Update an existing expense

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

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.

Request body

CarrierId string

Unique identifier for the Carrier
ClaimId string

Unique identifier of the Claims
ClaimLineNum integer <int32>

Refers to claim when multiple claim submitted
ClaimTypeCde enum<string>

Unique identifier for type of Claims : None = 0, Pharmacy = 1, Medical = 2, Dental = 4, Vision = 8, OTC = 16

Possible values: None Pharmacy Medical Dental Vision OTC
BenefitMaxMetAmount number <double>

Amount for a benefit maximum being met
RbbExcessAmount number <double>

Amount is used as the participant's excess amount responsibility Amount denied as not covered by the insurance plan
NotCoveredAmount number <double>

Amount which was not covered by the Participant associated with Employee
AboveRcAmount number <double>

Amount which is above the usual and customary rate
RenderingProvider string

Providing the service of the participant's Employee
BillingProviderTaxId string

Unique identifier for the Billing Provider
ServiceCategoryTierId string

Unique identifier for the Service Categories Tier
DependentId string

Unique identifier for the Dependent
ServiceCategoryCode string

Unique identifier for the Service Categories
TotalPatientRespAmt number <double>

Total amount will be Paid as the participant's responsibility
RenderingProviderId string

Unique identifier for the Rendering Provider
FirstName string

First Name of Participant associated with Employee
LastName string

Last Name of Participant associated with Employee
PayProviderKey integer <int32>

Unique identifier key for the Provider
ProviderAddress1 string

Address line 1 associated with the provider’s mailing address
ProviderAddress2 string

Address line 2 associated with the provider’s mailing address
ProviderCity string

City associated with the provider’s mailing address
ProviderState string

State associated with the provider’s mailing address
ProviderCountryCde string

Country Code associated with the provider’s mailing address
ProviderZip string

Zip Code associated with the provider’s mailing address
ProviderPhone string

Phone associated with the provider’s mailing address
ProviderId string

Unique identifier for the Provider
TpaId string

Unique identifier that WealthCare Admin assigns to Employee
ExpenseKey integer <int64>

Unique identifier key for Expense
EmpeKey integer <int32>

Unique identifier key for Employer
DepKey integer <int32>

Unique identifier key for the Dependent
ServiceStartDte string <date-time>

Date when the Service Start
ServiceEndDte string <date-time>

Date when the Service End
ProviderName string

Name of the Provider
DescOfService string

Description related to the Service
BilledAmt number <double>

Amount paid against total billed amount
InsAmtAllowed number <double>

Maximum Insurance Amount Allowed For Participant associated with Employee
InsAmtPaid number <double>

Insurance Amount paid to Participant associated with Employee
EmpePaidAmt number <double>

Amount paid to Employee
Notes string

Notes entered by user related to the transaction
FileKey integer <int32>

Unique identifier key for File
eClaimOptions integer <int64>

Option for Online submission of claim: Yes=1, No=0
DeductibleAmt number <double>

Amount will be used as the participant's deductible responsibility
CoinsAmt number <double>

Amount to participant's coinsurance
CoPayAmt number <double>

Amount will be used as participant's copay responsibility
TotalReimbAmt number <double>

Total Amount of transaction which got reimbursed
OriginCde enum<string>

Origin Code indicates which way claims initiated : 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
eClaimUIStatus enum<string>

Current status of the eClaim : None = 0, New = 1, Matched = 2, Reimbursed = 3,NotAllowParticipantClaimEntry = 4, MissParticipantClaimEntryUITemplate = 5,In_Process = 6,Fully_Paid = 7

Possible values: None New Matched Reimbursed NotAllowParticipantClaimEntry MissParticipantClaimEntryUITemplate In_Process Fully_Paid

Response

CarrierId string

Unique identifier for the Carrier
ClaimId string

Unique identifier of the Claims
ClaimLineNum integer <int32>

Refers to claim when multiple claim submitted
ClaimTypeCde enum<string>

Unique identifier for type of Claims : None = 0, Pharmacy = 1, Medical = 2, Dental = 4, Vision = 8, OTC = 16

Possible values: None Pharmacy Medical Dental Vision OTC
BenefitMaxMetAmount number <double>

Amount for a benefit maximum being met
RbbExcessAmount number <double>

Amount is used as the participant's excess amount responsibility Amount denied as not covered by the insurance plan
NotCoveredAmount number <double>

Amount which was not covered by the Participant associated with Employee
AboveRcAmount number <double>

Amount which is above the usual and customary rate
RenderingProvider string

Providing the service of the participant's Employee
BillingProviderTaxId string

Unique identifier for the Billing Provider
ServiceCategoryTierId string

Unique identifier for the Service Categories Tier
DependentId string

Unique identifier for the Dependent
ServiceCategoryCode string

Unique identifier for the Service Categories
TotalPatientRespAmt number <double>

Total amount will be Paid as the participant's responsibility
RenderingProviderId string

Unique identifier for the Rendering Provider
FirstName string

First Name of Participant associated with Employee
LastName string

Last Name of Participant associated with Employee
PayProviderKey integer <int32>

Unique identifier key for the Provider
ProviderAddress1 string

Address line 1 associated with the provider’s mailing address
ProviderAddress2 string

Address line 2 associated with the provider’s mailing address
ProviderCity string

City associated with the provider’s mailing address
ProviderState string

State associated with the provider’s mailing address
ProviderCountryCde string

Country Code associated with the provider’s mailing address
ProviderZip string

Zip Code associated with the provider’s mailing address
ProviderPhone string

Phone associated with the provider’s mailing address
ProviderId string

Unique identifier for the Provider
TpaId string

Unique identifier that WealthCare Admin assigns to Employee
ExpenseKey integer <int64>

Unique identifier key for Expense
EmpeKey integer <int32>

Unique identifier key for Employer
DepKey integer <int32>

Unique identifier key for the Dependent
ServiceStartDte string <date-time>

Date when the Service Start
ServiceEndDte string <date-time>

Date when the Service End
ProviderName string

Name of the Provider
DescOfService string

Description related to the Service
BilledAmt number <double>

Amount paid against total billed amount
InsAmtAllowed number <double>

Maximum Insurance Amount Allowed For Participant associated with Employee
InsAmtPaid number <double>

Insurance Amount paid to Participant associated with Employee
EmpePaidAmt number <double>

Amount paid to Employee
Notes string

Notes entered by user related to the transaction
FileKey integer <int32>

Unique identifier key for File
eClaimOptions integer <int64>

Option for Online submission of claim: Yes=1, No=0
DeductibleAmt number <double>

Amount will be used as the participant's deductible responsibility
CoinsAmt number <double>

Amount to participant's coinsurance
CoPayAmt number <double>

Amount will be used as participant's copay responsibility
TotalReimbAmt number <double>

Total Amount of transaction which got reimbursed
OriginCde enum<string>

Origin Code indicates which way claims initiated : 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
eClaimUIStatus enum<string>

Current status of the eClaim : None = 0, New = 1, Matched = 2, Reimbursed = 3,NotAllowParticipantClaimEntry = 4, MissParticipantClaimEntryUITemplate = 5,In_Process = 6,Fully_Paid = 7

Possible values: None New Matched Reimbursed NotAllowParticipantClaimEntry MissParticipantClaimEntryUITemplate In_Process Fully_Paid