iSalusExternal.ExportClaims

Overview

The iSalusExternal.ExportClaims webservice is used to obtain claim data for a practice based on given inputs.  Both the input and output of this webservice mirrors that which is available in the Data Export window for Claims.

Sample Call

Request

<request>
    <security>
        <key>9A136C9B-46C2-40CD-9023-5789245A928C</key>
        <version>1.0</version>
        <userid />
        <account>0F0A7417-B12C-41BA-97A9-60AAF7917F6C</account>
    </security>
    <start_date>01/01/2016</start_date>
    <end_date>06/01/2016</end_date>
   <submission></submission>
   <status_list>
         <claim_status>1</claim_status>
    </status_list>
   <sub_status_list>
         <claim_sub_status>1</claim_sub_status>
    </sub_status_list>
   <payer_list>
         <entity_id>1</entity_id>
   </payer_list>
   <location_list>
        <entity_id>1</entity_id>
   </location_list>
   <rendering_list>
        <entity_id>1</entity_id>
   </rendering_list>
   <referring_list>
        <entity_id>1</entity_id>
   </referring_list>
   <supervising_list>
        <entity_id>1</entity_id>
   </supervising_list>
   <ordering_list>
        <entity_id>1</entity_id>
   </ordering_list>
   <owner_list>
        <users_id>admin</users_id>
   </owner_list>
</request>

Element Description

Request

The Request element will serve as a wrapper for the entire body of the XML request.

Request > Security

See documentation for the Security node here:  Access to Webservices

Request > StartDate

The beginning encounter date for the claim.

Request > EndDate

The ending encounter date for the claim.

Request > Submission

A flag to indicate if the claim has been submitted to the payer/patient.

  • Y = Yes
  • N = No

Request > Status_List

A wrapper for the various claim_status element.

Request> Status_list > Claim_Status

1 to many claim_status elements can be wrapped in the Status_List element.  Accepts a numerical representation of the claim status. Leave blank to not filter by claim status. Claim statuses can be retrieved for a database here: iSalusWindow.GetList where <name> = claim_status

Request > Sub_Status_List

A wrapper for the various claim_sub_status element.

Request> Sub_Status_list > Claim_Sub_Status

1 to many claim_sub_status elements can be wrapped in the Sub_ Status_List element.  Accepts a numerical representation of the claim sub status. Leave blank to not filter by claim sub status. Claim sub statuses can be retrieved for a database here: iSalusWindow.GetList where <name> = claim_sub_status

Request > Payer_List

A wrapper for the various payer entity ID elements.

Request> Payer_List > Entity_ID

1 to many entity_id elements can be wrapped in the payer_list element.  Accepts a numerical representation of the payer entity ID. Leave blank to not filter by payer. Payer entity ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = insurance_payers

Request > Location_list

A wrapper for the various location entity ID elements.

Request> Location_List > Entity_ID

1 to many entity_id elements can be wrapped in the location_list element.  Accepts a numerical representation of the service location's entity ID. Leave blank to not filter by location. Location entity ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = service_location

Request > Rendering_list

A wrapper for the various rendering provider entity ID elements.

Request> Rendering_List > Entity_ID

1 to many entity_id elements can be wrapped in the rendering_list element.  Accepts a numerical representation of the rendering provider's entity ID. Leave blank to not filter by rendering provider. Rendering provider entity ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = rendering_provider

Request > Referring_list

A wrapper for the various referring provider entity ID elements.

Request> Referring_List > Entity_ID

1 to many entity_id elements can be wrapped in the referring_list element.  Accepts a numerical representation of the referring provider's entity ID. Leave blank to not filter by referring provider. Referring provider entity ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = referring_provider

Request > Supervising_list

A wrapper for the various supervising provider entity ID elements.

Request> Supervising_List > Entity_ID

1 to many entity_id elements can be wrapped in the supervising_list element.  Accepts a numerical representation of the supervising provider's entity ID. Leave blank to not filter by supervising provider. Supervising provider entity ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = rendering_provider

Request > Ordering_list

A wrapper for the various ordering provider entity ID elements.

Request> Ordering_List > Entity_ID

1 to many entity_id elements can be wrapped in the ordering_list element.  Accepts a numerical representation of the ordering provider's entity ID. Leave blank to not filter by ordering provider. Ordering provider entity ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = rendering_provider

Request > Owner_list

A wrapper for the various claim owner user ID's elements.

Request> Owner_List > User_id

1 to many user_id elements can be wrapped in the owner_list element.  Accepts a user ID for the end user assigned to the claim. Leave blank to not filter by claim owner. User ID's can be retrieved for a database here: iSalusWindow.GetList where <name> = users

Response

<response xmlns="http://www.isalushealthcare.webservices/">
<Claim>
<claim_number>30165</claim_number>
<dos>05/15/2016</dos>
<submission>09/15/2017 11:45AM</submission>
<status>Rejected</status>
<sub_status></sub_status>
<billing>Electronic</billing>
<level>Primary</level>
<owner>!ellen</owner>
<primary_insurance>Medicare Part B (P.O. Box 8855~Marion, IL 62959-0913)</primary_insurance>
<secondary_insurance>Cigna (P.O. Box 5200~Scranton, PA 18505-5200)</secondary_insurance>
<tertiary_insurance></tertiary_insurance>
<chart_number>9676</chart_number>
<last_name>Test</last_name>
<first_name>Ila</first_name>
<charge>150.00</charge>
<balance>150.00</balance>
<resp_party>Test, Ila</resp_party>
<aging_date></aging_date>
<aging_type></aging_type>
<aging_days>0</aging_days>
<rendering>Kildare MD, Richard</rendering>
<referring>Darko OT, John</referring>
<supervising></supervising>
<ordering></ordering>
<purchasing></purchasing>
<attending></attending>
<service_location>Family First Physicians</service_location>
<admission_date></admission_date>
<discharge_date></discharge_date>
<onset_date></onset_date>
<menstrual_date></menstrual_date>
<accident_date></accident_date>
<accident_state></accident_state>
<accident_country></accident_country>
<epsdt></epsdt>
<epsdt_code_1></epsdt_code_1>
<epsdt_code_2></epsdt_code_2>
<epsdt_code_3></epsdt_code_3>
<narrative_type></narrative_type>
<claim_narrative></claim_narrative>
</Claim>
....
</response>


Element Description

Response

The Response element will server as a wrapper for the entire body of the XML response.

Response > Claim

The Claim element will serve as a wrapper for all individual data points for the claim in question.  

Response > Claim > Nodes

For all remaining elements, please refer to the Data Export guide for Claims that explains the response elements:  Claims Export