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Parameters

Action
Parameters
{
  "$result_object_key": {
    "accept_assignment": true,
    "billing_provider_id": "PROV123",
    "client_sig_on_file": true,
    "cms1500_policies": [
      {
        "benefits": [
          {
            "coinsurance": "15",
            "copay": "50",
            "deductible_calendar_year": "2000",
            "deductible_year_to_date": "1500"
          }
        ],
        "effective_end": "2024-07-04",
        "group_num": "331256",
        "id": "202402",
        "insurance_card_back_id": "123452",
        "insurance_card_front_id": "123451",
        "insurance_plan": {
          "id": "611231",
          "name_and_id": "Blue Cross Blue Shield - 629913",
          "payer_id": "629913",
          "payer_name": "Blue Cross Blue Shield"
        },
        "insurance_type": "Medicaid",
        "notes": "Policy is active",
        "num": "1912310",
        "patient_id": "100121",
        "priority_type": "Primary",
        "updated_at": "2024-07-01T11:29:19+00:00"
      }
    ],
    "cpt_codes_cms1500s": [
      {
        "cpt_code": "99215",
        "description": "New patient office visit, 45-60 minutes",
        "display_name": "New patient office visit",
        "mod1": "25",
        "mod2": "59",
        "mod3": "12",
        "mod4": "34",
        "pointers": "1",
        "service_date": "2025-09-22",
        "units": "1"
      }
    ],
    "dietician_organization_id": "123450",
    "dietitian_email_address": "drfleming@example.com",
    "dietitian_first_name": "Alexander",
    "dietitian_id": "100070",
    "dietitian_last_name": "Fleming",
    "dietitian_organization_id": "123450",
    "icd_codes_cms1500s": [
      {
        "active": true,
        "code": "F41.1",
        "created_at": "2024-01-15T10:30:00Z",
        "display_name": "Generalized anxiety disorder",
        "end_date": "2024-12-31",
        "first_symptom_date": "2024-01-10",
        "id": "789012",
        "updated_at": "2024-01-15T10:30:00Z"
      }
    ],
    "id": "57211",
    "insured_sig_on_file": true,
    "organization_info_id": "ORG789",
    "patient": {
      "date_of_birth": "1985-03-15",
      "location": {
        "city": "San Francisco",
        "country": "USA",
        "line1": "123 Main Street",
        "line2": "Suite 100",
        "state": "CA",
        "zip": "94117"
      },
      "sex": "Male"
    },
    "patient_id": "121250",
    "referral_info": {
      "case_qualifier": "431",
      "prior_auth_number": "AUTH123456",
      "ref_provider_first": "John",
      "ref_provider_last": "Smith",
      "ref_provider_qual": "MD"
    },
    "service_location_id": "LOC456"
  }
}
{
  "$result_object_key": {
    "accept_assignment": "The provider agrees to accept assignment",
    "billing_provider_id": "The ID of the Billing Provider",
    "client_sig_on_file": "True if the client's signature is on file",
    "cms1500_policies": {
      "benefits": {
        "coinsurance": "Coinsurance percentage due",
        "copay": "Copay amount due",
        "deductible_calendar_year": "Deductible amount for the calendar year",
        "deductible_year_to_date": "Deductible amount for the year to-date"
      },
      "effective_end": "Date the policy coverage expires",
      "group_num": "Group number",
      "id": "ID for the policy",
      "insurance_card_back_id": "ID of the insurance card back image object",
      "insurance_card_front_id": "ID of the insurance card front image object",
      "insurance_plan": {
        "id": "ID of the insurance plan",
        "name_and_id": "Name of the payer and id of payer",
        "payer_id": "ID of the insurance payer",
        "payer_name": "Name of the insurance payer"
      },
      "insurance_type": "The type of insurance: `type_string`",
      "notes": "Notes about the policy",
      "num": "Policy number",
      "patient_id": "ID of the patient associated with the policy",
      "priority_type": "The priority type of insurance: `priority_type`",
      "updated_at": "Last time the Policy was updated"
    },
    "cpt_codes_cms1500s": {
      "cpt_code": "The CPT code",
      "description": "The CPT code description",
      "display_name": "The CPT display name used in labels",
      "mod1": "First modification code",
      "mod2": "Second modification code",
      "mod3": "Third modification code",
      "mod4": "Fourth modification code",
      "pointers": "Diagnostic pointers. These are used to connect Diagnosis(ICD) with appropriate Billing Item(CPT) in CMS1500 form",
      "service_date": "The service date for the specific code",
      "units": "Units for the CPT code"
    },
    "dietician_organization_id": "Organization ID for the User's (Patient's) registered dietitian",
    "dietitian_email_address": "Email address of the User's (Patient's) registered dietitian",
    "dietitian_first_name": "First name of the User's (Patient's) registered dietitian",
    "dietitian_id": "ID of the User's (Patient's) registered dietitian",
    "dietitian_last_name": "Last name of the User's (Patient's) registered dietitian",
    "dietitian_organization_id": "Organization ID for the User's (Patient's) registered dietitian",
    "icd_codes_cms1500s": {
      "active": "Active IcdCodesCms1500",
      "code": "The ICD code",
      "created_at": "Date created",
      "display_name": "Display name for the ICD code",
      "end_date": "End date",
      "first_symptom_date": "ICD codes in use for this claim",
      "id": "The unique identifier of the CMS 1500 ICD code",
      "updated_at": "Date updated"
    },
    "id": "CMS1500 object ID",
    "insured_sig_on_file": "True if the insured's signature is on file",
    "organization_info_id": "The ID of the Organization Info",
    "patient": {
      "date_of_birth": "Date of birth of user",
      "location": {
        "city": "City",
        "country": "Country",
        "line1": "First line of the address",
        "line2": "Second line of the address",
        "state": "State",
        "zip": "Zip code"
      },
      "sex": "Sex of the user (Stated on ID card for insurance purposes)"
    },
    "patient_id": "Patient's ID",
    "referral_info": {
      "case_qualifier": "The qualifier for case_date",
      "prior_auth_number": "The prior authorization number",
      "ref_provider_first": "The first name of the referring provider",
      "ref_provider_last": "The last name of the referring provider",
      "ref_provider_qual": "The qualifications of the referring provider"
    },
    "service_location_id": "The ID of the service location"
  }
}

Result Object Field Details

You can use the result of the action’s data as inputs to downstream workflow actions. Each fetch action requires a result object key to be specified which will nest the action’s result data inside the downstream data context in the Workflow. Here we demonstrate how to refer to this data using the prefix $result_object_key.
CMS1500
Fetch Action Response Object