UnitedHealthcare · JSON Structure

Provider Claim Pre Check Request Structure

Request for claim pre-submission validation

Type: object Properties: 0
Health InsuranceHealthcareFHIRClaimsEligibility

UnitedHealthcare Claim Pre-Check Request is a JSON Structure definition published by UnitedHealthcare. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Meta-schema: https://json-structure.org/meta/core/v0/#

JSON Structure

Raw ↑ 
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-structure/provider-claim-pre-check-request-structure.json",
  "name": "UnitedHealthcare Claim Pre-Check Request",
  "type": "object",
  "description": "Request for claim pre-submission validation",
  "fields": [
    {
      "name": "memberId",
      "type": "string",
      "description": "Member ID"
    },
    {
      "name": "npi",
      "type": "string",
      "description": "Billing provider NPI"
    },
    {
      "name": "serviceDate",
      "type": "date",
      "description": "Date of service"
    },
    {
      "name": "diagnosisCodes",
      "type": "array",
      "description": "ICD-10 diagnosis codes",
      "items": {
        "type": "string"
      }
    },
    {
      "name": "procedureCodes",
      "type": "array",
      "description": "CPT/HCPCS procedure codes",
      "items": {
        "type": "string"
      }
    },
    {
      "name": "charges",
      "type": "decimal",
      "description": "Total billed charges"
    },
    {
      "name": "placeOfService",
      "type": "string",
      "description": "Place of service code"
    }
  ]
}