Claim lifecycle

Claims

SKSuraj Kumar
Powered byPOST /nhcx/claim/request /v1/claim/on_submitGET /nhcx/transactions

Final claim

Select a patient
draft
Links the claim to its approval
billablePeriod.start
billablePeriod.end
ItemClaimedApprovedAdjudication
CABG procedure₹50,000pending
Medicines₹8,000pending
Investigations₹7,000pending
Consumables₹5,000pending
Total₹70,000
Set the billable period before submitting

Exchange status

not started
01Bundle built
02JWE encrypted
03NHCX queued
04Callback received

Adjudication summary

Claimed₹70,000
Approved
Deduction
Answers request
Settles
Why the claim can fail
A claim with no billablePeriod or a relatedPreAuthIdentifier the payer does not recognise is rejected at adjudication, not at dispatch — so it fails on the callback, several minutes after it looked accepted.