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PEAR

Fetch claims

Search member claims by service date.

POSThttps://preview.ontross.com/api/integrations/pear/fetch-claims
Request Fields
input.member_id
string
required
Member number from the patient's Pear plan card.
Example
"9310245733"
input.date_of_service
string
required
Claim service date, entered as both range start and end.
Example
"02/09/2026"
input.provider_npi
string
Group NPI picking the billing group from the provider dropdown.
Example
"4526825277"
auth_id
string
required
Saved connection to run this operation through, from the Authentication page. It decides which practice and login the call uses.
Example
"00000000-0000-4000-8000-000000000000"
Output Fields
claims
array
One entry per claim Pear returned.
claims[].memberId
string
Member id printed on the patient's card.
Example
"9990000123"
claims[].claimNumber
string
Payer's control number for this claim.
Example
"2026040999001"
claims[].providerId
string
Pear's id for the billing provider.
Example
"999000123"
claims[].patientAcctNo
string
Your own account number for the patient.
Example
"TEST000123"
claims[].payeeName
string
Who the payment was actually made out to.
Example
"Example Family Medicine LLC"
claims[].billType
string
UB-04 bill type code for the claim.
Example
"0131"
claims[].paymentDate
string
Date the payer issued the payment.
Example
"03/02/2026"
claims[].paymentId
string
Identifier for the payment covering this claim.
Example
"9000000123"
claims[].externalPaymentDate
string
Payment date from the system that issued it.
Example
"03/02/2026"
claims[].paymentClearedDate
string
Date the payment cleared the bank.
Example
"03/04/2026"
claims[].contractualAmt
string
Amount written off under the provider contract.
Example
"45.00"
claims[].allowedAmt
string
Amount the plan allowed after contract discounts.
Example
"105.00"
claims[].patientLiabilityAmt
string
Total the member owes after benefits.
Example
"25.00"
claims[].memberCoPay
string
Flat copay the member owes.
Example
"25.00"
claims[].memberCoInsurance
string
Member's percentage share of the allowed amount.
Example
"21.00"
claims[].memberDeductible
string
Allowed amount applied to the member's deductible.
Example
"50.00"
claims[].otherInsuranceAmt
string
Amount another carrier paid on this claim.
Example
"30.00"
claims[].penaltyPayment
string
Penalty amount included in the payment.
Example
"5.00"
claims[].rejectionsummary
string
Claim level rejection text, unrelated to the rejectionSummary list.
Example
"Duplicate claim or service."
claims[].claimeditor
string
Claim editor rule that touched the claim.
Example
"Duplicate claim review"
claims[].classDesc
string
Plain wording for the claim's class.
Example
"Medical"
claims[].claimType
string
Claim form family, for example professional or institutional.
Example
"Professional"
claims[].groupNumber
string
Policy number the member is covered under.
Example
"99900001"
claims[].claimReceivedDate
string
Date the payer received the claim.
Example
"02/12/2026"
claims[].subStatus
string
Finer status under the claim's main status.
Example
"Payment issued"
claims[].interestType
string
Why interest was added, for example prompt pay.
Example
"Prompt pay"
claims[].interestPayment
string
Interest the payer added for late payment.
Example
"1.25"
claims[].interestAgedDays
string
Calendar days used to compute interest owed.
Example
"15"
claims[].interestBusDays
string
Business days used to compute interest owed.
Example
"11"
claims[].platformSource
string
Which payer platform adjudicated the claim.
Example
"FACETS"
claims[].blueCardInd
string
Flag marking the claim as BlueCard inter-plan business.
Example
"N"
claims[].claimlines
array
One entry per service line on the claim.
claims[].claimlines[].serviceLineNo
string
Position of this line on the claim.
Example
"1"
claims[].claimlines[].serviceCode
string
CPT or HCPCS code billed on this line.
Example
"99213"
claims[].claimlines[].serviceUnits
string
Units of the procedure billed on this line.
Example
"1"
claims[].claimlines[].revenueCode
string
UB-04 revenue code for this service line.
Example
"0510"
claims[].claimlines[].lineStatus
string
Where this service line stands with the payer.
Example
"Paid"
claims[].claimlines[].patientLiabilityAmt
string
Total the member owes after benefits.
Example
"25.00"
claims[].claimlines[].rejectionCode
string
Code explaining why the line was rejected.
Example
"CO-97"
claims[].claimlines[].billedAmt
string
Charge the provider submitted on this line.
Example
"150.00"
claims[].claimlines[].paidAmount
string
Amount the plan paid on this line.
Example
"80.00"
claims[].claimlines[].serviceDateFrom
string
First date of service on the line.
Example
"02/09/2026"
claims[].claimlines[].serviceDateThru
string
Last date of service on the line.
Example
"02/09/2026"
claims[].claimlines[].allowedAmt
string
Amount the plan allowed after contract discounts.
Example
"105.00"
claims[].claimlines[].rejectionText
string
Plain wording for the line's rejection code.
Example
"Payment is included in the allowance for another service."
claims[].claimlines[].servicingProvider
string
Who actually performed the service on this line.
Example
"Example Family Medicine"
claims[].claimlines[].servicingProviderNPI
string
Performing provider's national provider identifier.
Example
"1999999999"
claims[].claimlines[].isMedicare
string
Flag marking the line as Medicare business.
Example
"N"
claims[].claimlines[].rejectionSummary
array
Rejection messages for this line, one entry each.
claims[].claimlines[].rejectionSummary[].code
string
Rejection or remark code on the line.
Example
"CO-45"
claims[].claimlines[].rejectionSummary[].desc
string
Plain wording for that rejection code.
Example
"Charge exceeds fee schedule or maximum allowable amount."
claims[].claimlines[].rejectionSummary[].amt
string
Dollar amount tied to this rejection message.
Example
"45.00"
claims[].claimlines[].rejectionSummary[].messageType
string
What kind of rejection message this is.
Example
"Rejection"
claims[].claimlines[].rejectionSummary[].label
string
Display label Pear shows for the rejection.
Example
"Contractual adjustment"
claims[].claimlines[].diagnosisCodes
array
ICD codes supporting this service line.
claims[].srcPrvId
string
Source system's provider id for the claim.
Example
"999000456"
Code
curl --request POST \
  --url https://preview.ontross.com/api/integrations/pear/fetch-claims \
  --header 'X-API-Key: REPLACE_KEY_VALUE' \
  --header 'content-type: application/json' \
  --data '{"input":{"member_id":"9310245733","date_of_service":"02/09/2026","provider_npi":"4526825277"},"auth_id":"auth_uuid_here"}'
Request BODY
{
  "input": {
    "member_id": "9310245733",
    "date_of_service": "02/09/2026",
    "provider_npi": "4526825277"
  },
  "auth_id": "auth_uuid_here"
}
Response BODY
{
  "id": "string",
  "workflow_id": "string",
  "auth_id": "string",
  "status": "string",
  "input": {},
  "output": {
    "claims": []
  },
  "files": null,
  "created_at": "2019-08-24T14:15:22Z",
  "started_at": "2019-08-24T14:15:22Z",
  "completed_at": "2019-08-24T14:15:22Z"
}