charge_payouts":[
{
...
],
"charges": {
{
...
}
]
},
"count": 2
}