UnitedHealthcare Claim Pre-Check Request

Request for claim pre-submission validation

Health InsuranceHealthcareFHIRClaimsEligibility

Properties

Name	Type	Description
memberId	string	Member ID
npi	string	Billing provider NPI
serviceDate	string	Date of service
diagnosisCodes	array	ICD-10 diagnosis codes
procedureCodes	array	CPT/HCPCS procedure codes
charges	number	Total billed charges
placeOfService	string	Place of service code

View JSON Schema on GitHub

JSON Schema

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-claim-pre-check-request-schema.json",
  "title": "UnitedHealthcare Claim Pre-Check Request",
  "description": "Request for claim pre-submission validation",
  "type": "object",
  "required": [
    "memberId",
    "npi",
    "serviceDate",
    "diagnosisCodes",
    "procedureCodes"
  ],
  "properties": {
    "memberId": {
      "type": "string",
      "description": "Member ID"
    },
    "npi": {
      "type": "string",
      "description": "Billing provider NPI"
    },
    "serviceDate": {
      "type": "string",
      "format": "date",
      "description": "Date of service"
    },
    "diagnosisCodes": {
      "type": "array",
      "items": {
        "type": "string"
      },
      "description": "ICD-10 diagnosis codes"
    },
    "procedureCodes": {
      "type": "array",
      "items": {
        "type": "string"
      },
      "description": "CPT/HCPCS procedure codes"
    },
    "charges": {
      "type": "number",
      "description": "Total billed charges"
    },
    "placeOfService": {
      "type": "string",
      "description": "Place of service code"
    }
  }
}

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