NikoHealth integration

Claim Tagged Billing Claims

Perform Claim Tagged Billing Claims through NikoHealth.

View as Markdown

nikohealth_claim_tagged_billing_claims

writenikohealth

Inputs

trigger_tag_name
textrequired
Trigger Tag Name
Required text value.
processing_tag_name
text
Processing Tag Name
Optional text value.
acquire_processing_marker
boolean
Acquire Processing Marker
Optional true-or-false value.
Default: true
exclude_tag_names
expression
Exclude Tag Names
Optional literal value or workflow expression.
exclude_order_statuses
expression
Exclude Order Statuses
Optional literal value or workflow expression.
Default: ["Cancelled"]
include_order_statuses
expression
Include Order Statuses
Optional literal value or workflow expression.
exclude_claim_statuses
expression
Exclude Claim Statuses
Optional literal value or workflow expression.
include_claim_statuses
expression
Include Claim Statuses
Optional literal value or workflow expression.
lookback_hours
number
Lookback Hours
Optional numeric value.
Default: 720
created_from
expression
Created From
Optional literal value or workflow expression.
created_to
expression
Created To
Optional literal value or workflow expression.
server_filter_created_window
boolean
Server Filter Created Window
Optional true-or-false value.
Default: false
order_created_from
date
Order Created From
Optional date in YYYY-MM-DD format.
timezone
text
Timezone
Optional text value.
Default: "America/Chicago"
page_size
number
Page Size
Optional numeric value.
Default: 100
max_pages
number
Max Pages
Optional numeric value.
Default: 10
record_limit
number
Record Limit
Optional numeric value.
Default: 100
max_order_refetches
number
Max Order Refetches
Optional numeric value.
max_order_date_filter_reads
number
Max Order Date Filter Reads
Optional numeric value.
Default: 1000
preferred_prior_auth_portal
text
Preferred Prior Auth Portal
Optional text value.
max_prior_auth_qualification_candidates
number
Max Prior Auth Qualification Candidates
Optional numeric value.
Default: 1000
preferred_payer_name_markers
expression
Preferred Payer Name Markers
Optional literal value or workflow expression.
note_subject
expression
Note Subject
Optional literal value or workflow expression.
Default: "GenHealth Claim Processing Marker"
marker_prefix
expression
Marker Prefix
Optional literal value or workflow expression.
Default: "GENHEALTH_CLAIM_PROCESSING"
stale_after_minutes
number
Stale After Minutes
Optional numeric value.
Default: 360
dry_run
boolean
Dry Run
Optional true-or-false value.
Default: true

Outputs

successSuccess
errorError
itemsItems
countCount
claimed_countClaimed Count
claim_attemptedClaim Attempted
claim_failed_countClaim Failed Count
marker_skipped_countMarker Skipped Count
skipped_stale_countSkipped Stale Count
excluded_by_order_created_date_countExcluded By Order Created Date Count
missing_order_created_date_countMissing Order Created Date Count
verify_failed_countVerify Failed Count
diagnosticsDiagnostics
route_qualified_countRoute Qualified Count
route_excluded_countRoute Excluded Count
route_unresolved_countRoute Unresolved Count
route_unresolved_hinted_countRoute Unresolved Hinted Count
route_payer_name_marker_countRoute Payer Name Marker Count
route_error_countRoute Error Count

Output schema completeness: best_effort_declared

Safety

External effect: write
Confirmation recommended: No
Retry safe: No
Dry run supported: Yes

Schemas

These schemas are first-pass authoring guidance. Runtime validation remains authoritative.

Input schema

{
  "type": "object",
  "required": [
    "trigger_tag_name"
  ],
  "properties": {
    "dry_run": {
      "type": "boolean",
      "default": true,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "timezone": {
      "type": "string",
      "default": "America/Chicago",
      "description": "Optional text value.",
      "x-workflow-field-type": "text"
    },
    "max_pages": {
      "type": "number",
      "default": 10,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "page_size": {
      "type": "number",
      "default": 100,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "created_to": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "created_from": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "note_subject": {
      "default": "GenHealth Claim Processing Marker",
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "record_limit": {
      "type": "number",
      "default": 100,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "marker_prefix": {
      "default": "GENHEALTH_CLAIM_PROCESSING",
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "lookback_hours": {
      "type": "number",
      "default": 720,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "trigger_tag_name": {
      "type": "string",
      "description": "Required text value.",
      "x-workflow-field-type": "text"
    },
    "exclude_tag_names": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "order_created_from": {
      "type": "string",
      "format": "date",
      "description": "Optional date in YYYY-MM-DD format.",
      "x-workflow-field-type": "date"
    },
    "max_order_refetches": {
      "type": "number",
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "processing_tag_name": {
      "type": "string",
      "description": "Optional text value.",
      "x-workflow-field-type": "text"
    },
    "stale_after_minutes": {
      "type": "number",
      "default": 360,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "exclude_claim_statuses": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "exclude_order_statuses": {
      "default": [
        "Cancelled"
      ],
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "include_claim_statuses": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "include_order_statuses": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "acquire_processing_marker": {
      "type": "boolean",
      "default": true,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "max_order_date_filter_reads": {
      "type": "number",
      "default": 1000,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    },
    "preferred_prior_auth_portal": {
      "type": "string",
      "description": "Optional text value.",
      "x-workflow-field-type": "text"
    },
    "preferred_payer_name_markers": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "server_filter_created_window": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "max_prior_auth_qualification_candidates": {
      "type": "number",
      "default": 1000,
      "description": "Optional numeric value.",
      "x-workflow-field-type": "number"
    }
  },
  "additionalProperties": false
}

Output schema

{
  "type": "object",
  "properties": {
    "count": {},
    "error": {},
    "items": {},
    "success": {},
    "diagnostics": {},
    "claimed_count": {},
    "claim_attempted": {},
    "route_error_count": {},
    "claim_failed_count": {},
    "skipped_stale_count": {},
    "verify_failed_count": {},
    "marker_skipped_count": {},
    "route_excluded_count": {},
    "route_qualified_count": {},
    "route_unresolved_count": {},
    "route_payer_name_marker_count": {},
    "route_unresolved_hinted_count": {},
    "missing_order_created_date_count": {},
    "excluded_by_order_created_date_count": {}
  },
  "additionalProperties": true
}

View all NikoHealth actions