Get Claims

Returns paginated claims with line items, payments, insurance details, and billing activity for a given date range.

GET /claims

Get Claims

cURL

curl --request GET \
  --url https://api.usecobalt.com/v1/claims \
  --header 'access_token: <api-key>' \
  --header 'client_id: <api-key>' \
  --header 'client_secret: <api-key>'

200

{
  "success": true,
  "claims": [
    {
      "id": "<string>",
      "emr_claim_id": "<string>",
      "emr_appointment_id": "<string>",
      "service_date": "2023-12-25",
      "claim_date": "2023-12-25",
      "claim_status": "<string>",
      "claim_status_description": "<string>",
      "claim_type": "<string>",
      "void_flag": true,
      "emr_patient_id": "<string>",
      "patient_name": "<string>",
      "emr_provider_id": "<string>",
      "provider_name": "<string>",
      "total_charge": 123,
      "total_payment": 123,
      "net_payment": 123,
      "balance": 123,
      "net_adjustment": 123,
      "patient_responsibility": 123,
      "insurances": [
        {
          "insurance_id": "<string>",
          "insurance_name": "<string>",
          "insurance_type": "<string>",
          "claim_indicator": "<string>",
          "claim_indicator_description": "<string>",
          "sequence_number": "<string>",
          "subscriber_name": "<string>",
          "subscriber_number": "<string>",
          "subscriber_dob": "2023-12-25",
          "subscriber_relation": "<string>",
          "group_name": "<string>",
          "group_number": "<string>",
          "provider_number": "<string>",
          "payment_source": "<string>",
          "assign_benefits": "<string>",
          "insurance_address_1": "<string>",
          "insurance_address_2": "<string>",
          "insurance_city": "<string>",
          "insurance_state": "<string>",
          "insurance_zip": "<string>",
          "medicaid_id": "<string>"
        }
      ],
      "balances": {
        "invoice_amount": "<string>",
        "total_payment": "<string>",
        "net_payment": "<string>",
        "balance": "<string>",
        "patient_balance": "<string>",
        "patient_payment": "<string>",
        "patient_responsibility": "<string>",
        "on_plan": "<string>"
      },
      "icd_codes": [
        "<string>"
      ],
      "void_claim": {
        "void_to_claim_id": "<string>",
        "void_from_claim_id": "<string>",
        "copy_to_claim_id": "<string>",
        "copy_from_claim_id": "<string>"
      },
      "submission_history": {
        "created_by": "<string>",
        "entries": "<array>",
        "auto_claim_data": {}
      },
      "billing_activity_log": [
        {
          "date": "<string>",
          "action": "<string>",
          "category": "<string>",
          "notes": "<string>",
          "user_name": "<string>"
        }
      ],
      "billing_notes": "<string>",
      "line_items": [
        {
          "id": "<string>",
          "line_number": 123,
          "cpt_code": "<string>",
          "description": "<string>",
          "modifiers": [
            "<string>"
          ],
          "units": 123,
          "billed_amount": 123,
          "allowed_amount": 123,
          "billed_unit_fee": 123,
          "icd_pointers": [
            "<string>"
          ],
          "place_of_service": "<string>",
          "type_of_service": "<string>",
          "service_date_start": "2023-12-25",
          "service_date_end": "2023-12-25",
          "rendering_provider_npi": "<string>",
          "ordering_provider_npi": "<string>",
          "referring_provider_npi": "<string>"
        }
      ],
      "payments": [
        {
          "id": "<string>",
          "emr_payment_id": "<string>",
          "check_number": "<string>",
          "payment_date": "2023-12-25",
          "amount": 123,
          "payment_type": "<string>",
          "payer_name": "<string>",
          "payer_type": "<string>",
          "adjustment": 123,
          "deductible": 123,
          "coinsurance": 123,
          "allowed": 123,
          "member_balance": 123,
          "withheld": 123,
          "era_claim_status": "<string>",
          "era_claim_status_code": "<string>",
          "era_payer_name": "<string>",
          "era_check_amount": 123,
          "era_adjustment_codes": {}
        }
      ],
      "synced_at": "2023-11-07T05:31:56Z",
      "created_at": "2023-11-07T05:31:56Z",
      "updated_at": "2023-11-07T05:31:56Z"
    }
  ],
  "pagination": {
    "page": 1,
    "page_size": 100,
    "total_count": 45,
    "total_pages": 1
  }
}

Example Request

curl -X GET https://api.usecobalt.com/v1/claims \
-H 'Content-Type: application/json' \
-H 'client_id: ci_live_198908HJDKJSH98789OHKJL' \
-H 'client_secret: cs_live_9827hofdsklOYYHJLJh' \
-H 'access_token: 493JKLHIU98789hLKH9HHJH' \
-G \
--data-urlencode "start_date=2025-08-01" \
--data-urlencode "end_date=2025-09-01"

Example Response

{
    "success": true,
    "claims": [
        {
            "id": "a1b2c3d4e5f6789012345678abcdef90",
            "emr_claim_id": "100234",
            "emr_appointment_id": "500100",
            "service_date": "2025-08-01",
            "claim_date": "2025-08-08",
            "claim_status": "48CL",
            "claim_status_description": "Closed (48-hour rule)",
            "claim_type": "0",
            "void_flag": false,
            "emr_patient_id": "40210",
            "patient_name": "DOE, JANE, M",
            "emr_provider_id": "10052",
            "provider_name": "Smith, Robert",
            "total_charge": "350.00",
            "total_payment": "280.00",
            "net_payment": "280.00",
            "balance": "20.00",
            "net_adjustment": "50.00",
            "patient_responsibility": "20.00",
            "insurances": [
                {
                    "insurance_id": "101",
                    "insurance_name": "Blue Cross Blue Shield",
                    "insurance_type": "C1",
                    "claim_indicator": "P",
                    "claim_indicator_description": "Primary",
                    "sequence_number": "1",
                    "subscriber_name": "DOE, JANE, M",
                    "subscriber_number": "XYZ123456789",
                    "subscriber_dob": "1975-06-15",
                    "subscriber_relation": "1",
                    "group_name": "ACME CORP",
                    "group_number": "GRP-98765",
                    "provider_number": "BCBS1",
                    "payment_source": "16",
                    "assign_benefits": "Y",
                    "insurance_address_1": "PO BOX 12345",
                    "insurance_address_2": "",
                    "insurance_city": "CHICAGO",
                    "insurance_state": "IL",
                    "insurance_zip": "60601",
                    "medicaid_id": ""
                },
                {
                    "insurance_id": "202",
                    "insurance_name": "Medicare Part B",
                    "insurance_type": "C1",
                    "claim_indicator": "S",
                    "claim_indicator_description": "Secondary",
                    "sequence_number": "2",
                    "subscriber_name": "DOE, JANE, M",
                    "subscriber_number": "1EG4TE5MK72",
                    "subscriber_dob": "1975-06-15",
                    "subscriber_relation": "1",
                    "group_name": "",
                    "group_number": "",
                    "provider_number": "MED01",
                    "payment_source": "MB",
                    "assign_benefits": "Y",
                    "insurance_address_1": "CMS CLAIMS",
                    "insurance_address_2": "PO BOX 5678",
                    "insurance_city": "BALTIMORE",
                    "insurance_state": "MD",
                    "insurance_zip": "21244",
                    "medicaid_id": ""
                }
            ],
            "balances": {
                "invoice_amount": "350.00",
                "total_payment": "280.00",
                "net_payment": "280.00",
                "balance": "20.00",
                "patient_balance": "20.00",
                "patient_payment": "0.00",
                "patient_responsibility": "20.00",
                "on_plan": "false"
            },
            "icd_codes": ["M54.5", "Z96.641"],
            "void_claim": {
                "void_to_claim_id": "-1",
                "void_from_claim_id": "-1",
                "copy_to_claim_id": "-1",
                "copy_from_claim_id": "-1"
            },
            "submission_history": {
                "created_by": "Johnson, Sarah",
                "entries": [],
                "auto_claim_data": {
                    "isUserInactive": "false",
                    "schedulerJobId": "-1",
                    "isClaimCreatedByJob": "false"
                }
            },
            "billing_activity_log": [
                {
                    "date": "2025-08-19 14:57:00",
                    "action": "Modified",
                    "category": "Claim Status",
                    "notes": "Changed From: Pending With Errors to Closed Zero Balance",
                    "user_name": "Sarah Johnson (sjohnson)"
                },
                {
                    "date": "2025-08-08 15:40:40",
                    "action": "Created",
                    "category": "Insurance",
                    "notes": "Created Insurance [P] [Id: 101] Blue Cross Blue Shield",
                    "user_name": "Sarah Johnson (sjohnson)"
                },
                {
                    "date": "2025-08-08 15:40:00",
                    "action": "Modified",
                    "category": "Claim Status",
                    "notes": "Changed From:  to Pending",
                    "user_name": "Sarah Johnson (sjohnson)"
                }
            ],
            "billing_notes": "Eligibility verified 2025-08-01: Primary active, deductible met, copay $20. Secondary Medicare active.",
            "line_items": [
                {
                    "id": "f1e2d3c4b5a6789012345678",
                    "line_number": 1,
                    "cpt_code": "99213",
                    "description": "Office visit, established patient",
                    "modifiers": ["25"],
                    "units": 1,
                    "billed_amount": 150.00,
                    "allowed_amount": 120.00,
                    "billed_unit_fee": 150.00,
                    "icd_pointers": ["1", "2"],
                    "place_of_service": "11",
                    "type_of_service": null,
                    "service_date_start": "2025-08-01",
                    "service_date_end": "2025-08-01",
                    "rendering_provider_npi": "1234567890",
                    "ordering_provider_npi": null,
                    "referring_provider_npi": null
                },
                {
                    "id": "a9b8c7d6e5f4321098765432",
                    "line_number": 2,
                    "cpt_code": "20610",
                    "description": "Arthrocentesis, major joint",
                    "modifiers": [],
                    "units": 1,
                    "billed_amount": 200.00,
                    "allowed_amount": 160.00,
                    "billed_unit_fee": 200.00,
                    "icd_pointers": ["1"],
                    "place_of_service": "11",
                    "type_of_service": null,
                    "service_date_start": "2025-08-01",
                    "service_date_end": "2025-08-01",
                    "rendering_provider_npi": "1234567890",
                    "ordering_provider_npi": null,
                    "referring_provider_npi": null
                }
            ],
            "payments": [
                {
                    "id": "d4c3b2a1f6e5789012345678",
                    "emr_payment_id": "55001",
                    "check_number": "EFT-20250825-001",
                    "payment_date": "2025-08-25",
                    "amount": 280.00,
                    "payment_type": "Insurance",
                    "payer_name": "Blue Cross Blue Shield",
                    "payer_type": "Insurance",
                    "adjustment": 50.00,
                    "deductible": 0.00,
                    "coinsurance": 20.00,
                    "allowed": 280.00,
                    "member_balance": 20.00,
                    "withheld": 0.00,
                    "era_claim_status": "Processed as Primary",
                    "era_claim_status_code": "1",
                    "era_payer_name": "Blue Cross Blue Shield",
                    "era_check_amount": 280.00,
                    "era_adjustment_codes": null
                }
            ],
            "synced_at": "2025-08-31T04:40:00.002Z",
            "created_at": "2025-08-31T04:40:00.002Z",
            "updated_at": "2025-08-31T04:40:00.002Z"
        }
    ],
    "pagination": {
        "page": 1,
        "page_size": 100,
        "total_count": 45,
        "total_pages": 1
    }
}

Authorizations

client_id · string · header · required

client_secret · string · header · required

access_token · string · header · required

Query Parameters

start_date · string<date> · required

Start of the service date range (YYYY-MM-DD)

end_date · string<date> · required

End of the service date range (YYYY-MM-DD)

patient_mrn · string

Filter by patient MRN (Medical Record Number)

claim_status · string

Filter by claim status

page · integer · default: 1

Page number for pagination

page_size · integer · default: 100

Number of claims per page (max 1000)

Required range: x <= 1000

Response

200 - application/json

Successful response

success · boolean

claims · object[]

Show child attributes

pagination · object

Show child attributes