insurance object format:
| Key | Type | POST/PUT request |
Notes |
|---|---|---|---|
insurance_claim_office_number |
string | optional | Insurance office phone number. |
insurance_company |
string | optional | |
insurance_group_name |
string | optional | |
insurance_group_number |
string | optional | |
insurance_id_number |
string | optional | |
insurance_payer_id |
string | optional | |
insurance_plan_name |
string | optional | |
insurance_plan_type |
string | optional | One of these choices |
is_subscriber_the_patient |
boolean | optional | Defaults to true. |
patient_relationship_to_subscriber |
string | optional | HCFA/1500 individual relationship code. |
subscriber_address |
string | optional | |
subscriber_city |
string | optional | |
subscriber_country |
string | optional | Two-letter country code. |
subscriber_date_of_birth |
date | optional | |
subscriber_first_name |
string | optional | |
subscriber_gender |
string | optional | One of "Male" or "Female". |
subscriber_last_name |
string | optional | |
subscriber_middle_name |
string | optional | |
subscriber_social_security |
string | optional | |
subscriber_state |
string | optional | Two-letter state code. |
subscriber_suffix |
string | optional | E.g. "II" or "III". |
subscriber_zip_code |
string | optional | |
photo_front |
base64encoded file | optional | photo of front of insurance card |
photo_back |
base64encoded file | optional | photo of back of insurance card |
auto_accident_insurance object format:
| Key | Type | POST/PUT request |
Notes |
|---|---|---|---|
auto_accident_company |
string | optional | |
auto_accident_payer_id |
string | optional | |
auto_accident_policy_number |
string | optional | |
auto_accident_case_number |
string | optional | |
auto_accident_payer_address |
string | optional | |
auto_accident_payer_zip |
string | optional | |
auto_accident_payer_city |
string | optional | |
auto_accident_payer_state |
string | optional | Two-letter abbreviation |
auto_accident_date_of_accident |
date | optional | |
auto_accident_state_of_occurrence |
string | optional | Two-letter abbreviation |
auto_accident_is_subscriber_the_patient |
boolean | optional | |
auto_accident_patient_relationship_to_subscriber |
string | optional | One of the following, "", "01"("Spouse"), "04"("Grandparent"), "05"("Grandchild"), "07"("Nephew or Niece"), "10"("Foster Child"), "15"("Ward"), "17"("Stepson or Stepdaughter"), "19"("Child"), "20"("Employee"), "21"("Unknown"), "22"("Handicapped Dependent"), "23"("Sponsored Dependent"), "24"("Dependent of a Minor Dependent"), "29"("Significant Other"), "32"("Mother"), "33"("Father"), "36"("Emancipated Minor"), "39"("Organ Donor"), "40"("Cadaver Donor"), "41"("Injured Plaintiff"), "43"("Child Where Insured Has No Financial Responsibility"), "53"("Life Partner"), "76"("Dependent"), "G8"("Other Relationship") |
auto_accident_subscriber_first_name |
string | optional | |
auto_accident_subscriber_middle_name |
string | optional | |
auto_accident_subscriber_last_name |
string | optional | |
auto_accident_subscriber_suffix |
string | optional | |
auto_accident_subscriber_date_of_birth |
string | optional | |
auto_accident_subscriber_social_security |
string | optional | |
auto_accident_subscriber_phone_number |
string | optional | |
auto_accident_subscriber_address |
string | optional | |
auto_accident_subscriber_city |
string | optional | |
auto_accident_subscriber_zip_code |
string | optional | |
auto_accident_subscriber_state |
string | optional | Two-letter abbreviation |
auto_accident_notes |
string | optional | |
auto_accident_had_similar_condition |
boolean | optional | |
auto_accident_similar_condition_date |
date | optional | |
auto_accident_similar_condition_notes |
string | optional | |
auto_accident_significant_injury |
string | optional | One of the following, 'N\A'(Not determinable at this time), 'Yes', 'No' |
auto_accident_significant_injury_notes |
string | optional | |
auto_accident_disabled_from_date |
date | optional | |
auto_accident_disabled_to_date |
date | optional | |
auto_accident_return_to_work_date |
date | optional | |
auto_accident_still_under_care |
boolean | optional | |
auto_accident_treatment_duration |
string | optional | |
auto_accident_will_require_therapy |
boolean | optional | |
auto_accident_will_require_therapy_rec |
string | optional | |
auto_accident_claim_rep_is_insurer |
boolean | optional | |
auto_accident_claim_rep_name |
string | optional | |
auto_accident_claim_rep_address |
string | optional | |
auto_accident_claim_rep_zip |
string | optional | |
auto_accident_claim_rep_city |
string | optional | |
auto_accident_claim_rep_state |
string | optional | Two-letter abbreviation |
workers_comp_insurance object format:
| Key | Type | POST/PUT request |
Notes |
|---|---|---|---|
workers_comp_company |
string | optional | |
workers_comp_payer_id |
string | optional | |
workers_comp_group_name |
string | optional | |
workers_comp_group_number |
string | optional | |
workers_comp_wcb |
string | optional | |
workers_comp_wcb_rating_code |
string | optional | |
workers_comp_carrier_code |
string | optional | |
workers_comp_case_number |
string | optional | |
workers_comp_payer_address |
string | optional | |
workers_comp_payer_zip |
string | optional | |
workers_comp_payer_city |
string | optional | |
workers_comp_payer_state |
string | optional | Two-letter abbreviation |
workers_comp_date_of_accident |
date | optional | |
workers_comp_state_of_occurrence |
string | optional | Two-letter abbreviation |
property_and_casualty_agency_claim_number |
string | optional | |
workers_comp_notes |
string | optional |