UnitedHealthcare · Schema
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 |
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"
}
}
}