Custom API Endpoint
Paths
/service-reviews
Initiate a new service review inquiery request or view an existing request.
The Availity payer id of the member.
The requesting provider's specialty code.
The requesting provider's last or business name.
The requesting provider's first name.
The requesting provider's middle name.
The requesting provider's suffix.
The requesting provider's national provider id.
The requesting provider's tax id.
The requesting provider's payer assigned provider id.
The requesting provider's submitter id.
The requesting provider's address.
The requesting provider's address.
The requesting provider's city.
The requesting provider's state code.
The requesting provider's ZIP code.
The requesting provider's contact name.
The requesting provider's phone.
The requesting provider's extension.
The requesting provider's fax.
The subcriber's member id.
The subcriber's first name.
The subcriber's last name.
The subcriber's middle name.
The subcriber's suffix.
The patient's last name.
The patient's first name.
The patient's middle name.
The patient's suffix.
The patient's birth date.
The patient's relationship to subscriber code.
The request type code.
The service from date.
The service to date.
The certification issue date.
The certification number.
The reference number.
The status code.
The session id.
application/xml
OK
Accepted
Bad Request
Not Authorized
Forbidden
Internal Server Error
Create a new service review.
application/xml
application/xml
Accepted
Bad Request
Not Authorized
Forbidden
Internal Server Error
Update a service review.
application/xml
application/xml
Accepted
Bad Request
Not Authorized
Forbidden
Internal Server Error
/service-reviews/{id}
Get the a service review by id.
application/xml
Accepted
Bad Request
Not Authorized
Forbidden
Not Found
Internal Server Error
Void a service review.
application/xml
Accepted
No Content
Bad Request
Not Authorized
Forbidden
Not Found
Internal Server Error
Definitions
{
"type": "object",
"properties": {
"totalCount": {
"type": "integer",
"description": "Total number of assets."
},
"count": {
"type": "integer",
"description": "Number of assets in the result set."
},
"offset": {
"type": "integer",
"description": "Paging offset."
},
"limit": {
"type": "integer",
"description": "Paging limit."
},
"links": {
"type": "object",
"description": "Links.",
"additionalProperties": {
"$ref": "#\/definitions\/Link"
}
},
"serviceReviews": {
"type": "array",
"description": "list of service reviews",
"items": {
"$ref": "#\/definitions\/ServiceReview"
}
}
}
}
{
"type": "object",
"properties": {
"href": {
"type": "string",
"description": "The URL."
}
}
}
{
"type": "object",
"properties": {
"id": {
"type": "string",
"description": "The service review id."
},
"customerId": {
"type": "string",
"description": "The Availity Customer ID of the customer that owns this service review."
},
"controlNumber": {
"type": "string",
"description": "The control number of the X12 request that this service review was created from."
},
"userId": {
"type": "string",
"description": "The User ID of the customer that owns this service review."
},
"shortFormIndicator": {
"type": "boolean",
"description": "short form indicator"
},
"updatable": {
"type": "boolean",
"description": "Indicates if this service review is updateable."
},
"deletable": {
"type": "boolean",
"description": "Indicates if this service review is deletable."
},
"updatableFields": {
"type": "array",
"description": "Updatable fields.",
"items": {
"type": "string"
}
},
"status": {
"type": "string",
"description": "The status of the service review."
},
"statusCode": {
"type": "string",
"description": "The status code of the service review."
},
"statusReasons": {
"type": "array",
"description": "Status reasons",
"items": {
"type": "object",
"properties": {
"code": {
"type": "string",
"description": "Status reason code."
},
"value": {
"type": "string",
"description": "Status reason."
}
}
}
},
"createdDate": {
"type": "string",
"format": "date-time",
"description": "The date this coverage entry was created."
},
"updatedDate": {
"type": "string",
"format": "date-time",
"description": "The date when this coverage entry was last updated."
},
"expirationDate": {
"type": "string",
"format": "date-time",
"description": "The date when this coverage entry expires."
},
"validationMessages": {
"type": "array",
"description": "Messages after validation.",
"items": {
"$ref": "#\/definitions\/FieldError"
}
},
"providerNotes": {
"type": "array",
"description": "Notes from the provider.",
"items": {
"$ref": "#\/definitions\/Note"
}
},
"payerNotes": {
"type": "array",
"description": "Notes from the payer.",
"items": {
"$ref": "#\/definitions\/Note"
}
},
"payer": {
"$ref": "#\/definitions\/Payer"
},
"requestingProvider": {
"$ref": "#\/definitions\/RequestingProvider"
},
"subscriber": {
"$ref": "#\/definitions\/Subscriber"
},
"patient": {
"$ref": "#\/definitions\/Patient"
},
"diagnoses": {
"type": "array",
"description": "Diagnoses.",
"items": {
"$ref": "#\/definitions\/Diagnosis"
}
},
"certificationIssueDate": {
"type": "string",
"format": "date",
"description": "The date this service review was created."
},
"certificationEffectiveDate": {
"type": "string",
"format": "date",
"description": "The date this service review became effective."
},
"certificationExpirationDate": {
"type": "string",
"format": "date",
"description": "The date this service review expires."
},
"certificationNumber": {
"type": "string",
"description": "The service review number."
},
"referenceNumber": {
"type": "string",
"description": "The reference number."
},
"traceNumbers": {
"type": "array",
"description": "Trace numbers added to this Service Review by the payer.",
"items": {
"type": "string"
}
},
"requestType": {
"type": "string",
"description": "type of request."
},
"requestTypeCode": {
"type": "string",
"description": "request type code"
},
"serviceType": {
"type": "string",
"description": "type of service."
},
"serviceTypeCode": {
"type": "string",
"description": "type code."
},
"additionalServiceTypes": {
"type": "array",
"description": "Additional service types.",
"items": {
"type": "object",
"properties": {
"code": {
"type": "string",
"description": "Additional service type code."
},
"value": {
"type": "string",
"description": "Additional service type."
}
}
}
},
"placeOfService": {
"type": "string",
"description": "place of service."
},
"placeOfServiceCode": {
"type": "string",
"description": "place of service code."
},
"serviceLevel": {
"type": "string",
"description": "level of service."
},
"serviceLevelCode": {
"type": "string",
"description": "level of service code."
},
"fromDate": {
"type": "string",
"format": "date",
"description": "The date the service started."
},
"toDate": {
"type": "string",
"format": "date",
"description": "The date the service ended."
},
"quantity": {
"type": "string",
"description": "the quantity of the procedure."
},
"quantityType": {
"type": "string",
"description": "the unit of measure for quantity of the procedure."
},
"quantityTypeCode": {
"type": "string",
"description": "the code for the unit of measure for quantity of the procedure."
},
"admissionType": {
"type": "string",
"description": "the admission type."
},
"admissionTypeCode": {
"type": "string",
"description": "the admission type code."
},
"admissionSource": {
"type": "string",
"description": "the admission source."
},
"admissionSourceCode": {
"type": "string",
"description": "the admission source code."
},
"nursingHomeResidentialStatus": {
"type": "string",
"description": "The nursing home residential status."
},
"nursingHomeResidentialStatusCode": {
"type": "string",
"description": "The nursing home residential status code."
},
"homeHealthStartDate": {
"type": "string",
"format": "date",
"description": "The date the home health service started."
},
"homeHealthCertificationPeriodStartDate": {
"type": "string",
"format": "date",
"description": "The date the home health service started."
},
"homeHealthCertificationPeriodEndDate": {
"type": "string",
"format": "date",
"description": "The date the home health service started."
},
"transportType": {
"type": "string",
"description": "The type of medically related tranport."
},
"transportTypeCode": {
"type": "string",
"description": "The type code of medically related tranport."
},
"transportDistance": {
"type": "string",
"description": "The distance of medically related tranport."
},
"transportPurpose": {
"type": "string",
"description": "The purpose of medically related tranport."
},
"chiropracticTreatmentCount": {
"type": "string",
"description": "The chiropractic treatment count."
},
"beginningSubluxationLevel": {
"type": "string",
"description": "The beginning subluxation level."
},
"beginningSubluxationLevelCode": {
"type": "string",
"description": "The beginning subluxation level code."
},
"endingSubluxationLevel": {
"type": "string",
"description": "The ending subluxation level."
},
"endingSubluxationLevelCode": {
"type": "string",
"description": "The ending subluxation level code."
},
"spinalCondition": {
"type": "string",
"description": "The spinal condition."
},
"spinalConditionCode": {
"type": "string",
"description": "The spinal condition code."
},
"spinalConditionDescription": {
"type": "string",
"description": "A description of the spinal condition."
},
"oxygenEquipmentType": {
"type": "string",
"description": "The oxygen equipment type."
},
"oxygenEquipmentTypeCode": {
"type": "string",
"description": "The oxygen equipment type code."
},
"oxygenFlowRate": {
"type": "string",
"description": "The oxygen flow rate."
},
"oxygenDailyUseCount": {
"type": "string",
"description": "The oxygen daily use count."
},
"oxygenUsePeriodHourCount": {
"type": "string",
"description": "The oxygen use period hour count."
},
"oxygenOrderText": {
"type": "string",
"description": "The oxygen order text."
},
"oxygenDeliverySystemType": {
"type": "string",
"description": "The oxygen delivery system type."
},
"oxygenDeliverySystemTypeCode": {
"type": "string",
"description": "The oxygen delivery system type code."
},
"transportLocations": {
"type": "array",
"description": "The locations of medically related tranport.",
"items": {
"$ref": "#\/definitions\/TransportLocation"
}
},
"procedures": {
"type": "array",
"description": "The medical procedures to be performed.",
"items": {
"$ref": "#\/definitions\/Procedures"
}
},
"renderingProviders": {
"type": "array",
"description": "The rendering providers to perform the procedures.",
"items": {
"$ref": "#\/definitions\/RenderingProvider"
}
},
"supplementalInformation": {
"$ref": "#\/definitions\/SupplementalInformation"
}
}
}
{
"type": "object",
"properties": {
"type": {
"type": "string",
"description": "The type of note."
},
"typeCode": {
"type": "string",
"description": "The type code of the note."
},
"message": {
"type": "string",
"description": "The message from the payer."
}
}
}
{
"type": "object",
"properties": {
"id": {
"type": "string",
"description": "Service review payer id"
},
"name": {
"type": "string",
"description": "Service review payer name"
},
"contactName": {
"type": "string",
"description": "Full Name"
},
"phone": {
"type": "string",
"description": "Phone Number"
},
"extension": {
"type": "string",
"description": "Extension"
},
"fax": {
"type": "string",
"description": "Fax"
},
"emailAddress": {
"type": "string",
"description": "E-mail Address"
},
"url": {
"type": "string",
"description": "Website URL"
}
}
}
{
"type": "object",
"properties": {
"lastName": {
"type": "string",
"description": "The last name of an individual provider or the name of an organizational provider."
},
"firstName": {
"type": "string",
"description": "The first name of an individual provider."
},
"middleName": {
"type": "string",
"description": "The middle name of an individual provider."
},
"suffix": {
"type": "string",
"description": "The suffix of an individual provider."
},
"npi": {
"type": "string",
"description": "The NPI of a provider."
},
"taxId": {
"type": "string",
"description": "The tax id of a provider."
},
"payerAssignedProviderId": {
"type": "string",
"description": "The payer assigned provider id of the provider."
},
"submitterId": {
"type": "string",
"description": "The payer assigned provider reference number."
},
"specialty": {
"type": "string",
"description": "The speciality of a provider."
},
"specialtyCode": {
"type": "string",
"description": "The speciality code of a provider."
},
"addressLine1": {
"type": "string",
"description": "The street line 1."
},
"addressLine2": {
"type": "string",
"description": "The street line 2."
},
"city": {
"type": "string",
"description": "The city."
},
"state": {
"type": "string",
"description": "The state."
},
"stateCode": {
"type": "string",
"description": "The state code."
},
"zipCode": {
"type": "string",
"description": "The ZIP code."
},
"contactName": {
"type": "string",
"description": "Full Name"
},
"phone": {
"type": "string",
"description": "Phone Number"
},
"extension": {
"type": "string",
"description": "Phone Extension"
},
"fax": {
"type": "string",
"description": "Fax"
},
"emailAddress": {
"type": "string",
"description": "E-mail Address"
},
"url": {
"type": "string",
"description": "Website URL"
}
}
}
{
"type": "object",
"properties": {
"firstName": {
"type": "string",
"description": "The subscriber's first name."
},
"middleName": {
"type": "string",
"description": "The subscriber's middle name."
},
"lastName": {
"type": "string",
"description": "The subscriber's last name."
},
"suffix": {
"type": "string",
"description": "The subscriber's suffix."
},
"memberId": {
"type": "string",
"description": "The health plan member id of the subscriber."
},
"addressLine1": {
"type": "string",
"description": "The street line 1."
},
"addressLine2": {
"type": "string",
"description": "The street line 2."
},
"city": {
"type": "string",
"description": "The city."
},
"state": {
"type": "string",
"description": "The state."
},
"stateCode": {
"type": "string",
"description": "The state code."
},
"zipCode": {
"type": "string",
"description": "The ZIP code."
}
}
}
{
"type": "object",
"properties": {
"firstName": {
"type": "string",
"description": "The patient's first name."
},
"middleName": {
"type": "string",
"description": "The patient's middle name."
},
"lastName": {
"type": "string",
"description": "The patient's last name."
},
"suffix": {
"type": "string",
"description": "The patient's suffix."
},
"subscriberRelationship": {
"type": "string",
"description": "The patient's relationship to the subscriber or policy holder."
},
"subscriberRelationshipCode": {
"type": "string",
"description": "The patient's relationship code to the subscriber or policy holder."
},
"birthDate": {
"type": "string",
"format": "date",
"description": "The patient's date of birth."
},
"gender": {
"type": "string",
"description": "The patient's gender."
},
"genderCode": {
"type": "string",
"description": "The patient's gender code."
},
"addressLine1": {
"type": "string",
"description": "The street line 1."
},
"addressLine2": {
"type": "string",
"description": "The street line 2."
},
"city": {
"type": "string",
"description": "The city."
},
"state": {
"type": "string",
"description": "The state."
},
"stateCode": {
"type": "string",
"description": "The state code."
},
"zipCode": {
"type": "string",
"description": "The ZIP code."
},
"status": {
"type": "string",
"description": "The patient's status"
},
"statusCode": {
"type": "string",
"description": "The patient's status code"
},
"condition": {
"type": "string",
"description": "The condition"
},
"conditionCode": {
"type": "string",
"description": "The condition code"
},
"medicareCoverage": {
"type": "boolean",
"description": "The patient is covered by Medicare"
},
"prognosis": {
"type": "string",
"description": "The prognosis"
},
"prognosisCode": {
"type": "string",
"description": "The prognosis code"
}
}
}
{
"type": "object",
"properties": {
"qualifier": {
"type": "string",
"description": "The qualifier for the diagnosis."
},
"qualifierCode": {
"type": "string",
"description": "The qualifier code for the diagnosis."
},
"value": {
"type": "string",
"description": "The value or description of the diagnosis."
},
"code": {
"type": "string",
"description": "The code for the diagnosis."
},
"date": {
"type": "string",
"format": "date",
"description": "The date the diagnosis was reached."
}
}
}
{
"type": "object",
"properties": {
"name": {
"type": "string",
"description": "The name of the transport location"
},
"addressLine1": {
"type": "string",
"description": "The address line 1 of the transport location"
},
"addressLine2": {
"type": "string",
"description": "The address line 2 of the transport location"
},
"city": {
"type": "string",
"description": "The city of the transport location"
},
"state": {
"type": "string",
"description": "The state of the transport location"
},
"stateCode": {
"type": "string",
"description": "The state code of the transport location"
},
"zipCode": {
"type": "string",
"description": "The ZIP code of the transport location"
}
}
}
{
"type": "object",
"properties": {
"revenueValue": {
"type": "string",
"description": "for institutional procedure the revenue value of the procedure."
},
"revenueCode": {
"type": "string",
"description": "for institutional procedure the revenue code of the procedure."
},
"qualifier": {
"type": "string",
"description": "the qualifier for the procedure."
},
"qualifierCode": {
"type": "string",
"description": "the qualifier code for the procedure."
},
"value": {
"type": "string",
"description": "the value or description for the procedure."
},
"code": {
"type": "string",
"description": "the code for the procedure."
},
"modifier1": {
"type": "string",
"description": "modifier for the procedure"
},
"modifierCode1": {
"type": "string",
"description": "modifier code for the procedure"
},
"modifier2": {
"type": "string",
"description": "modifier for the procedure"
},
"modifierCode2": {
"type": "string",
"description": "modifier code for the procedure"
},
"modifier3": {
"type": "string",
"description": "modifier for the procedure"
},
"modifierCode3": {
"type": "string",
"description": "modifier code for the procedure"
},
"modifier4": {
"type": "string",
"description": "modifier for the procedure"
},
"modifierCode4": {
"type": "string",
"description": "modifier code for the procedure"
},
"description": {
"type": "string",
"description": "description of the procedure."
},
"quantity": {
"type": "string",
"description": "the quantity of the procedure."
},
"quantityType": {
"type": "string",
"description": "the unit of measure for quantity of the procedure."
},
"quantityTypeCode": {
"type": "string",
"description": "the code for the unit of measure for quantity of the procedure."
},
"fromDate": {
"type": "string",
"format": "date",
"description": "The date the procedure started."
},
"toDate": {
"type": "string",
"format": "date",
"description": "The date the procedure ended."
},
"status": {
"type": "string",
"description": "the status of the procedure."
},
"statusCode": {
"type": "string",
"description": "the status code of the procedure."
},
"statusReasons": {
"type": "array",
"description": "Status reasons",
"items": {
"type": "object",
"properties": {
"code": {
"type": "string",
"description": "Status reason code."
},
"value": {
"type": "string",
"description": "Status reason."
}
}
}
},
"certificationIssueDate": {
"type": "string",
"format": "date",
"description": "The date the authorization was issued."
},
"certificationEffectiveDate": {
"type": "string",
"format": "date",
"description": "The date the authorization became effective."
},
"certificationExpirationDate": {
"type": "string",
"format": "date",
"description": "The date the authorization expired."
},
"certificationNumber": {
"type": "string",
"description": "the authorization number."
},
"traceNumbers": {
"type": "array",
"description": "Trace numbers added to this Service Review by the payer.",
"items": {
"type": "string"
}
},
"notes": {
"type": "array",
"description": "Notes, disclaimers, and descriptions.",
"items": {
"$ref": "#\/definitions\/Note"
}
}
}
}
{
"type": "object",
"properties": {
"lastName": {
"type": "string",
"description": "The last name of an individual provider or the name of an organizational provider."
},
"firstName": {
"type": "string",
"description": "The first name of an individual provider."
},
"middleName": {
"type": "string",
"description": "The middle name of an individual provider."
},
"suffix": {
"type": "string",
"description": "The suffix of an individual provider."
},
"npi": {
"type": "string",
"description": "The NPI of a provider."
},
"taxId": {
"type": "string",
"description": "The tax id of a provider."
},
"payerAssignedProviderId": {
"type": "string",
"description": "The payer assigned provider id of a provider."
},
"specialty": {
"type": "string",
"description": "The speciality of a provider."
},
"specialtyCode": {
"type": "string",
"description": "The speciality code of a provider."
},
"role": {
"type": "string",
"description": "The role of a provider."
},
"roleCode": {
"type": "string",
"description": "The role code of a provider."
},
"addressLine1": {
"type": "string",
"description": "The street line 1."
},
"addressLine2": {
"type": "string",
"description": "The street line 2."
},
"city": {
"type": "string",
"description": "The city."
},
"state": {
"type": "string",
"description": "The state."
},
"stateCode": {
"type": "string",
"description": "The state code."
},
"zipCode": {
"type": "string",
"description": "The ZIP code."
},
"contactName": {
"type": "string",
"description": "Full Name"
},
"phone": {
"type": "string",
"description": "Phone Number"
},
"extension": {
"type": "string",
"description": "Phone Extension"
},
"fax": {
"type": "string",
"description": "fax"
},
"emailAddress": {
"type": "string",
"description": "E-mail Address"
},
"url": {
"type": "string",
"description": "Website URL"
}
}
}
{
"type": "object",
"properties": {
"attachments": {
"type": "array",
"description": "The attachments information.",
"items": {
"$ref": "#\/definitions\/Attachment"
}
},
"diagnoses": {
"type": "array",
"description": "The diagnosis information.",
"items": {
"$ref": "#\/definitions\/Diagnosis"
}
},
"procedures": {
"type": "array",
"description": "The procedure information.",
"items": {
"$ref": "#\/definitions\/Diagnosis"
}
},
"refAuthNumber": {
"type": "string",
"description": "The authorization or referral number."
},
"sequence": {
"type": "string",
"description": "The sequence number."
},
"updateType": {
"type": "string",
"description": "The update type."
}
}
}
{
"type": "object",
"properties": {
"fileName": {
"type": "string",
"description": "The attachment file name."
},
"id": {
"type": "string",
"description": "The id number of the attachments."
},
"idType": {
"type": "string",
"description": "The id type for the attachment."
},
"dateReceived": {
"type": "string",
"format": "date",
"description": "The date the attachment info was received."
}
}
}
{
"type": "object",
"properties": {
"userMessage": {
"type": "string",
"description": "A high level error message."
},
"developerMessage": {
"type": "string",
"description": "A more technical error message."
},
"reasonCode": {
"type": "integer",
"description": "A reason code."
},
"statusCode": {
"type": "integer",
"description": "The status code."
},
"errors": {
"type": "array",
"description": "A list of detailed user friendly messages.",
"items": {
"$ref": "#\/definitions\/FieldError"
}
}
}
}
{
"type": "object",
"properties": {
"field": {
"type": "string",
"description": "The field or parameter associated with this error."
},
"code": {
"type": "string",
"description": "A code for the error."
},
"errorMessage": {
"type": "string",
"description": "The message associated with this error."
},
"index": {
"type": "integer",
"description": "The array index of the item associated with this error."
}
}
}