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Review a claim (predictions, no funding)
curl --request POST \
  --url https://api.sandbox.thrivory.com/v1/claims/reviews \
  --header 'Authorization: Bearer <token>' \
  --header 'Content-Type: application/json' \
  --data '{
  "facility": "ABC",
  "claim_identifier": "CLM-10001",
  "chart_identifier": "PAT-5678",
  "date_of_service": "2025-08-15",
  "date_of_submission": "2025-08-16",
  "servicer_npi": "1111111111",
  "billing_npi": "5556667778",
  "patient_primary_payor_id": "thrivoryid:123456",
  "service_lines": [
    {
      "cpt": "J1745",
      "modifier": "JW",
      "units": 1,
      "amount": 5000
    }
  ],
  "submitted_amount": 5000
}'
{
  "authorization_id": "<string>",
  "denial_predicted": true,
  "denial_reasons": [
    {
      "code": "<string>",
      "description": "<string>"
    }
  ],
  "expected_reimbursement": {
    "allowed": 123,
    "expected": 123
  },
  "expected_payment_date": "2023-12-25",
  "confidence": 0.5,
  "id": "<string>"
}

Authorizations

​
Authorization
string
header
required

The access token received from the authorization server in the OAuth 2.0 flow.

Headers

​
Idempotency-Key
string

Provide a unique key per request to enable safe retries

Body

application/json

Submit encounter/claim context for prediction. Fields align with Thrivory Data Feed Requirements.

​
claim_identifier
string
required

Unique claim ID

​
chart_identifier
string
required

Patient chart ID

​
date_of_service
string<date>
required
​
servicer_npi
string
required
​
billing_npi
string
required
​
patient_primary_payor_id
string
required

Thrivory payer ID

​
submitted_amount
number
required
​
facility
string

Location/facility identifier

​
date_of_entry
string<date>
​
date_of_submission
string<date>
​
patient_primary_payor_text
string
​
patient_primary_payor_plan_text
string
​
icd10_codes
string[]
​
cpt_billing_codes
string
deprecated

Prefer service_lines[].cpt

​
cpt_billing_modifier
string
deprecated

Prefer service_lines[].modifier

​
cpt_billing_text
string
​
balance_payor
number
​
balance_patient
number
​
payments_payor
number
​
payments_patient
number
​
payments_total
number
​
settlement_date
string<date>
​
payment_account_location
string

Last four digits or token reference

​
denial_code
string
​
denial_code_text
string
​
service_lines
object[]

Response

Review results

​
authorization_id
string
required

Short‑lived authorization handle used to create an adjudication

​
denial_predicted
boolean
required
​
expected_reimbursement
object
required
​
denial_reasons
object[]
​
expected_payment_date
string<date>
​
confidence
number

Model confidence

Required range: 0 <= x <= 1
​
id
string

Review ID