Get list of claims

https://api.wealthcare.com/participant/services/participant/claims/{tpaId}/{employerId}/{participantId}

Retrieve the list of claims.

Path parameters

tpaId string Required

A unique identifier used to identify your admin instance. This value was system generated with the admin instance was created.
employerId string Required

Unique identifier for the employer. Note: When the employer was created, WealthCare Admin assigned the 3-character prefix; you assigned the remaining characters.
participantId string Required

Participant Id

Query parameters

decrypt integer <int32>

Indicate if the URI parameters are encrypted or not. 1: encrypted, 0: decrypted, default to 0.
opt integer <int32>

If a returned claim is for a dependent, this flag indicates whether to mask certain information on the claim or not. 0: do not mask, 1: mask provider information on dependent claim. PRIVATE will be returned for the claim description, claim provider description, claim provder ID, service category code, service category code description, and merchant name., 2: mask provider information on dependent claim only if Dependency Privacy is enabled. PRIVATE will be returned for the claim description, claim provider description, claim provder ID, service category code, service category code description, and merchant name.

Response

array <object>
- TpaId string
  
  A unique identifier used to identify your admin instance. This value was system generated with the admin instance was created.
- EmployerId string
  
  Unique identifier for the employer. Note: When the employer was created, WealthCare Admin assigned the 3-character prefix; you assigned the remaining characters.
- TransactionDate string <date-time>
  
  Date of the transaction
- ServiceStartDate string <date-time>
  
  Service Start Date for the claim
- ServiceEndDate string <date-time>
  
  Service End Date for the claim
- Type string
  
  A code indicating the type of transaction this is: Deposit = 0, Card = 1, Bank = 2, HSA Online Recurring Payment = 3, HSA Online Single Payment = 4, Fee = 5, Transfer = 6, ACH Credit = 7, ACH Debit = 8, Check = 9, Commission = 10, Interest Payment = 11, Recurring Claim = 12, Claim = 13, Manual Claim = 14, Fee Paid To Admin = 15, Fee Paid By Admin = 16, Fee Paid To Employer = 17, Fee Paid By Employer = 18
- Claimant object
  - TpaId string
    
    A unique identifier used to identify your admin instance. This value was system generated with the admin instance was created.
  - EmprId string
    
    Unique identifier for the employer. Note: When the employer was created, WealthCare Admin assigned the 3-character prefix; you assigned the remaining characters.
  - CardholderKey integer <int32>
    
    A system generated key used to indicate the specific employee or dependent.
  - LastName string
    
    The last name of the claimant.
  - FirstName string
    
    The first name of the claimant.
  - SocSecNum string
    
    Depending on the CardholderTypeCde, this will be the employee ID or the dependent ID (this is not necessarily an actual SSN unless you use SSNs for your employee IDs).
  - NamePrefix string
    
    The prefix for the claimant's name. Valid values are Mr., Mrs., Ms., Dr., and Rev.
  - Initial string
    
    The middle initial of the claimant
  - CardholderTypeCde integer <int32>
    
    Cardholder Type Cde: Employee = 1, Dependent = 2
  - CardNum string
    
    Card Proxy Number
- AcctTypeCde string
  
  The account type code for the benefit account the claim is processed under.
- AcctTypeDesc string
  
  The account type description for the benefit account the claim is processed under.
- AccountKey integer <int32>
  
  A system generated ID for the benefit account the claim is processed under.
- PlanStartDate string <date-time>
  
  Plan Start Date for the account the claim is processed under
- PlanEndDate string <date-time>
  
  Plan End Date for the account the claim is processed under
- Status string
  
  Claim status
- TxnAmt number <double>
  
  Transaction Amount
- FlexAcctKey integer <int32>
  
  A system generated ID for the benefit account the claim is processed under. Same value as AccountKey
- TxnAmtOrig number <double>
  
  Original Transaction Amount
- TxnAmtDenied number <double>
  
  Transaction Denied Amount
- TxnAmtPending number <double>
  
  Transaction Pending Amount
- TxnCde integer <int32>
  
  Transaction Code
- TxnMsg string
  
  Transaction Message
- TxnAmtRefund number <double>
  
  Transaction Refund Amount
- TxnOriginCde enum<string>
  
  Transaction Origin Code: None = 0, POSCardSwipe = 1, POSKeyedIn = 2, POSPhonedIn = 3, POSMbiSubmitted = 4, ManualScreen = 50, ManualEFT = 51, ManualAgent = 52, ParticipantManualScreen = 53, ParticipantMobileScreen = 54, HZDirect = 55, eClaimManagerManual = 56, eClaimManagerTPS = 57, WebServiceClaim = 58
  
  Possible values: None POSCardSwipe POSKeyedIn POSPhonedIn POSMbiSubmitted ManualScreen ManualEFT ManualAgent ParticipantManualScreen ParticipantMobileScreen HZDirect eClaimManagerManual eClaimManagerTPS WebServiceClaim
- TxnOptions enum<string>
  
  Transaction Options
  
  Possible values: None IncludeNoteInReceiptNotificationLetter ResolveRefund IncludeNoteInDenialLetter GenerateDenialLetter IsDuplicate DenialLetterReportKeyGenerated WasChargedBack IsAChargeback ChargebackWasReversed IsAChargebackReversal EligibleForPOSOffset ManualClaimFullyOffset ManualClaimPartiallyOffset ReimbLetterGenerated ReissueCheckPending PartialAuthInd PartialAuthorized HideOrigOnHoldTxn CheckVoided IiasMerchant CheckReissued TxnReissued OverrideSuspendActivity OnHoldFlg DenialOverride ReduceForBalanceMax BypassDeductibleRule PrimaryRolloverTxn FixedEmprFundingDeposit SplitTxn ByPassPercentCoverage EnforceParticipantEligibility EnforceAccountEligibility ManualClaimFullyDeductible PendingVerify CrossOverClaim SkipDuplicateClaimCheck PayProvider PendingLetter2 Reprocessed PendedWorkflow NachaGenearated CurrentReprocessed EmployerEnteredDeposits PayrollFundingDeposit FutureDeposited PendingDepositProcessed TxnWasReimbursed PendingExternalDepositVoid PriorYearContribution OverpaymentPartiallyResolved OverpaymentResolved CopayFirstApplied HideFromReports AutoDepositAgentDeposit ExcludeFromEmployerFunding PayrollNacha ForceExternalNacha OriginatedFromTPSEntry OriginatedFromEClaims CardProcessed SCTierAmountFeatureEnabled EmailSentForPayrollFunding
- BalanceDue number <double>
  
  Balance Due
- CardHolderDisplay boolean
  
  True if the claim the receipt is attached to should display to the participant. False if the claim should not be displayed to the participant.
- ProviderId string
  
  Provider Id on the claim
- ProviderDesc string
  
  Provider Description on the claim
- FileKey integer <int32>
  
  A system generated ID used to identify the receipt just uploaded.
- HasReceipt boolean
  
  True if the claim has a receipt attached to it.
- ReceiptExpired boolean
  
  Returns true if the receipt has expired. Returns false if the receipt is still active. If the document routing feature is not enabled, documents are retained for 30 days after the transaction has been adjudicated. If the document routing feature is enabled, documents are stored for three years and then archived. Documents containing eSignatures are stored on the claim as long as the claim is visible in WCA
- ReceiptsInfo array <object>
  
  Receipts Info
  - TpaId string
    
    A unique identifier used to identify your admin instance. This value was system generated with the admin instance was created.
  - FileKey integer <int32>
    
    A system generated ID used to identify the receipt file.
  - DocId string
    
    A system generated ID created when a file is submitted through a document queue instead of by a participant.
  - DocDisplayName string
    
    Document Display Name
  - OriginalFileName string
    
    Original File Name
  - UploadDate string <date-time>
    
    The date the receipt file was uploaded.
- DisplayableFields array <object>
  
  Displayable Fields
  - OriginalFieldName string
    
    Displays Orignal Filed Name.
  - AlternativeFieldName string
    
    Displays Alternative Field Name.
  - DisplayOptions enum<string>
    
    Field Display Options - NoDisplay = 0, Original = 1, Alternative = 2,
    
    Possible values: NoDisplay Original Alternative
  - DisplaySpecifications enum<string>
    
    Field Display Specifications - None = 0, IsVisible = 1, IsRequired = 2, IsOptional = 4, IsReadOnly = 8, MAX_COMMON_VALUE = 4294967296
    
    Possible values: None IsVisible IsRequired IsOptional IsReadOnly MAX_COMMON_VALUE
- InsertDate string <date-time>
  
  The date the claim was inserted.
- UpdateDte string <date-time>
  
  The last update date of the claim
- InsertUserIdKey integer <int32>
  
  A system generated ID for the user ID that inserted the claim.
- UpdateUserIdKey integer <int32>
  
  A system generated ID used to identify the user that last updated the claim
- ExpenseKey integer <int64>
  
  This will return 0 when on a UploadManualClaimReceipt response.