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Review a claim (predictions, no funding)

Authorizations

Authorization
string
header
required

The access token received from the authorization server in the OAuth 2.0 flow.

Headers

Idempotency-Key
string

Provide a unique key per request to enable safe retries

Body

application/json

Submit encounter/claim context for prediction. Fields align with Thrivory Data Feed Requirements.

claim_identifier
string
required

Unique claim ID

chart_identifier
string
required

Patient chart ID

date_of_service
string<date>
required
servicer_npi
string
required
Pattern: ^[0-9]{10}$
billing_npi
string
required
Pattern: ^[0-9]{10}$
patient_primary_payor_id
string
required

Thrivory payer ID

submitted_amount
number
required
facility
string

Location/facility identifier

date_of_entry
string<date>
date_of_submission
string<date>
patient_primary_payor_text
string
patient_primary_payor_plan_text
string
icd10_codes
string[]
cpt_billing_codes
string
deprecated

Prefer service_lines[].cpt

cpt_billing_modifier
string
deprecated

Prefer service_lines[].modifier

cpt_billing_text
string
balance_payor
number
balance_patient
number
payments_payor
number
payments_patient
number
payments_total
number
settlement_date
string<date>
payment_account_location
string

Last four digits or token reference

denial_code
string
denial_code_text
string
service_lines
object[]

Response

Review results

authorization_id
string
required

Short‑lived authorization handle used to create an adjudication

denial_predicted
boolean
required
expected_reimbursement
object
required
denial_reasons
object[]
expected_payment_date
string<date>
confidence
number

Model confidence

Required range: 0 <= x <= 1
id
string

Review ID