Primary Flow APIs
Details of the APIs that facilitate the claims exchange flow
CoverageEligibility
Eligibility check
/coverageeligibility/check (provider->HCX, HCX->payor)
/coverageeligibility/on_check (payor->HCX, HCX->provider)
Claims
PreDetermination submission
/predetermination/submit (provider->HCX, HCX->payor)
/predetermintation/on_submit (payor->HCX, HCX->provider)
PreAuth submission
/preauth/submit (provider->HCX, HCX->payor)
/preauth/on_submit (payor->HCX, HCX->provider)
Claim submission
/claim/submit (provider->HCX, HCX->payor)
/claim/on_submit (payor->HCX, HCX->provider)
Payments
Payment notice and acknowledgement
/paymentnotice/request (payor>HCX, HCX->provider-)
/paymentnotice/on_request (provider->HCX, HCX->payor)
Following OpenAPI 3.0 specification details these APIs in detail. These API specs can be opened in swagger editor via this link.
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