Skip to main content
POST
/
v0
/
insurance-claims
Create insurance claim
curl --request POST \
  --url https://api.getlemma.com/v0/insurance-claims \
  --header 'Authorization: Bearer <token>' \
  --header 'Content-Type: application/json' \
  --data '
{
  "provider_id": "<string>",
  "payer_name": "<string>",
  "claim_number": "<string>",
  "payer_claim_number": "<string>",
  "subscriber_id": "<string>",
  "patient_name": "<string>",
  "charged_amount": 123,
  "service_date": "<string>",
  "service_end_date": "<string>"
}
'
{
  "id": "claim_Rv8nXm3hTw5pBk7c",
  "provider_id": "entity_k7mXp2vR9nTfBw4s",
  "payer_name": "Aetna Health Insurance",
  "claim_number": "CLM-2026-03-1542",
  "payer_claim_number": "ACN7829304561",
  "subscriber_id": "W123456789",
  "patient_name": "Jane Smith",
  "charged_amount": 325000,
  "service_date": "2026-02-15T00:00:00Z",
  "service_end_date": null,
  "reconciled": false,
  "transaction_ids": [],
  "created_at": "2026-03-15T14:30:00Z"
}

Documentation Index

Fetch the complete documentation index at: https://docs.getlemma.com/llms.txt

Use this file to discover all available pages before exploring further.

Submits an insurance claim so Lemma can track it and automatically reconcile it against incoming payments. When a matching deposit arrives, the claim is marked as reconciled and linked to the corresponding transactions. Lemma matches claims against incoming 835 remittance data using the payer_claim_number, claim_number, subscriber_id, and charged_amount fields. Provide as many fields as possible to improve match accuracy.

​
Request body

​
provider_id
string
required
The ID of the provider this claim is for.
​
payer_name
string
required
The name of the insurance payer (e.g., “Aetna Health Insurance”). Maps to the payer identified in the 835 N1 loop.
​
claim_number
string
required
Your internal claim or patient account number. This is the provider-assigned identifier used to match against CLP01 (patient control number) in the 835.
​
payer_claim_number
string
The payer-assigned claim control number, if known. Maps to CLP07 in the 835. Including this significantly improves reconciliation accuracy.
​
subscriber_id
string
The patient’s insurance member or subscriber ID. Used for matching against subscriber identification in the 835 NM1 loop.
​
patient_name
string
required
The name of the patient.
​
charged_amount
integer
required
The total billed amount for the claim in cents. Maps to CLP03 (total claim charge amount) in the 835.
​
service_date
string
required
The date the service was rendered, or the start of the service period. ISO 8601 format.
​
service_end_date
string
The end of the service period, if the claim spans multiple dates. ISO 8601 format. Omit for single-date services.

​
Response

Returns the created claim object.
​
id
string
Unique identifier for the insurance claim.
​
provider_id
string
The ID of the provider this claim belongs to.
​
payer_name
string
The name of the insurance payer.
​
claim_number
string
Your internal claim or patient account number.
​
payer_claim_number
string | null
The payer-assigned claim control number.
​
subscriber_id
string | null
The patient’s insurance member or subscriber ID.
​
patient_name
string
The name of the patient.
​
charged_amount
integer
The total billed amount for the claim in cents.
​
service_date
string
The date or start of the service period.
​
service_end_date
string | null
The end of the service period, if applicable.
​
reconciled
boolean
Whether this claim has been matched to an incoming payment. Newly created claims are always false.
​
transaction_ids
string[]
The IDs of transactions this claim has been reconciled against. A claim can have multiple payments — for example, when primary and secondary payers each remit separately. Empty array until reconciled.
​
created_at
string
ISO 8601 timestamp of when the claim was created.
{
  "id": "claim_Rv8nXm3hTw5pBk7c",
  "provider_id": "entity_k7mXp2vR9nTfBw4s",
  "payer_name": "Aetna Health Insurance",
  "claim_number": "CLM-2026-03-1542",
  "payer_claim_number": "ACN7829304561",
  "subscriber_id": "W123456789",
  "patient_name": "Jane Smith",
  "charged_amount": 325000,
  "service_date": "2026-02-15T00:00:00Z",
  "service_end_date": null,
  "reconciled": false,
  "transaction_ids": [],
  "created_at": "2026-03-15T14:30:00Z"
}