Page Comparison

...

Steps

Example Request

Example Response

1

Contact the VSee team to configure which insurers you want to support. Once configured, use https://vsee.atlassian.net/wiki/spaces/VD/pages/55083127/Insurance+API#GET-%2Finsurance%2F to pull the list which will also contain insurer_id.

Code Block
curl --location --request GET 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/insurances/' \ --header 'X-ApiToken: xxxx'

Code Block

language	json

{
    "data": {
        "insurers": [
            {
                "id": "car7551",
                "name": "AETNA"
            },
            {
                "id": "car7414",
                "name": "AETNA BETTER HEALTH OF ILLINOIS"
            },
            {
                "id": "car11406",
                "name": "ANTHEM BLUE SHIELD"
            },
            {
                "id": "car7147",
                "name": "CIGNA HEALTH CARE"
            },
            {
                "id": "car7580",
                "name": "MONTGOMERY HEALTH INSURANCE"
            },
            {
                "id": "car7556",
                "name": "HEALTH CHOICE ARIZONA"
            }
        ]
    }
}

2

Create a VSee Clinic user via https://vsee.atlassian.net/wiki/spaces/VD/pages/14942243/User+API#POST-%2Fusers%2Fsso

As a response you will receive patient data on VSee side.

Code Block

curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/sso' \
--header 'X-AccountCode: vclinic' \
--header 'X-ApiKey: xxx' \
--header 'X-ApiSecret: xxx' \
--header 'X-ApiToken: xxx' \
--form 'first_name="Edward"' \
--form 'last_name="VSee"' \
--form 'type="200"' \
--form 'code="edward+001.vclinic@vseelab.com"' \
--form 'email="edward+001.vclinic@vseelab.com"' \
--form 'dob="1986-01-01"' \
--form 'gender="1"' \
--form 'street_addr="2868 Tully Street"' \
--form 'state="Detroit"' \
--form 'city="MI"' \
--form 'zip="48226"' \
--form 'insurance__primary__carrier_code="car11400"' \
--form 'insurance__primary__subscriber_num="10000022"' \
--form 'insurance__primary__group_number="test"' \
--form 'insurance__primary__card_front="card_front_url"' \
--form 'insurance__primary__card_back="card_back_url"' \
--form 'insurance__secondary__carrier_code="car11406"' \
--form 'insurance__secondary__group_number="XX1243"' \
--form 'insurance__secondary__subscriber_num="5678"' \
--form 'insurance__secondary__card_front="card_front_url"' \
--form 'insurance__secondary__card_back="card_back_url"' \
--form 'insurance__patient__respparty="self"' \
--form 'insurance__patient__guarantor_name="Edward VSee"' \
--form 'insurance__patient__guarantor_dob="1986-01-01"' \
--form 'insurance__patient__guarantor_city="NY"' \
--form 'insurance__patient__guarantor_zip="10001"' \
--form 'insurance__patient__guarantor_address="test"' \
--form 'extra__th_id="123456"'

Code Block

language	json

{
    "data": {
        "id": "132407",
        "code": "edward+001.vclinic@vseelab.com",
        "first_name": "Edward",
        "last_name": "VSee",
        "full_name": "Edward VSee",
        "username": "edward+001.vclinic@vseelab.com",
        "vseeid": "ccpreview+6258012d656449b8b5e73ad964457b1f",
        "dob": "1986-01-01",
        "email": "edward+001.vclinic@vseelab.com",
        "gender": 1,
        "active": true,
        "tos": false,
        "status": 20,
        "subtype": "",
        "street_addr": "2868 Tully Street",
        "state": "Detroit",
        "city": "MI",
        "zip": "48226",
        "timezone": "America/Los_Angeles",
        "email_verified": true,
        "insurance": {
            "primary": {
                "carrier_code": "car11400",
                "subscriber_num": "10000022",
                "group_number": "test"
            },
            "patient": {
                "respparty": "self",
                "guarantor_name": "Edward VSee",
                "guarantor_city": "NY",
                "guarantor_zip": "10001",
                "guarantor_address": "test"
            },
            "guarantor_dob": "1986-01-01"
        },
        "account_code": "vclinic",
        "clinics": [
            "vclinic"
        ],
        "created": 1649934637,
        "token": {
            "user_id": "132407",
            "token": "xxxx",
            "expiry": 1650021037,
            "created": 1649934637,
            "user_type": "200",
            "refresh_token": {
                "user_id": "132407",
                "token": "xxxx",
                "expiry": 1652526637,
                "created": 1649934637
            }
        }
    }
}

3

Run Insurance API (Draft) | POST-/users/:id/:carrier_code/eligibility to trigger the eligibility check for the given user_id. The eligibility check may take some time. A cron job will be created. The cron job will run after 10 seconds and the response will be saved in the user_data.insurance.{primary/secondary}.eligibility_response

Use the Token provided with your API Credentials for the X-ApiToken header.

Code Block
curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/132407/car7556/eligibility' \ --header 'X-AccountCode: vclinic' \ --header 'X-ApiToken: xxxx'

Code Block

language	json

{
    "data": {
        "eligibility_id": "2505465",
        "carrier_code": "car7556"
    }
}

4

Receive a webhook request with eligibility_response message which will contain the result of the eligibility check. Skip this step if the clinic doesn’t have webhook.

Code Block

language	json

{
  "id": "62583ab3-8cfc-4a47-b6c9-272850e631f8",
  "type": "eligibility.checked",
  "created": 1649949363,
  "account_code": "vclinic",
  "data": {
    "eligibility_id": "2505464",
    "member_id": "132407",
    "eligibility_response": "No response received by clearinghouse",
    "external_member_id": "5991794"
  }
}

5

If the user is eligible, trigger a claim submission process for the usermember_id https://vsee.atlassian.net/wiki/spaces/VD/pages/55083127/Insurance+API#POST-%2Finsurance%2Fclaims

TDB

TBD

6

Receive a webhook request which will contain the result of the claim.

TBD

POST /users/:id/edit

https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/:id/edit

...

Request

Response

Code Block
curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/

dev/api

devapi_v3/

users

insurances/

123407/edit

claims' \
--header 'X-

ApiToken

AccountCode:

xxxx

vclinic' \
--

form

header '

first_name="Edward"

X-ApiKey: xxx' \
--

form

header '

last_name="VSee"

X-ApiSecret: xxx' \
--

form

header '

dob="1986-01-01"

X-ApiToken: xxx' \
--data-

form

raw '

gender="1"' \ --form 'street_addr="2868 Tully Street"' \ --form 'state="Detroit"' \ --form 'city="MI"' \ --form 'zip="48226"' \ --form 'insurance__primary__carrier_code="car11400"' \ --form 'insurance__primary__subscriber_num="10000022"' \ --form 'insurance_

{
    "member_id": "2186945",
    "date_of_service": "08/19/2022",
    "location": "41",
    "charge_list": [
        {
            "procedure_code": "10022",
            "units": 1,
            "diagnosis_code": "Z20.822 R05.9"
        },
         {
            "procedure_code": "10022",
            "units": 1,
            "diagnosis_code": "Z209822"
        }
    ]
}'

Code Block

language	json

{
  "data": {
    "id": "82828",
  }
}

6

Receive a webhook request which will contain the result of the claim.

TBD

POST /users/:id/edit

https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/:id/edit

Update patient insurance information.

Request

Response

Code Block

curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/123407/edit' \
--header 'X-ApiToken: xxxx' \
--form 'first_name="Edward"' \
--form 'last_name="VSee"' \
--form 'dob="1986-01-01"' \
--form 'gender="1"' \
--form 'street_addr="2868 Tully Street"' \
--form 'state="Detroit"' \
--form 'city="MI"' \
--form 'zip="48226"' \
--form 'insurance__primary__carrier_code="car11400"' \
--form 'insurance__primary__subscriber_num="10000022"' \
--form 'insurance__primary__group_number="test"' \
--form 'insurance__primary__card_front="card_front_url"' \
--form 'insurance__primary__card_back="card_back_url"' \
--form 'insurance__secondary__carrier_code="car11406"' \
--form 'insurance__secondary__group_number="XX1243"' \
--form 'insurance__secondary__subscriber_num="5678"' \
--form 'insurance__secondary__card_front="card_front_url"' \
--form 'insurance__secondary__card_back="card_back_url"' \
--form 'insurance__patient__respparty="self"' \
--form 'insurance__patient__guarantor_name="Edward VSee"' \
--form 'insurance__patient__guarantor_dob="1986-01-01"' \
--form 'insurance__patient__guarantor_city="NY"' \
--form 'insurance__patient__guarantor_zip="10001"' \
--form 'insurance__patient__guarantor_address="test"' \
--form 'extra__th_id="123456"'

Code Block

language	json

{
    "data": {
        "id": "132407",
        "code": "edward+001.vclinic@vseelab.com",
        "first_name": "Edward",
        "last_name": "VSee",
        "full_name": "Edward VSee",
        "username": "edward+001.vclinic@vseelab.com",
        "vseeid": "ccpreview+6258012d656449b8b5e73ad964457b1f",
        "dob": "1986-01-01",
        "email": "edward+001.vclinic@vseelab.com",
        "gender": 1,
        "active": true,
        "tos": false,
        "status": 20,
        "subtype": "",
        "street_addr": "2868 Tully Street",
        "state": "Detroit",
        "city": "MI",
        "zip": "48226",
        "timezone": "America/Los_Angeles",
        "email_verified": true,
        "insurance": {
            "primary": {
                "carrier_code": "car7556",
                "subscriber_num": "234234",
                "insurance_order": 1
            },
            "secondary": {
                "carrier_code": "car11406",
                "group_number": "asdasd",
                "subscriber_num": "aaaaa",
                "insurance_order": 2
            },
            "patient": {
                "respparty": "self"
            }
        },
        "account_code": "vclinic",
        "clinics": [
            "vclinic"
        ],
        "created": 1649934637
    }
}

...

Code Block

language	json

{
    "data": {
        "id": "132407",
        "code": "edward+001.vclinic@vseelab.com",
        "first_name": "Edward",
        "last_name": "VSee",
        "full_name": "Edward VSee",
        "username": "edward+001.vclinic@vseelab.com",
        "vseeid": "ccpreview+6258012d656449b8b5e73ad964457b1f",
        "dob": "1986-01-01",
        "email": "edward+001.vclinic@vseelab.com",
        "gender": 1,
        "active": true,
        "tos": false,
        "status": 20,
        "subtype": "",
        "street_addr": "2868 Tully Street",
        "state": "Detroit",
        "city": "MI",
        "zip": "48226",
        "timezone": "America/Los_Angeles",
        "email_verified": true,
        "insurance": {
            "primary": {
                "carrier_code": "car7556",
                "subscriber_num": "234234",
                "insurance_order": 1,
                "insurance_coverage_id": "3708039",
                "eligibility_id": "2505465",
                "last_checked": 1649950742,
                "eligibility_response": "No response received by clearinghouse",
                "eligibility_text": "The payer response contains invalid or non compliant data.(70002)",
                "raw_response": {
                    "?xml": {
                        "@version": "1.0",
                        "@encoding": "ISO-8859-1"
                    },
                    "PPMDResults": {
                        "@s": "PRDAPI1WFEYU1PO",
                        "@lst": "4/14/2022 8:39:02 AM",
                        "Results": {
                            "@eligibilityid": "2505465",
                            "@eligibilitystatusid": "1",
                            "@eligibilitycreatedat": "04/14/2022  8:38AM",
                            "@eligibilitychangedat": "04/14/2022  8:38AM",
                            "@eligibilityresponsedate": "04/14/2022  8:38AM",
                            "@patientname": "VSEE,EDWARD",
                            "@address2": "2868 TULLY STREET",
                            "@city": "MI",
                            "@state": "DET",
                            "@zipcode": "48226     ",
                            "@dob": "1986-01-01T00:00:00",
                            "@subscriberid": "234234",
                            "@eligibilitystc": "30",
                            "Edi271": {
                                "@xmlns:xsi": "http://www.w3.org/2001/XMLSchema-instance",
                                "@xmlns:xsd": "http://www.w3.org/2001/XMLSchema",
                                "InterchangeControlHeader": {
                                    "@ISA01_AuthorizationInformationQualifier": "00",
                                    "@ISA02_AuthorizationInformation": "          ",
                                    "@ISA03_SecurityInformationQualifier": "00",
                                    "@ISA04_SecurityInformation": "          ",
                                    "@ISA05_SenderInterchangeIdQualifier": "ZZ",
                                    "@ISA06_SendersInterchangeId": "MCKESSON_TSH   ",
                                    "@ISA07_ReceiverInterchangeIdQualifier": "ZZ",
                                    "@ISA08_ReceiversInterchangeId": "007454         ",
                                    "@ISA09_Date": "220414",
                                    "@ISA10_Time": "1038",
                                    "@ISA11_InterchangeStandardsIdentifier": "|",
                                    "@ISA12_InterchangeVersionId": "00501",
                                    "@ISA13_InterchangeControlNumber": "000000001",
                                    "@ISA14_AcknowledgementRequested": "0",
                                    "@ISA15_TestIndicator": "P",
                                    "@ISA16_SubElementDelimeter": ":"
                                },
                                "FunctionalGroupHeader": {
                                    "@GS01_FunctionalIdentifierCode": "HB",
                                    "@GS02_ApplicationSendersCode": "ZZDEMO",
                                    "@GS03_ApplicationReceiversCode": "025924AMD",
                                    "@GS04_Date": "20220414",
                                    "@GS05_Time": "103848",
                                    "@GS06_GroupControlNumber": "314159265",
                                    "@GS07_ResponsibleAgencyCode": "X",
                                    "@GS08_VersionIdentificationCode": "005010X279A1"
                                },
                                "TransactionSets": {
                                    "TransactionSet": {
                                        "Header": {
                                            "STSegment": {
                                                "@ST01_TransactionSetIdentifierCode": "271",
                                                "@ST02_TransactionSetControlNumber": "000000001",
                                                "@ST03_ImplementationConventionReference": "005010X279A1"
                                            },
                                            "BHTSegment": {
                                                "@BHT01_HierarchicalStructuralCode": "0022",
                                                "@BHT02_TransactionSetPurposeCode": "11",
                                                "@BHT03_ReferenceIdentification": "Prod9917412505465",
                                                "@BHT04_Date": "20220414",
                                                "@BHT05_Time": "103848"
                                            }
                                        },
                                        "InformationSourceDetail": {
                                            "InformationSourceLevel": {
                                                "InformationSourceLevel": {
                                                    "@HL01_HierarchicalIdNumber": "1",
                                                    "@HL03_HierarchicalLevelCode": "20",
                                                    "@HL04_HierarchicaChildCode": "1"
                                                }
                                            },
                                            "InformationSourceName": {
                                                "InformationSourceName": {
                                                    "@NM101_EntityIdentifierCode": "PR",
                                                    "@NM102_EntityTypeQualifier": "2",
                                                    "@NM103_LastOrOrganizationalName": "HEALTH CHOICE ARIZONA",
                                                    "@NM108_IdentificationCodeQualifier": "PI",
                                                    "@NM109_IdentificationCode": "ZZDEMO"
                                                },
                                                "RequestValidations": {
                                                    "AAASegment": {
                                                        "@AAA01_ConditionOrResponseCode": "N",
                                                        "@AAA03_RejectReasonCode": "80",
                                                        "@AAA04_FollowUpActionCode": "R"
                                                    }
                                                }
                                            }
                                        },
                                        "InformationReceiverDetail": {
                                            "InformationReceiverLevel": {
                                                "ReceiverLevel": {
                                                    "@HL01_HierarchicalIdNumber": "2",
                                                    "@HL02_HierarchicalParentIdNumber": "1",
                                                    "@HL03_HierarchicalLevelCode": "21",
                                                    "@HL04_HierarchicaChildCode": "1"
                                                }
                                            },
                                            "InformationReceiverName": {
                                                "ReceiverName": {
                                                    "@NM101_EntityIdentifierCode": "1P",
                                                    "@NM102_EntityTypeQualifier": "1",
                                                    "@NM103_LastOrOrganizationalName": "JONES",
                                                    "@NM104_FirstName": "CAMERON",
                                                    "@NM108_IdentificationCodeQualifier": "XX",
                                                    "@NM109_IdentificationCode": "2133321234"
                                                }
                                            }
                                        },
                                        "SubscriberDetail": {
                                            "HierarchicalLevel": {"HierarchicalLevel": {
                                                "@HL01_HierarchicalIdNumber": "3",
                                                "@HL02_HierarchicalParentIdNumber": "2",
                                                "@HL01@HL03_HierarchicalIdNumberHierarchicalLevelCode": "322",
                                                "@HL02@HL04_HierarchicalParentIdNumberHierarchicaChildCode": "2",0"
                                            },
       "@HL03_HierarchicalLevelCode": "22",                                    "Name": {
           "@HL04_HierarchicaChildCode": "0"                                    "Name": {
       },                                             "Name@NM101_EntityIdentifierCode": {"IL",
                                                    "Name@NM102_EntityTypeQualifier": {"1",
                                                    "@NM101@NM103_EntityIdentifierCodeLastOrOrganizationalName": "ILVSEE",
                                                    "@NM102@NM104_EntityTypeQualifierFirstName": "1EDWARD",
                                                    "@NM103@NM108_LastOrOrganizationalNameIdentificationCodeQualifier": "VSEEMI",
                                                    "@NM104@NM109_FirstName": "EDWARD",IdentificationCode": "234234"
                                                },
                                      "@NM108_IdentificationCodeQualifier": "MI",         "EligibilityOrBenefitInformation": {
                                          "@NM109_IdentificationCode": "234234"         "EligibilityOrBenefitInformation": {
                                      },                  "EligibilityOrBenefitInformation": {
                             "EligibilityOrBenefitInformation": {                              "@EB01_EligibilityOrBenefitInformationCode": "V"
                     "EligibilityOrBenefitInformation": {                                  },
                      "EligibilityOrBenefitInformation": {                                 "MessageTexts": {
                          "@EB01_EligibilityOrBenefitInformationCode": "V"                                 "MSGSegment": {
                      },                                          "@MSG01_FreeFormMessageText": "The payer response contains invalid or non compliant data.(70002)"
     "MessageTexts": {                                                      }
      "MSGSegment": {                                                 }
               "@MSG01_FreeFormMessageText": "The payer response contains invalid or non compliant data.(70002)"                            }
                                }                }
                                        }    }
                                        }
       }                             }
                   }             },
                               } "FunctionalGroupTrailer": {
                                    "@GE01_NumberOfTransactionSets": "1",
}                                     }"@GE02_GroupControlNumber": "314159265"
                                },
                                "FunctionalGroupTrailerInterchangeControlTrailer": {
                                    "@GE01@IEA01_NumberOfTransactionSetsNumberOfFunctionalGroups": "1",
                                    "@GE02@IEA02_GroupControlNumberInterchangeControlReference": "314159265000000001"
                                },
                            }
   "InterchangeControlTrailer": {                    }
                "@IEA01_NumberOfFunctionalGroups": "1",   }
                }
            },
   "@IEA02_InterchangeControlReference": "000000001"        "secondary": {
                "carrier_code": "car11406",
     }           "group_number": "asdasd",
                }
       "subscriber_num": "aaaaa",
                }
"insurance_order": 2
            },
      }      "patient": {
         }       "respparty": "self",
    },
            "secondarymember_id": {"5991794",
                "carrierresponse_party_codeid": "car114066858376",
                "group_number": "asdasd",}
         },
        "subscriberaccount_numcode": "aaaaavclinic",
        "clinics": [
       "insurance_order": 2    "vclinic"
        }],
        "created": 1649934637
   "patient":  }
}

Webhook

Code Block

language	json

{
  "id": "62583ab3-8cfc-4a47-b6c9-272850e631f8",
  "type": "eligibility.checked",
    "created": 1649949363,
   "resppartyaccount_code": "selfvclinic",
  "data": {
       "eligibility_id": "2505464",
    "member_id": "5991794132407",
    "eligibility_response": "No response received by   clearinghouse",
    "responseexternal_partymember_id": "68583765991794"
  }
}

Eligibility Responses List

eligibility_response may be one of the following:

Code Block

Success / Reject reason not found
Authorized quantity exceeded
}Required application data missing
Input Errors
Out of Network
},Authorization/Access restrictions
Unable to respond at current time.
 "account_code": "vclinic",
        "clinics": [
            "vclinic"
        ],
        "created": 1649934637
    }
}

Webhook

Code Block

language	json

{
  "id": "62583ab3-8cfc-4a47-b6c9-272850e631f8",
  "type": "eligibility.checked",
  "created": 1649949363,
  "account_code": "vclinic",
  "data": {
    "eligibility_id": "2505464",
    "member_id": "132407",
    "eligibility_response": "No response received by clearinghouse",
    "external_member_id": "5991794"
  }
}

Eligibility Responses List

eligibility_response may be one of the following:

Code Block

Success / Reject reason not found
Authorized quantity exceeded
Required application data missing
Input Errors
Out of Network
Authorization/Access restrictions
Unable to respond at current time.
Invalid/Missing provider information
Invalid/Missing provider name
Invalid/Missing provider speciality
Invalid/Missing provider phone number
Invalid/Missing provider state
Invalid/Missing referring provider identification number
Provider is not primary care physician
Provider ineligible for inquiries
Provider not on file
Service dates not within provider plan enrollment
Inquired benefit inconsistent with provider type
Inappropriate date
Invalid/Missing dates of service
Invalid/Missing date of birth
Date of birth follows date of service
Date of death preceeds dates of service
Date of service not within allowable inquiry period
Date of service in future
Invalid/Missing patient ID
Invalid/Missing patient name
Invalid/Missing patient gender code
Patient not found
Inconsistent with patient age.
Inconsistent with patient gender.
Patient birth date does not match that for the patient in the
Invalid/Missing subscriber/insured ID
Invalid/Missing subscriber/insured name
Invalid/Missing subscriber/insured gender code
Subscriber/Insured not found
Duplicate Subscriber/Insured ID number
Subscriber found, patient not found
Subscriber/Insured not in Group/Plan identified
Invalid participant identification
invalid or missing provider address
Payer name or identifier missing
Certification Information Missing
No response received by clearinghouse
Expiremental service or procedure.
Authorization number not found.
Requires primary care physician authorization.
Invalid/Missing diagnosis codes.
Invalid/Missing procedure codes.
Additional patient condition information required.
Certification information does not match patient.
Requires medical review.
Invalid authorization number format.
Missing authorization number.

Rejection reason and codes

Code Block

'04' => 'Authorized quantity exceeded',
'15' => 'Required application data missing',
'33' => 'Input Errors',
'35' => 'Out of Network',
'41' => 'Authorization/Access restrictions',
'42' => 'Unable to respond at current time.',
'43' => 'Invalid/Missing provider information',
'44' => 'Invalid/Missing provider name',
'45' => 'Invalid/Missing provider speciality',
'46Invalid/Missing provider information
Invalid/Missing provider name
Invalid/Missing provider speciality
Invalid/Missing provider phone number
Invalid/Missing provider state
Invalid/Missing referring provider identification number
Provider is not primary care physician
Provider ineligible for inquiries
Provider not on file
Service dates not within provider plan enrollment
Inquired benefit inconsistent with provider type
Inappropriate date
Invalid/Missing dates of service
Invalid/Missing date of birth
Date of birth follows date of service
Date of death preceeds dates of service
Date of service not within allowable inquiry period
Date of service in future
Invalid/Missing patient ID
Invalid/Missing patient name
Invalid/Missing patient gender code
Patient not found
Inconsistent with patient age.
Inconsistent with patient gender.
Patient birth date does not match that for the patient in the
Invalid/Missing subscriber/insured ID
Invalid/Missing subscriber/insured name
Invalid/Missing subscriber/insured gender code
Subscriber/Insured not found
Duplicate Subscriber/Insured ID number
Subscriber found, patient not found
Subscriber/Insured not in Group/Plan identified
Invalid participant identification
invalid or missing provider address
Payer name or identifier missing
Certification Information Missing
No response received by clearinghouse
Expiremental service or procedure.
Authorization number not found.
Requires primary care physician authorization.
Invalid/Missing diagnosis codes.
Invalid/Missing procedure codes.
Additional patient condition information required.
Certification information does not match patient.
Requires medical review.
Invalid authorization number format.
Missing authorization number.

Rejection reason and codes

Code Block

'04' => 'Authorized quantity exceeded',
'15' => 'Required application data missing',
'33' => 'Input Errors',
'35' => 'Out of Network',
'41' => 'Authorization/Access restrictions',
'42' => 'Unable to respond at current time.',
'43' => 'Invalid/Missing provider information',
'44' => 'Invalid/Missing provider name',
'45' => 'Invalid/Missing provider speciality',
'46' => 'Invalid/Missing provider phone number',
'47' => 'Invalid/Missing provider state',
'48' => 'Invalid/Missing referring provider identification number',
'49' => 'Provider is not primary care physician',
'50' => 'Provider ineligible for inquiries',
'51' => 'Provider not on file',
'52' => 'Service dates not within provider plan enrollment',
'53' => 'Inquired benefit inconsistent with provider type',
'56' => 'Inappropriate date',
'57' => 'Invalid/Missing dates of service',
'58' => 'Invalid/Missing date of birth',
'60' => 'Date of birth follows date of service',
'61' => 'Date of death preceeds dates of service',
'62' => 'Date of service not within allowable inquiry period',
'63' => 'Date of service in future',
'64' => 'Invalid/Missing patient ID',
'65' => 'Invalid/Missing patient name',
'66' => 'Invalid/Missing patient gender code',
'67' => 'Patient not found',
'69' => 'Inconsistent with patient age.',
'70' => 'Inconsistent with patient gender.',
'71' => 'Patient birth date does not match that for the patient in the database',
'72' => 'Invalid/Missing provider phone numbersubscriber/insured ID',
'4773' => 'Invalid/Missing providersubscriber/insured statename',
'4874' => 'Invalid/Missing referringsubscriber/insured providergender identification numbercode',
'4975' => 'ProviderSubscriber/Insured is not primary care physicianfound',
'5076' => 'ProviderDuplicate ineligibleSubscriber/Insured forID inquiriesnumber',
'5177' => 'ProviderSubscriber found, patient not on filefound',
'5278' => 'ServiceSubscriber/Insured dates not withinin provider plan enrollmentGroup/Plan identified',
'5379' => 'InquiredInvalid benefit inconsistent with provider typeparticipant identification',
'5697' => 'Inappropriate dateinvalid or missing provider address',
'57T4' => 'Invalid/Missing dates of servicePayer name or identifier missing',
'58T5' => 'Invalid/Missing date of birth 'Certification Information Missing',
'6080' => 'DateNo ofresponse birthreceived follows date of serviceby clearinghouse',
'6198' => 'DateExpiremental ofservice death preceeds dates of serviceor procedure.',
'62AA' => 'DateAuthorization of servicenumber not within allowable inquiry periodfound.',
'63AE' => 'DateRequires ofprimary servicecare inphysician futureauthorization.',
'64AF' => 'Invalid/Missing patientdiagnosis IDcodes.',
'65AG' => 'Invalid/Missing patientprocedure namecodes.',
'66AO' => 'Invalid/MissingAdditional patient gender codecondition information required.',
'67CI' => 'PatientCertification information does not foundmatch patient.',
'E8' => 'Requires medical review.',
'69IA' => 'InconsistentInvalid withauthorization patientnumber ageformat.',
'70MA' => 'InconsistentMissing with patient gender.',
'71' => 'Patient birth date does not match that for the patient in the database',
'72' => 'Invalid/Missing subscriber/insured ID',
'73' => 'Invalid/Missing subscriber/insured name',
'74' => 'Invalid/Missing subscriber/insured gender code',
'75' => 'Subscriber/Insured not found',
'76' => 'Duplicate Subscriber/Insured ID number',
'77' => 'Subscriber found, patient not found',
'78' => 'Subscriber/Insured not in Group/Plan identified',
'79' => 'Invalid participant identification',
'97' => 'invalid or missing provider address',
'T4' => 'Payer name or identifier missing',
'T5' => 'Certification Information Missing',
'80' => 'No response received by clearinghouse',
'98' => 'Expiremental service or procedure.',
'AA' => 'Authorization number not found.',
'AE' => 'Requires primary care physician authorization.',
'AF' => 'Invalid/Missing diagnosis codes.',
'AG' => 'Invalid/Missing procedure codes.',
'AO' => 'Additional patient condition information required.',
'CI' => 'Certification information does not match patient.',
'E8' => 'Requires medical review.',
'IA' => 'Invalid authorization number format.',
'MA' => 'Missing authorization number.'

GET /insurances/

https://api-vclinic.vseepreview.com/vc/next/api_v3/insurance/

Get the available list of insurers for patient to pick from.

Is it stored in clinic Raw settings.

Output

A list of supported insurers.

“id” here is AMD’s payer ID. “name” is readable name.

Code Block

language	json

{
    "data": {authorization number.'

GET /insurances/

https://api-vclinic.vseepreview.com/vc/next/api_v3/insurance/

Get the available list of insurers for patient to pick from.

Is it stored in clinic Raw settings.

Output

A list of supported insurers.

“id” here is AMD’s payer ID. “name” is readable name.

Code Block

language	json

{
    "data": {
        "insurers": [
            {
                "id": "car7551",
                "name": "AETNA"
            },
            {
                "id": "car7414",
                "name": "AETNA BETTER HEALTH OF ILLINOIS"
            },
            {
                "id": "car11406",
                "insurersname": [ "ANTHEM BLUE SHIELD"
            },
            {
                "id": "car7551car7147",
                "name": "AETNACIGNA HEALTH CARE"
            },
            {
                "id": "car7414car7580",
                "name": "AETNAMONTGOMERY BETTER HEALTH OF ILLINOISINSURANCE"
            },
            {
                "id": "car11406car7556",
                "name": "ANTHEMHEALTH BLUECHOICE SHIELDARIZONA"
            }
    },
            {
               ]
    }
}

POST /insurance/claims

https://api-vclinic.vseepreview.com/vc/next/api_v3/insurance/claims

Request

Response

Code Block

curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/insurances/claims' \
--header 'X-AccountCode: vclinic' \
--header 'X-ApiKey: xxx' \
--header 'X-ApiSecret: xxx' \
--header 'X-ApiToken: xxx' \
--data-raw '{

...

"member_id": "

...

2186945",

...

"date_of_service": "08/19/2022",

...

location": "

...

41",
    "charge_list": [

...

"procedure_code": "10022",
            "

...

units":

...

1,

...

"diagnosis_code": "Z20.822 R05.9"

...

},

...

   "procedure_code": "10022",
            "

...

units":

...

1,

...

diagnosis_code": "

...

Z209822"

...

       }
    ]
}'

Code Block

language	json

{
  "data": {

...

"id": "82828",

...

}
}

...

POST /insurance/claims

...

Claims collection

Code Block
claims.type claims.account_code claims.visit_id //optional claims.member_id claims.status claims.advancedmd.date_of_service // all input fields claims.advancedmd.visit_id

...

Versions Compared

Old Version 44

New Version 45

Key

POST /users/:id/edit

POST /users/:id/edit

Webhook

Eligibility Responses List

Webhook

Eligibility Responses List

Rejection reason and codes

Rejection reason and codes

GET /insurances/

Output

GET /insurances/

Output

POST /insurance/claims

POST /insurance/claims

Claims collection