Claims

Create, view, update, and delete insurance claims. Per OpenDental API.

What are Claims in OpenDental?

Claims are insurance submissions that bundle procedures for a patient. Create a claim with procNums (completed procedures) and a ClaimType (P = primary, S = secondary, PreAuth). ClaimProcs attach each procedure to the claim. ClaimStatus flows: U (Unsent) → W (Waiting) → S (Sent) → R (Received). After receipt, use ClaimPayments to record insurance checks. Requires PatPlans and completed procedures.

PatNum

ClaimStatus

ClaimType

ClaimNum	PatNum	DateService	ClaimStatus	ClaimType	PlanNum	ClaimFee	Actions

Claims

Claims

Create Claim

Required

Required for PreAuth / Other

Optional

Result:

Search & Update Claim

Select a claim to update or delete:

Update Claim

Result:

Claims

Create Claim

Required

Required for PreAuth / Other

Optional

Result:

Search & Update Claim

Select a claim to update or delete:

Update Claim

Result:

Claims - GET Response

Example Response:

Key Fields:

Create Claim - JSON Structure

Example (Primary):

Example (PreAuth/Other):

Update & Delete Claim

PUT Fields: