GET api/Claims/GetClaims?MemberId={MemberId}&ProviderId={ProviderId}&ClaimNo={ClaimNo}&CompanyId={CompanyId}&DateOfServiceRangeStart={DateOfServiceRangeStart}&DateOfServiceRangeEnd={DateOfServiceRangeEnd}&IncludeEncounters={IncludeEncounters}&ProviderNPI={ProviderNPI}

Request Information

URI Parameters

Name	Type	Additional information
MemberId	string	None.
ProviderId	string	None.
ClaimNo	string	None.
CompanyId	Company	None.
DateOfServiceRangeStart	date	Data type: Date
DateOfServiceRangeEnd	date	Data type: Date
IncludeEncounters	boolean	None.
ProviderNPI	string	None.

Body Parameters

None.

Request Formats

text/json, application/json

Sample:

Request sample for request 

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{
  "MemberId": "sample string 1",
  "ProviderId": "sample string 2",
  "ClaimNo": "sample string 3",
  "CompanyId": 0,
  "DateOfServiceRangeStart": "2026-06-03T09:19:53.2327462-07:00",
  "DateOfServiceRangeEnd": "2026-06-03T09:19:53.2327462-07:00",
  "IncludeEncounters": true,
  "ProviderNPI": "sample string 5"
}

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text/xml, application/xml

Sample:

Request sample for request 

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<ClaimRequestDTO xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs.Claims" xmlns:i="http://www.w3.org/2001/XMLSchema-instance">
  <ClaimNo>sample string 3</ClaimNo>
  <CompanyId>None</CompanyId>
  <DateOfServiceRangeEnd>2026-06-03T09:19:53.2483705-07:00</DateOfServiceRangeEnd>
  <DateOfServiceRangeStart>2026-06-03T09:19:53.2483705-07:00</DateOfServiceRangeStart>
  <IncludeEncounters>true</IncludeEncounters>
  <MemberId>sample string 1</MemberId>
  <ProviderId>sample string 2</ProviderId>
  <ProviderNPI>sample string 5</ProviderNPI>
</ClaimRequestDTO>

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Response Information

Resource Description

IHttpActionResult

None.

Response Formats

text/json, application/json

Sample:


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{
  "Claims": [
    {
      "ReceivedDate": "2026-06-03T09:19:53.2483705-07:00",
      "Status": {
        "Status": 0
      },
      "ClaimDetailsUrl": "sample string 1",
      "ClaimNo": "sample string 2",
      "ClaimSubType": 0,
      "DateOfServiceStart": "2026-06-03T09:19:53.2483705-07:00",
      "DateOfServiceEnd": "2026-06-03T09:19:53.2483705-07:00",
      "MemberId": "sample string 3",
      "MemberName": "sample string 4",
      "VendorId": "sample string 5",
      "VendorName": "sample string 6",
      "DOB": "2026-06-03T09:19:53.2483705-07:00",
      "PlaceOfService": {
        "Code": "sample string 1",
        "Description": "sample string 2"
      },
      "PrimaryDiagnosis": {
        "Code": "sample string 1",
        "Description": "sample string 2"
      },
      "CompanyId": 0,
      "CheckNumber": 1,
      "PaidDate": "2026-06-03T09:19:53.2483705-07:00",
      "AuthorizationNumber": "sample string 7",
      "AdjustmentPaidDate": "2026-06-03T09:19:53.2483705-07:00",
      "Provider": {
        "Id": "sample string 1",
        "FirstName": "sample string 2",
        "LastName": "sample string 3",
        "MI": "sample string 4",
        "FullName": "sample string 5"
      },
      "AmountDetail": {
        "Paid": "sample string 1",
        "Billed": "sample string 2",
        "Contract": "sample string 3",
        "Net": "sample string 4"
      }
    },
    {
      "ReceivedDate": "2026-06-03T09:19:53.2483705-07:00",
      "Status": {
        "Status": 0
      },
      "ClaimDetailsUrl": "sample string 1",
      "ClaimNo": "sample string 2",
      "ClaimSubType": 0,
      "DateOfServiceStart": "2026-06-03T09:19:53.2483705-07:00",
      "DateOfServiceEnd": "2026-06-03T09:19:53.2483705-07:00",
      "MemberId": "sample string 3",
      "MemberName": "sample string 4",
      "VendorId": "sample string 5",
      "VendorName": "sample string 6",
      "DOB": "2026-06-03T09:19:53.2483705-07:00",
      "PlaceOfService": {
        "Code": "sample string 1",
        "Description": "sample string 2"
      },
      "PrimaryDiagnosis": {
        "Code": "sample string 1",
        "Description": "sample string 2"
      },
      "CompanyId": 0,
      "CheckNumber": 1,
      "PaidDate": "2026-06-03T09:19:53.2483705-07:00",
      "AuthorizationNumber": "sample string 7",
      "AdjustmentPaidDate": "2026-06-03T09:19:53.2483705-07:00",
      "Provider": {
        "Id": "sample string 1",
        "FirstName": "sample string 2",
        "LastName": "sample string 3",
        "MI": "sample string 4",
        "FullName": "sample string 5"
      },
      "AmountDetail": {
        "Paid": "sample string 1",
        "Billed": "sample string 2",
        "Contract": "sample string 3",
        "Net": "sample string 4"
      }
    }
  ],
  "ConfirmationNumber": "sample string 1",
  "Notes": "sample string 2",
  "ProcessingStatusList": [
    {
      "StatusCode": "sample string 1",
      "StatusDescription": "sample string 2"
    },
    {
      "StatusCode": "sample string 1",
      "StatusDescription": "sample string 2"
    }
  ]
}

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text/xml, application/xml

Sample:


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<ClaimSummaryResponseDTO xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs.Claims" xmlns:i="http://www.w3.org/2001/XMLSchema-instance">
  <ProcessingStatusList xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs" xmlns:a="http://schemas.datacontract.org/2004/07/AHC.Core">
    <a:ProcessingStatus>
      <a:StatusCode>sample string 1</a:StatusCode>
      <a:StatusDescription>sample string 2</a:StatusDescription>
    </a:ProcessingStatus>
    <a:ProcessingStatus>
      <a:StatusCode>sample string 1</a:StatusCode>
      <a:StatusDescription>sample string 2</a:StatusDescription>
    </a:ProcessingStatus>
  </ProcessingStatusList>
  <ConfirmationNumber xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs">sample string 1</ConfirmationNumber>
  <EstimatedFulfillmentDate xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs">2026-06-03T09:19:53.2483705-07:00</EstimatedFulfillmentDate>
  <Notes xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs">sample string 2</Notes>
  <Claims>
    <ClaimSummaryDTO>
      <AdjustmentPaidDate>2026-06-03T09:19:53.2483705-07:00</AdjustmentPaidDate>
      <AmountDetail>
        <Billed>sample string 2</Billed>
        <Contract>sample string 3</Contract>
        <Net>sample string 4</Net>
        <Paid>sample string 1</Paid>
      </AmountDetail>
      <AuthorizationNumber>sample string 7</AuthorizationNumber>
      <CheckNumber>1</CheckNumber>
      <ClaimNo>sample string 2</ClaimNo>
      <ClaimSubType>None</ClaimSubType>
      <CompanyId>None</CompanyId>
      <DOB>2026-06-03T09:19:53.2483705-07:00</DOB>
      <DateOfServiceEnd>2026-06-03T09:19:53.2483705-07:00</DateOfServiceEnd>
      <DateOfServiceStart>2026-06-03T09:19:53.2483705-07:00</DateOfServiceStart>
      <MemberId>sample string 3</MemberId>
      <MemberName>sample string 4</MemberName>
      <PaidDate>2026-06-03T09:19:53.2483705-07:00</PaidDate>
      <PlaceOfService>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
      </PlaceOfService>
      <PrimaryDiagnosis>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
      </PrimaryDiagnosis>
      <Provider>
        <FirstName>sample string 2</FirstName>
        <FullName>sample string 5</FullName>
        <Id>sample string 1</Id>
        <LastName>sample string 3</LastName>
        <MI>sample string 4</MI>
      </Provider>
      <VendorId>sample string 5</VendorId>
      <VendorName>sample string 6</VendorName>
      <ClaimDetailsUrl>sample string 1</ClaimDetailsUrl>
      <ReceivedDate>2026-06-03T09:19:53.2483705-07:00</ReceivedDate>
      <Status>
        <Status>None</Status>
      </Status>
    </ClaimSummaryDTO>
    <ClaimSummaryDTO>
      <AdjustmentPaidDate>2026-06-03T09:19:53.2483705-07:00</AdjustmentPaidDate>
      <AmountDetail>
        <Billed>sample string 2</Billed>
        <Contract>sample string 3</Contract>
        <Net>sample string 4</Net>
        <Paid>sample string 1</Paid>
      </AmountDetail>
      <AuthorizationNumber>sample string 7</AuthorizationNumber>
      <CheckNumber>1</CheckNumber>
      <ClaimNo>sample string 2</ClaimNo>
      <ClaimSubType>None</ClaimSubType>
      <CompanyId>None</CompanyId>
      <DOB>2026-06-03T09:19:53.2483705-07:00</DOB>
      <DateOfServiceEnd>2026-06-03T09:19:53.2483705-07:00</DateOfServiceEnd>
      <DateOfServiceStart>2026-06-03T09:19:53.2483705-07:00</DateOfServiceStart>
      <MemberId>sample string 3</MemberId>
      <MemberName>sample string 4</MemberName>
      <PaidDate>2026-06-03T09:19:53.2483705-07:00</PaidDate>
      <PlaceOfService>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
      </PlaceOfService>
      <PrimaryDiagnosis>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
      </PrimaryDiagnosis>
      <Provider>
        <FirstName>sample string 2</FirstName>
        <FullName>sample string 5</FullName>
        <Id>sample string 1</Id>
        <LastName>sample string 3</LastName>
        <MI>sample string 4</MI>
      </Provider>
      <VendorId>sample string 5</VendorId>
      <VendorName>sample string 6</VendorName>
      <ClaimDetailsUrl>sample string 1</ClaimDetailsUrl>
      <ReceivedDate>2026-06-03T09:19:53.2483705-07:00</ReceivedDate>
      <Status>
        <Status>None</Status>
      </Status>
    </ClaimSummaryDTO>
  </Claims>
</ClaimSummaryResponseDTO>

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