Moxe Health Claim Management API

{
  "openapi": "3.0.1",
  "x-readme": {
    "explorer-enabled": false,
    "proxy-enabled": true
  },
  "x-amazon-apigateway-importexport-version": "1.0",
  "info": {
    "title": "Chart Retrieval API",
    "version": "0.1.0",
    "description": "In order to use this api, we require each request gets sent with an api key in the named header, \"x-api-key\". <br><br> We impose a rate limit for the whole api. If the rate limit is reached, the client will receive the response, \"HTTP 429 Too Many Requests\"."
  },
  "servers": [
    {
      "url": "https://${environment}-api.moxehealth.com/chart-retrieval"
    }
  ],
  "paths": {
    "/v1/claim-management-request": {
      "post": {
        "tags": [
          "Claims"
        ],
        "summary": "Initiate Claim Request",
        "description": "Initiate a new request for claim management",
        "operationId": "initiateClaimManagementRequest",
        "requestBody": {
          "description": "Information about the patient whose data is being requested",
          "content": {
            "application/json": {
              "schema": {
                "$ref": "#/components/schemas/claimManagementRequestRequest"
              }
            }
          },
          "required": true
        },
        "x-amazon-apigateway-integration": {
          "type": "http_proxy",
          "uri": "https://${environment}-chaselistmanager.moxehealth.com/chart-retrieval/v1/claim-management-request",
          "httpMethod": "POST",
          "connectionType": "VPC_LINK",
          "connectionId": "${vpc_link}"
        },
        "responses": {
          "202": {
            "description": "Claim Management request was accepted but processing has not necessarily begun",
            "content": {
              "application/json": {
                "schema": {
                  "$ref": "#/components/schemas/patientChartRequestResponse"
                }
              }
            }
          },
          "400": {
            "description": "Invalid input"
          },
          "401": {
            "description": "The user or app initiating the request was not authenticated. Reauthenticate and try again."
          },
          "403": {
            "description": "The user or app does not have the appropriate permissions to make this request"
          },
          "429": {
            "description": "Too many requests. API rate limit reached."
          },
          "500": {
            "description": "The request was valid, but an unexpected error occured on the server"
          }
        },
        "security": [
          {
            "moxe_auth": [
              "write:claim-management-request"
            ]
          },
          {
            "${environment}-chart-retrieval-api-authorizer": []
          },
          {
            "x-api-key": []
          }
        ]
      }
    }
  },
  "components": {
    "schemas": {
      "patientChartRequestResponse": {
        "type": "object",
        "properties": {
          "data": {
            "type": "object",
            "properties": {
              "moxeRequestId": {
                "type": "string",
                "description": "The unique identifier of this request within Moxe's system"
              },
              "links": {
                "type": "array",
                "description": "A list of links that can be used to access resources related to the created patient chart request",
                "items": {
                  "$ref": "#/components/schemas/link"
                }
              }
            }
          },
          "createdDate": {
            "type": "string",
            "format": "date-time",
            "description": "The timestamp of when this request was created"
          },
          "createdBy": {
            "type": "string",
            "description": "The unique identifier of the client that initiated this request"
          }
        }
      },
      "claimManagementRequestRequest": {
        "required": [
          "RequestId",
          "SubscriberId",
          "PatientId",
          "PatientIdType",
          "DateOfBirth",
          "FirstName",
          "LastName",
          "AdministrativeGender",
          "VisitId",
          "PurposeOfUse",
          "RequestSourceId",
          "StartDate",
          "EndDate",
          "ClaimId",
          "DenialRemarkCode",
          "ProviderOrganizationId"
        ],
        "type": "object",
        "properties": {
          "RequestId": {
            "type": "string",
            "description": "Customer generated RequestId. This does not have to be unique between requests."
          },
          "MemberId": {
            "type": "string",
            "description": "Member’s Unique Identifier"
          },
          "SubscriberId": {
            "type": "string",
            "description": "Member’s coverage provided through this individual"
          },
          "PatientId": {
            "type": "string",
            "description": "Patient’s unique identifier"
          },
          "PatientIdType": {
            "type": "string",
            "description": "Patient’s unique identifier type"
          },
          "DateOfBirth": {
            "type": "string",
            "description": "Member’s date of birth (YYYY-MM-DD)"
          },
          "FirstName": {
            "type": "string",
            "description": "Member’s first name"
          },
          "LastName": {
            "type": "string",
            "description": "Member’s last name"
          },
          "MiddleName": {
            "type": "string",
            "description": "Member’s middle name"
          },
          "AdministrativeGender": {
            "type": "string",
            "description": "Member’s gender. Allowed values — male, female, other, unknown."
          },
          "VisitId": {
            "type": "string",
            "description": "Encounter identifier"
          },
          "Address1": {
            "type": "string",
            "description": "Member’s primary address line 1"
          },
          "Address2": {
            "type": "string",
            "description": "Member’s primary address line 2"
          },
          "City": {
            "type": "string",
            "description": "Member’s primary city"
          },
          "State": {
            "type": "string",
            "description": "Member’s primary state (2 letter abbreviation)"
          },
          "Zip": {
            "type": "string",
            "description": "Member’s primary 5-digit zip code"
          },
          "PurposeOfUse": {
            "type": "string",
            "description": "The reason for the request. Work with your Moxe representative to discuss allowed values."
          },
          "RequestSourceId": {
            "type": "string",
            "description": "The group authorized to issue the request. Work with your Moxe representative to discuss allowed values."
          },
          "StartDate": {
            "type": "string",
            "description": "The start date of service for data to include in the request (YYYY-MM-DD)"
          },
          "EndDate": {
            "type": "string",
            "description": "The end date of service for data to include in the request (YYYY-MM-DD)"
          },
          "ProviderOrganizationId": {
            "type": "string",
            "description": "An identifier agreed used to specify the organization from which Moxe will pull data. Work with your Moxe representative to discuss allowed values."
          },
          "ClaimId": {
            "type": "string",
            "description": "Claim invoice identifier"
          },
          "PatientAccountNumber": {
            "type": "string",
            "description": "Patient account identifier in provider system"
          },
          "DenialRemarkCode": {
            "type": "string",
            "description": "Claim adjustment code"
          },
          "ProviderNpi": {
            "type": "string",
            "description": "The Type 1 NPI associated with the request"
          },
          "GroupNpi": {
            "type": "string",
            "description": "The Type 2 NPI associated with the request location"
          },
          "TaxId": {
            "type": "string",
            "description": "The TaxID associated with the request location"
          },
          "ProcedureCode": {
            "type": "object",
            "properties": {
              "Type": {
                "type": "string"
              },
              "Category": {
                "type": "string"
              },
              "Section": {
                "type": "string"
              },
              "Codes": {
                "type": "array"
              }
            }
          }
        }
      },
      "link": {
        "type": "object",
        "properties": {
          "href": {
            "type": "string",
            "description": "A URL endpoint used to fetch the status of the request"
          },
          "method": {
            "type": "string",
            "description": "The HTTP verb used with the href to return the status of the request"
          }
        }
      }
    },
    "securitySchemes": {
      "moxe_auth": {
        "type": "oauth2",
        "flows": {
          "clientCredentials": {
            "tokenUrl": "https://${environment}-api.moxehealth.com/oauth/token",
            "scopes": {
              "write:patient-chart-request": "create patient chart transactions",
              "read:patient-chart-request": "get information on existing transactions"
            }
          }
        }
      }
    }
  },
  "x-si-base": "./api/chartretrievalapi.yaml",
  "x-github-repo": "MoxeHealth/ChaseListManager",
  "x-github-sha": "6705c89c377f138b5d91395fcaba1440c7aed96a",
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