Query APIs – Detail that may assist

The following tables show views of the Query APIs that may assist software vendors in understanding the differences offered.

We would appreciate feedback on whether you feel this adds value, or on how we could improve this to add value.

 

Query Claim APIs

Query Invoices APIs

QueryPayments APIs

 

Query Claim APIs: What Exists Now

Extract from https://developer.acc.co.nz/products/query-claims-api

Distinctions

Content Delivered

POST claims/status
https://provider.api-compliance.acc.co.nz/api/v2/claims/status
Multiple clients, multiple claims Any claim Results generally include, for each claim retrieved:
  • ACC45 number or Eos number
  • claim number
  • cover status (1) for possible values
  • injury details*
  • partial NHI number*
  • accident date*
  • diagnoses*, including for each diagnosis:
    • code type and code, with the SNOMED code if available
    • diagnosis action, description, and side
    • the registration status (2) for possible values
    • any error codes
  • the result code (0 or 1) for each diagnosis.

* If the claim is sensitive, or the patient is working for an accredited employer, the 
starred details are not available.
(1) Cover Status:
A claim processed in Eos may have a status from the following lists:
  • Not applicable
  • Interim Accept
  • Accept
  • Pending Accept
  • Accredited Employer
  • Pending Accredited Emp
  • Decline
  • Pending Decline
  • Duplicate
  • Pending Held
  • Held
  • Investigating Gradual Process
GET claims/claimid/status
https://provider.api-compliance.acc.co.nz/api/v2/claims/status
One client, multiple claims
GET claims/status/filter
https://provider.api-compliance.acc.co.nz/api/v2/claims/status/filter
One client, one claim
GET claims/status/patient
https://provider.api-compliance.acc.co.nz/api/v2/claims/summary/patient
One client, multiple claims Only by org who submitted claim Results include:
  • claim ID, the unique identifier for this submitted claim
  • claim number, the ACC45 number
  • the date the claim request was submitted
  • the submission status, that is Failed or Receipted
  • patient’s first name and family name
  • the names of the facility and the treatment provider
(2) Registration Status:
  • Investigating
  • Provisional
  • Approved
  • Declined
GET claims/organisation
https://provider.api-compliance.acc.co.nz/api/v2/claims/summary/status
All provider submitted claims
GET claims/claimnumber
https://provider.api-compliance.acc.co.nz/api/v2/claims/summary/{claimNumber}
One client, one claim
GET claims/claimid
https://provider.api-compliance.acc.co.nz/api/v2/claims
One claim using 40 character claim ID Only by org who submitted claim Results include:
  • the provider’s contact details and address
  • the patient’s contact details, address, employment details, NHI number, date of birth, gender, and ethnicity
  • details of the injury and diagnoses
  • details of any fitness-for-work periods
  • any referrals.

If the claim is sensitive, or the patient is working for an accredited employer, the
following details are not available:
  • injury details, including the accident date
  • partial NHI number
  • diagnosis details, except for the result

 

Query Invoices APIs: What Exists Now

Extract from https://developer.acc.co.nz/products/query-invoices-api

Distinctions

Content Delivered

GET vendors/submissions
https://provider.api-compliance.acc.co.nz/api/v2/claims/vendors/submissions
Single or Multiple Invoices
Single vendor
Any Invoice This API allows for a vendor to check the submission status (receipted or failed) of the invoices for the specified vendor ID. For failed submissions it will show the error response message. The response will return the below set of information for each invoice submission:
  • Vendor ID
  • Invoice number
  • Time submitted
  • Invoice amount
  • Submission status
  • Error reason
GET vendors/invoices/batch
https://provider.api-compliance.acc.co.nz/api/v2/claims/vendors/invoices/batch
Multiple Invoices All Invoices for a specified Vendor
Only by Vendor who submitted claim
This API allows for a vendor to query the status of invoices for a specified vendor ID. The response will return the below set of information for each invoice:
  • Schedule ID
  • Vendor ID
  • Invoice number
  • Time submitted
  • Comments
  • Claimed amount
  • Processing status
  • Claim number
GET vendors/invoice/{scheduleId}
https://provider.api-compliance.acc.co.nz/api/v2/claims/vendors/invoice/{scheduleId}
Single invoice Only by Vendor who submitted claim This API allows for a vendor to check the status of an invoice that was received by ACC. The scheduleId is an identifier which can be obtained by using the GET vendors/invoices/batch query. The response will return the below set of information for each schedule line item:
  • Schedule ID
  • Schedule Line ID
  • Provider ID
  • Claim number
  • Claimed amount
  • Amount awarded
  • Payment status
  • Status reason
  • Payment reference
  • Payment date

 

QueryPayments APIs: What Exists Now

Extract from https://developer.acc.co.nz/products/query-payments-api

Distinctions

Content Delivered

GET vendors/payments
https://provider.api-compliance.acc.co.nz/api/v2/claims/vendors/payments
Multiple payment remittance numbers Only by Vendor who submitted invoices This API allows for a vendor to check the payment remittance numbers for the specified vendor ID.

The API will return details including:
  • Vendor ID
  • Payment reference
  • Payment date
  • Total payment amount
GET payments/summary/{paymentReference}
https://provider.api-compliance.acc.co.nz/api/v2/claims/vendors/payments/summary/{paymentReference}
Summary of payment remittance
Summary details for multiple invoices
Only by Vendor who submitted invoices This API allows for a vendor to check the payment summary for a payment remittance under a specified vendor ID. A payment remittance may contain multiple invoices.

The API will return a summary of information for each invoice:
  • Vendor ID
  • Payment reference
  • Invoice number
  • Invoice date
  • Invoice amount
  • Payment amount
  • GST payment amount
  • Comments
  • Payment date
  • Bank account number
GET payments/details/{paymentReference}
https://provider.api-compliance.acc.co.nz/api/v2/claims/vendors/payments/details/{paymentReference}
Summary of a single payment remittance
Invoice line details for multiple invoices
Only by Vendor who submitted invoices This API allows for a vendor to check the payment details for a payment remittance under a specified vendor ID. A payment remittance may contain multiple invoices.

The API will return information for each invoice line item including:
  • Vendor ID
  • Payment reference
  • Invoice number
  • Invoice date
  • ACC45 number
  • Claim number
  • Client name
  • Service date
  • Service code
  • Provider ID
  • Facility
  • Amount invoiced
  • Amount paid
  • Reason for declined payments
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