# Medical claim services API
Provides services for the claims lifecycle management.
* **Type**: SOAP
* **Production WSDL**: https://services.generali.gr/soap/v2/medicalClaimWs?wsdl
* **Test WSDL**: https://services-test.generali.gr/soap/v2/medicalClaimWs?wsdl
Methods
* [listPersons](#listPersons)
* [listPolicies](#listPolicies)
* [listPoliciesByDate](#listPoliciesByDate)
* [listPoliciesByCustomer](#listPoliciesByCustomer)
* [listNoBenefitPolicies](#listNoBenefitPolicies)
* [listNoBenefitPoliciesByCustomer](#listNoBenefitPoliciesByCustomer)
* [listBenefits](#listBenefits)
* [createClaim](#createClaim)
* [updateClaim](#updateClaim)
* [listClaims](#listClaims)
* [addDocumentToClaim](#addDocumentToClaim)
* [addMessageToClaim](#addMessageToClaim)
* [listClaimMessages](#listClaimMessages)
* [listPendencies](#listPendencies)
* [addDocumentToPendency](#addDocumentToPendency)
* [addMessageToPendency](#addMessageToPendency)
* [listPendencyMessages](#listPendencyMessages)
* [listDocuments](#listDocuments)
* [listNoContentDocuments](#listNoContentDocuments)
* [listBills](#listBills)
* [addBillToClaim](#addBillToClaim)
* [setBillEOPYY](#setBillEOPYY)
* [approveBill](#approveBill)
* [rejectBill](#rejectBill)
* [listInvoices](#listInvoices)
* [addInvoiceToClaimFromBillId](#addInvoiceToClaimFromBillId)
* [addInvoiceToClaimFromProviderBillId](#addInvoiceToClaimFromProviderBillId)
* [submit](#submit)
* [unsubmitBill](#unsubmitBill)
* [listCollaborators](#listCollaborators)
* [findAppointmentRequest](#findAppointmentRequest)
* [listAppointmentRequests](#listAppointmentRequests)
* [addAppointmentResponse](#addAppointmentResponse)
* [deleteAppointmentResponse](#deleteAppointmentResponse)
* [findAppointmentResponses](#findAppointmentResponses )
* [listAppointmentResponses](#listAppointmentResponses)
* [updateAppointmentResponseStatus](#updateAppointmentResponseStatus)
* [addAppointmentResponseNote](#addAppointmentResponseNote)
* [createAppointment](#createAppointment)
* [updateAppointmentStatus](#updateAppointmentStatus)
* [listAppointments](#listAppointments)
* [addAppointmentNote](#addAppointmentNote)
* [createAppointmentByPhone](#createAppointmentByPhone)
## Flowchart
![Medical Services Process](images/MedicalClaimsServicesProcess.png)
## Bidirectional communication
Sometimes Generali would want to synchronously inform its collaborators about an action that had just happened. For that reason we have the 'Bidirectional communication' procedure. The collaborator will decide how the information will be sent. Either by email or a Web Service.
By following that procedure Generali will send the necessary intel about that action:
**Bidirectional communication intel**
| Field | Type | Description | Example |
| ----- | ---- | ------------------ | ------- |
| action | String | it's describing the action | a new pendency is created by the claim handler |
| entity| EntityId | where this action is referring to| ['FHY', '000309746'] |
| properties | List[Property]| ... | ... |
## General entities
**Mime Type**
* application/json
* application/zip
* application/x-gzip
* application/tgz
* application/msword
* application/postscript
* application/pdf
* application/jnlp
* application/oda
* application/java-archive
* application/smil
* application/srgs
* application/vnd.mif
* pplication/xml
* image/bmp
* image/cgm
* image/gif
* image/ief
* image/jpeg
* image/tiff
* image/png
* audio/basic
* audio/midi
* audio/mpeg
* model/iges
* model/mesh
* model/vrml
* text/plain
* text/richtext
* text/rtf
* text/html
* text/calendar
* text/css
* text/sgml
* video/quicktime
* video/mpeg
* video/vnd.mpegurl
**File Type**
* Εισιτήριο Νοσοκομείου: 127
* Εξιτήριο Νοσοκομείου: 136
* Γνωμάτευση θεράποντος ιατρού: 124 (in general 124 code refers to 'Γνωμάτευση')
* Προτιμολόγιο (με την αναγραφή του ΚΕΝ που τιμολογείται προς τον Ε.Ο.Π.Υ.Υ.): 197
* Αναλυτική καρτέλα χρεώσεων Υγειονομικού Υλικού: 206 (in general 206 code refers to 'Χρεώσεις')
* Αναλυτική καρτέλα χρεώσεων Φαρμάκων Χρεώσεις: 206 (in general 206 code refers to 'Χρεώσεις')
* Αναλυτική καρτέλα χρεώσεων Ειδικών Υλικών Χρεώσεις: 206 (in general 206 code refers to 'Χρεώσεις')
* Τιμολόγιο Νοσοκομείου: 157
* Πρακτικό χειρουργείου: 151
* Ιατρικές εξετάσεις νοσηλείας: HIST_EXA (in general HIST_EXA code refers to 'Ιστολογική Εξέταση (Ιατρικό Ιστορικό)')
* Ιστολογική: HIST_EXA (in general HIST_EXA code refers to 'Ιστολογική Εξέταση (Ιατρικό Ιστορικό)')
* Ιστορικό φύλλο νοσηλείας: 207 (in general 207 code refers to 'Φύλλο ασθενούς')
* Διάγραμμα αναισθησίας: 229
* Αποτελέσματα προεγχειρητικού: 119 (in general 119 code refers to 'Αποτελέσματα εξετάσεων')
* Καρτέλα ημερήσιας παρακολούθησης: 208 (in general 207 code refers to 'Κατάσταση νοσηλείας')
**Damage Type**
| code | Description | Category |
| ------------- | ------------- | ------------ |
| 10390 | Δωμάτιο/Τροφή | ΝΟΣΗΛΕΙΑ |
| 10391 | Διάφορα Έξοδα νοσοκομείου | ΦΥΣΙΚΟΘ. , ΛΟΙΠΑ |
| 10392 | Έξοδα χειρουργείου | ΕΞΟΔΑ ΧΕΙΡ., γ-KNIFE, ΕΞΟΔΑ ΑΝΑΙΣΘΗΣΙΑΣ |
| 10543 | Διαγνωστικές κατά τη νοσηλεία | ΕΡΓΑΣΤΗΡ., ΑΚΤΙΝΟΛ., ΑΞΟΝ ΤΟΜΟΓ., ΗΧΟΚΑΡΔ/ΤΑ, ΗΚΓ , ΡΑΔΙΟΙΣΟΤΟΠΑ, ΥΠΕΡΗΧΟΤΟΜΟΓΡ., ΓΑΣΤΡΕΝΤ/ΚΟ, ΑΓΓΕΙΟ/ΚΟ, ΠΑΘΟΛΟΓΟΑΝ/ΚΟ, ΜΑΓΝΗΤΙΚΟΣ, ΨΗΦΙΑΚΟΣ ΑΓΓ., Γ.ΚΑΜΕΡΑ , ΑΙΜΟΔΥΝΑΜΙΚΟ |
| 10544 | Ειδικά υλικά κατά τη νοσηλεία | ΕΙΔΙΚΑ ΥΛ. |
| 10545 | Υλικά γενικώς κατά τη νοσηλεία | ΥΛΙΚΑ |
| 10547 | Φάρμακα κατά τη νοσηλεία | ΦΑΡΜΑΚΑ |
| 10605 | Αμοιβή παρακολούθησης | (Αμοιβές Ιατρών, Xειρουργών, Aναισθησιολόγων) |
**Document**
A generic document.
| Field | Type | Constraints | Description | Example |
| ----- | ---- | ------------------ | ----------- | ------- |
| filename | String | Required | Filename, including the extension. | 'my-document.pdf' |
| fileType| String | Optional | The type of the file| 127 |
| mimeType | String | Optional | Mime Type of the file. | 'application/pdf' |
| content | Byte Array | Required | The content of the file | - |
**DetailedDocument**
A generic document.
| Field | Type | Constraints | Description | Example |
| ----- | ---- | ------------------ | ----------- | ------- |
| filename | String | Required | Filename, including the extension. | 'my-document.pdf' |
| fileType| Property | Optional | The Property object of the file's type| ['197', 'Προτιμολόγιο'] |
| mimeType | String | Optional | Mime Type of the file. | 'application/pdf' |
| content | Byte Array | Required | The content of the file | - |
**Participant**
Some info of an entity that took part in the claim
| Field | Type | Constraints | Description | Example |
| ------------- | ------------- | --------------- | ------------ | -------- |
| firstName | String | Optional | the firstname | - |
| lastName | String | Optional | the lastName | - |
| email | String | Optional | the email | - |
| role | String | Optional | the specific role of the Participant in the claim | Hospital, Claim's Adjuster, Medical provider |
**Message**
| Field | Type | Constraints | Description | Example |
| ------------- | ------------- | --------------- | ------------ | -------- |
| subject | String | Optional | a subject of the message. | - |
| content| String | Optional | the message content| - |
| sentDate | Date | Required | The date the message was sent | 2020-05-15T12:57:55 |
| sender | Participant | Required | The sender of the message | - |
| receiver | Participant | Required | The receiver of the message | - |
**Param**
A search parameter.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String | The parameter to search | personId |
| value | Value | The relative value to the id | 094327684 |
** Property **
A generic type used to describe items represented by an id and described by a text.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String | The id of the value, which is related to the type (like Gender, | '1' |
| description | String | The relative value to the id | 'Male' |
** Value **
A wrapper for a multi-type value. Use only one of the fields at a time.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| text | String | Text value | 'Lorem ipsum ...' |
| number | Double | Numeric value| 240.00 |
| date | Date | Date value | 2015-09-30 |
## Persons
### listPersons
Returns a list of Person objects (referring to insured persons or customers) according to the search criteria.
We will limit the number of results to 20.
Search parameters:
* firstName (text)
* lastName (text)
* afm (text)
* amka (text)
* birthdate (date)
* yearOfBirth (numeric)
* policyId (text - must be accompanied by at least one more parameter)
####Input (List[Param])
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String | The id of the parameter to search | afm |
| value | Value | The relative value to the id | 094327684 (Afm value) |
####Output (Person)
The Person is identified by the id and in the case of life policies the amka is an important attribute of the object.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String | Normally is the afm of the person. For the children we use the string 'ID' followed by an internal id | ID10629622|
| firstName | String | The name of the insured | Antonis |
| lastName | String | The last name of the insured | Apergis |
| gender | Property | This a code value entry | [1, Άντρας] |
| afm | String | The afm of the insured if he is adult | 094327684 |
| amka | Numeric | The amka of the insured | 20117703334 |
| birthDate | Date | The insured date of birth | 1977-11-20 |
### Example
####Input
```
070244595
```
####Output
```
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
1978-04-30T00:00:00+03:00
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
1978-04-30T00:00:00+03:00
```
## Policy services
####Policy
Policy level information per insured person. It contains information about the product, the insurance period and the related covers.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String (8) | Policy id | 50114975 |
| policyHolder | String | Polic Holder | ΑΝΤΩΝΙΟΣ ΑΠΕΡΓΗΣ |
| lobCode | String (3) | The line of business code | 279 |
| lobDescription | String | Normally the name of the product | Medical Safety |
| startDate | Date | Insurance start date | 2015-09-30 |
| endDate | Date | Insurance end date | 2155-09-30 |
| status | Property | Status of the policy | 100 = Active, 200 = Cancelled |
| specialTerms | List [Property]| In some cases the policy has special terms that overrides the default terms of the product| - |
| insuredPersons | List [InsuredPerson] | Insured person| (*see InsuredPerson entity*) |
####InsuredPerson
The InsuredPerson is identified by the id and in the case of life policies the amka is an important attribute of the object.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String | Normally is the afm of the person. For the children we use the string 'ID' followed by an internal id | ID10629622|
| firstName | String | The name of the insured | Antonis |
| lastName | String | The last name of the insured | Apergis |
| gender | Property | This a code value entry | [1, Άντρας] |
| afm | String | The afm of the insured if he is adult | 094327684 |
| amka | Numeric | The amka of the insured | 20117703334 |
| birthDate | Date | The insured date of birth | 1977-11-20 |
| insuranceType | Property | Describes if the customer is policy holder, main or spouse insured| 105 = main insured, 106 = spouse, 107 = dependant |
| covers | List [Cover] | The list of the available covers for this person | (*see Cover entity*) |
####Cover
Cover for a policy. Effective dates, which may be different from the main policy, sum insured, deductible and various parameters.
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String (9) | The id of the cover | 895515000 |
| description | String | The name of the cover | Outhospital cover |
| startDate | Date | Cover's start date | 2018-09-30 |
| endDate | Date | Cover's end date | 2019-09-30 |
| specialTerms | List [Property]| Cover's special terms| - |
| hospitalizationBenefits | List [Usage] | This is a wrapper object for the limits of the cover if hospitalized | (*see Usage entity*) |
| outpatientBenefits | List [Usage] | This is a wrapper object for the limits of the cover if not hospitalized | (*see Usage entity*) |
####Usage
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| type | Property | The type of the usage | [01, Υπολειπόμενο ποσό κάλυψης για έκτακτο περιστατικό], [02, Υπολειπόμενο ποσό κάλυψης από ασθένεια], [03, Υπολειπόμενο ποσό κάλυψης από ατύχημα], [04, Απαλλαγή από ασθένεια], [05, Απαλλαγή από ατύχημα], [06, Συμμετοχή εταιρίας/ποσοστό από ασθένεια], [07, Συμμετοχή εταιρίας/ποσοστό από ατύχημα], [08, Δωμάτιο/Τροφή από ασθένεια], [09, Δωμάτιο/Τροφή από ατύχημα], [10, Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια], [11, Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ατύχημα], [12, Αμοιβή Χειρουργού], [13, Αμοιβή Αναισθησιολόγου], [14, Υπολειπόμενο ποσό κάλυψης ΜΕΘ], [15, "Χρήση Ταμείου" για ατομικά / "Υποχρεωτική χρήση ΚΑΦ" για ομαδικά], [16, "Συμψηφισμός Ταμείου"]. Όλα θα εμφανίζονται στη λίστα hospitalizationBenefits εκτός από το 01, που θα εμφανίζεται στη λίστα outpatientBenefits |
| limit | Value | The limit of the type | 100000 |
### listPolicies
####Input
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| personId | String | Required |The id of the person | 12346329 |
####Output (List of Policy objects)
It returns a list of the person's policies. The policy object contains info regarding the covers and the remaining benefits.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| policies | List [Policy]| Required| Lists the person's policies | (*see Policy entity and example below*) |
### Example
####Input
```
########
12346329
```
####Output
```
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
279
Med.Safety ετ.αν.
2019-09-22T00:00:00+03:00
2020-03-22T00:00:00+02:00
Active
142019017
ΑΙΚΑΤΕΡΙΝΗ
ΒΟΥΤΣΙΩΤΗ
Γυναίκα
21118501143
1985-11-21T00:00:00+02:00
Σύζυγος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2019-09-22T00:00:00+03:00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Δωμάτιο/Τροφή
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή
0.00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Δωμάτιο/Τροφή
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή
0.00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Υπολειπόμενο ποσό κάλυψης για έκτακτο περιστατικό
419600.00
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2019-09-22T00:00:00+03:00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Δωμάτιο/Τροφή
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή
0.00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Δωμάτιο/Τροφή
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή
0.00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Απαλλαγή
0.00
Συμμετοχή εταιρίας/ποσοστό
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
419600.00
Υπολειπόμενο ποσό κάλυψης για έκτακτο περιστατικό
419600.00
```
### listPoliciesByDate
####Input
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| personId | String | Required |The id of the person | 12346329 |
| date | Date | Required |The spesific date on which we want to check the policies| 2019-10-20 |
####Output (List of Policy objects)
It returns a list of the person's policies. The policy object contains info regarding the covers and the remaining benefits.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| policies | List [Policy]| Required| Lists the person's policies | (*see Policy entity*) |
### listPoliciesByCustomer
Search parameters:
* firstName (text)
* lastName (text)
* afm (text)
* amka (text)
* birthdate (date)
* yearOfBirth (numeric)
* policyId (text - must be accompanied by at least one more parameter)
####Input (List[Param])
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| params | List[Param] | Required | the parameter to search | Param[id:'afm', value:'094327684'] |
####Output (List of Policy objects)
It returns a list of the person's policies. The policy object contains info regarding the covers and the remaining benefits.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| policies | List [Policy]| Required| Lists the person's policies | (*see Policy entity and example below*) |
### Example
####Input
```
########
070244595
```
####Output
```
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
279
Med.Safety ετ.αν.
2020-03-22T00:00:00+02:00
2020-09-22T00:00:00+03:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2020-03-22T00:00:00+02:00
Δωμάτιο/Τροφή από ασθένεια
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Δωμάτιο/Τροφή από ασθένεια
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Απαλλαγή από ασθένεια
1500.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
420000.00
Απαλλαγή από ασθένεια
1500.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
420000.00
Υπολειπόμενο ποσό κάλυψης για έκτακτο περιστατικό
420000.00
142019017
ΑΙΚΑΤΕΡΙΝΗ
ΒΟΥΤΣΙΩΤΗ
Γυναίκα
21118501143
1985-11-21T00:00:00+02:00
Σύζυγος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2019-09-22T00:00:00+03:00
Δωμάτιο/Τροφή από ασθένεια
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Δωμάτιο/Τροφή από ασθένεια
Θέση Γ
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Απαλλαγή από ασθένεια
1500.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
420000.00
Απαλλαγή από ασθένεια
1500.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
100.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
420000.00
Υπολειπόμενο ποσό κάλυψης για έκτακτο περιστατικό
420000.00
GENERALI HELLAS Α.A.E.
410
GL Ομαδικών Ζωής
2020-01-01T00:00:00+02:00
2020-01-01T00:00:00+02:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Επιστροφή Εξόδων Νοσοκομειακής Περίθαλψης από ατύχημα / ασθένεια
2019-01-01T00:00:00+02:00
Δωμάτιο/Τροφή από ασθένεια
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Δωμάτιο/Τροφή από ασθένεια
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Απαλλαγή από ασθένεια
0.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
0.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
0.00
Απαλλαγή από ασθένεια
0.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
0.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
0.00
ΑΙΚΑΤΕΡΙΝΗ
ΒΟΥΤΣΙΩΤΗ ΑΙΚΑΤΕΡ
Γυναίκα
1985-11-21T00:00:00+02:00
Σύζυγος
Επιστροφή Εξόδων Νοσοκομειακής Περίθαλψης από ατύχημα / ασθένεια
2019-01-01T00:00:00+02:00
Δωμάτιο/Τροφή από ασθένεια
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Δωμάτιο/Τροφή από ασθένεια
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Απαλλαγή από ασθένεια
0.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
0.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
0.00
Απαλλαγή από ασθένεια
0.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
0.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
0.00
```
### listNoBenefitPolicies
####Input
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| personId | String | Required |The id of the person | 12346329 |
####Output (List of Policy objects)
It returns a list of the person's policies. The policy object contains info regarding the covers.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| policies | List [Policy]| Required| Lists the person's policies but it does not contain the benefits' info| (*see Policy entity and example below*) |
### Example
####Input
```
########
12346329
```
####Output
```
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
279
Med.Safety ετ.αν.
2020-03-22T00:00:00+02:00
2020-09-22T00:00:00+03:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2020-03-22T00:00:00+02:00
142019017
ΑΙΚΑΤΕΡΙΝΗ
ΒΟΥΤΣΙΩΤΗ
Γυναίκα
21118501143
1985-11-21T00:00:00+02:00
Σύζυγος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2019-09-22T00:00:00+03:00
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
218
Medical Safety
2020-07-13T00:00:00+03:00
2021-07-13T00:00:00+03:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2020-07-13T00:00:00+03:00
```
### listNoBenefitPoliciesByCustomer
Search parameters:
* firstName (text)
* lastName (text)
* afm (text)
* amka (text)
* birthdate (date)
* yearOfBirth (numeric)
* policyId (text - must be accompanied by at least one more parameter)
####Input (List[Param])
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| params | List[Param] | Required | the parameter to search | Param[id:'afm', value:'070244595'] |
####Output (List of Policy objects)
It returns a list of the person's policies. The policy object contains info regarding the covers.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| policies | List [Policy]| Required| Lists the person's policies but it does not contain the benefits' info| (*see Policy entity and example below*) |
### Example
####Input
```
########
070244595
```
####Output
```
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
279
Med.Safety ετ.αν.
2020-03-22T00:00:00+02:00
2020-09-22T00:00:00+03:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2020-03-22T00:00:00+02:00
142019017
ΑΙΚΑΤΕΡΙΝΗ
ΒΟΥΤΣΙΩΤΗ
Γυναίκα
21118501143
1985-11-21T00:00:00+02:00
Σύζυγος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2019-09-22T00:00:00+03:00
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
218
Medical Safety
2020-07-13T00:00:00+03:00
2021-07-13T00:00:00+03:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2020-07-13T00:00:00+03:00
GENERALI HELLAS Α.A.E.
410
GL Ομαδικών Ζωής
2020-01-01T00:00:00+02:00
2020-01-01T00:00:00+02:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Επιστροφή Εξόδων Νοσοκομειακής Περίθαλψης από ατύχημα / ασθένεια
2019-01-01T00:00:00+02:00
ΑΙΚΑΤΕΡΙΝΗ
ΒΟΥΤΣΙΩΤΗ ΑΙΚΑΤΕΡ
Γυναίκα
1985-11-21T00:00:00+02:00
Σύζυγος
Επιστροφή Εξόδων Νοσοκομειακής Περίθαλψης από ατύχημα / ασθένεια
2019-01-01T00:00:00+02:00
```
### listBenefits
####Input
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| policyId | String | Required | The policy's Id | 11515927 |
| personId | String | Required | The insured person's Id | 12346329 |
####Output (Policy object)
It returns a person's policy. The policy object contains info regarding the covers and the remaining benefits.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| policy | Policy | Required| Returns a Policy object containing in detail only the specific insured person's benefits' info| (*see Policy entity and example below*) |
### Example
####Input
```
########
11515927
12346329
```
####Output
```
ΜΑΣΟΥΡΑΣ ΧΡΥΣΑΝΘΟΣ ΔΗΜΗΤΡΙΟΥ
279
Med.Safety ετ.αν.
2020-03-22T00:00:00+02:00
2020-09-22T00:00:00+03:00
Active
070244595
ΧΡΥΣΑΝΘΟΣ
ΜΑΣΟΥΡΑΣ
Άντρας
30047802977
1978-04-30T00:00:00+03:00
Κυρίως Ασφαλισμένος
Medical Safety - Νοσοκομειακή περίθαλψη από ατύχημα / ασθένεια
2020-03-22T00:00:00+02:00
Υπολειπόμενο ποσό κάλυψης από ατύχημα
420000.00
Υπολειπόμενο ποσό κάλυψης από ασθένεια
420000.00
Δωμάτιο/Τροφή από ασθένεια
Θέση Γ
Απαλλαγή από ατύχημα
1500.00
Δωμάτιο/Τροφή από ατύχημα
Θέση Γ
Απαλλαγή από ασθένεια
1500.00
Συμμετοχή εταιρίας/ποσοστό από ασθένεια
100.00
Συμμετοχή εταιρίας/ποσοστό από ατύχημα
100.00
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ασθένεια
0.00
Υπολειπόμενο ποσό κάλυψης για Δωμάτιο/Τροφή από ατύχημα
0.00
```
## Claims
**ClaimRequest**
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| providerClaimId| String | Optional | Provider's Claim id in order to easily track a claim request| CLAIM12345 |
| damageDate | Date | Required | The date of the damage, it may be in the future in some cases | 2019-09-20 |
| policyId | String | Required | The id of the related policy that the claim is going to be opened| 50114975 |
| personId | String | Required | The person that is related to the claims and is covered | 094327684|
| hospitalazitationType | Property | Required | If it is pathological, emergency, chemiotherapy| 101 = pathological, 102 = surgery, 103 = chemiotherapy, 104 = emergency|
| description | String | Optional | A description | Lorem ipsum ... |
| medicalParts | List [MedicalPart]| Optional | The participants of the claim, like the hospital, the surgeon, etc. | (*see MedicalPart entity*) |
| diseaseGravity | Property | Required | Whether it is an accident or a disease | 101 = Ασθένεια , 103 = Ατύχημα |
| diseaseText | String | Optional | Optional extra information about disease Gravity| - |
| ICD10 | String | Required | The ICD10 Code |J02.08 |
| DRG | String | Optional | The DRG Code (στα ελληνικά ΚΕΝ) |Μ31Μ |
| operationType | Property | Optional | type of operation| 101 = simple, 102 = multiple, 103 = polytrauma - multiple traumatic injuries|
| coverIds | List [String] | Required | The cover ids that the claim is created| [895515000]|
| notes | String | Optional | Optional extra information | - |
| preApproved | Boolean | Optional - By default is false| Defines if the hospitalization is preapproved | true|
| businessType | String | Optional | Defines the flow of the hospitalization| 1 = if hospitalization is preapproved, 2 = if hospitalization is programmed && hospital is in contract, 3 = if hospitalization is programmed && hospital is out of contract, 4 = Check up|
**ClaimUpdateRequest**
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| providerClaimId| String | Optional | Provider's Claim id in order to update it to our database| CLAIM12345 |
| claimId| String | Required | Claim id in order to easily track a claim request| 100973157 |
| damageDate | Date | Required | The date of the damage, it may be in the future in some cases | 2019-09-20 |
| collaboratorId | String | Required | The collaborator's Id | see listCollaborators |
| hospitalazitationType | Property | Optional | If it is pathological, emergency, chemiotherapy| 101 = pathological, 102 = surgery, 103 = chemiotherapy, 104 = emergency|
| description | String | Optional | A description | Lorem ipsum ... |
| medicalParts | List [MedicalPart]| Optional | The participants of the claim, like the hospital, the surgeon, etc. | (*see MedicalPart entity*) |
| diseaseGravity | Property | Required | Whether it is an accident or a disease | 101 = Ασθένεια , 103 = Ατύχημα |
| diseaseText | String | Optional | Optional extra information about disease Gravity| - |
| ICD10 | String | Required | The ICD10 Code |J02.08 |
| DRG | String | Optional | The DRG Code (στα ελληνικά ΚΕΝ) |Μ31Μ |
| operationType | Property | Optional | type of operation| 101 = simple, 102 = multiple, 103 = polytrauma - multiple traumatic injuries|
| coverIds | List [String] | Required | The cover ids that the claim is created| [895515000]|
| notes | String | Optional | Optional extra information | - |
| preApproved | Boolean | Optional - By default is false| Defines if the hospitalization is preapproved | true|
**MedicalPart**
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| id | String | Optional | The id of the medical participant, normally is the afm | 094327684 |
| type | Property | Required | If it is hospital or surgeon |01 = surgeon, 02 = doctor, 03 = medical, 04 = physiotherapist, 05 = hospital|
####Claim
General information about a claim. Contains information about the claimant (insured person) and the medical participants.
| Field | Type | Constraints | Description | Example |
| ------------- | ------------- | --------------- | ------------ | -------- |
| id | String(9) | Required | Generali id of the created invoice. | '011122345' |
| providerClaimId| String | Optional | Provider's Claim id| CLAIM12345 |
| damageDate | Date | Required | The date of the damage, it may be in the future in some cases | 2019-09-20 |
| policyId | String | Required | The id of the related policy that the claim is going to be opened | '50114975' |
| personId | String | Required | The person that is related to the claims and is covered | 094327684|
| description | String | Optional | A description | Lorem ipsum ... |
| medicalParts | List [MedicalPart] | Required | The participants of the claim, like the hospital, the surgeon, etc. (*see MedicalPart entity*)| - |
| causes | List [ClaimCause] | Optional | The cause of the claim| (*see ClaimCause entity*)|
| status | ClaimStatus | Required | The detailed status of the claim (*see ClaimStatus entity*) | - |
| notes | String | Optional | Optional extra information | - |
| subStatus | String | Optional | any action required from the medical provider | "pending submit" |
####ClaimStatus
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| status | Property | Required | The main status of the claim | 100 = Opened, 200 = Closed |
| stage | Property | Optional | The current stage of the claim| '120' (authorization stage) |
| responsible | Property | Optional | Which actor of the system is now responsible | 100 claim handler |
####ClaimCause
Identifies the cause of the claim event. Contains information about the claim cause and identifies a product that has covered or will cover the claim partly or fully.
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | --------------| ------------ | -------- |
| coverId | String (9) | Required | The id of the cover | 895515000 |
| diseaseICD10 | String | Required | The ICD10 code of the disease | A00.00 |
| diseaseType | Property | Required | The type of the disease | 001 = Καρδιακή Προσβολή |
| diseaseGravity| Property | Required | if it is accident, etc. | 101 = disease, 103 = accident |
| hospitalazitationType | Property | Required | If it is pathological, emergency, chemiotherapy| 101 = pathological, 102 = surgery, 103 = chemiotherapy, 104 = emergency|
| operationType | Property | Optional | If it is simple, multi or muti injured | 101 = simple, 102 = multi, 103 = multi injured |
| foreign | Boolean | By default is false| Defines if is a foreign claim | true|
| notes | String | Optional | Optional extra information | - |
### createClaim
#### Input
| Field | Type | Constraint | Description | Example |
| ---------------- | ------------- | -------------- | ------------ | -------- |
| claim | ClaimRequest | Required | Claim to be created | (see ClaimRequest entity) |
#### Output (Claim)
| Field | Type | Constraints | Description | Example |
| ------------- | ------------- | --------------- | ------------ | -------- |
| id | String(9) | Required | Generali id of the created invoice. | '011122345' |
| providerClaimId| String | Optional | Provider's Claim id| CLAIM12345 |
| damageDate | Date | Required | The date of the damage, it may be in the future in some cases | 2019-09-20 |
| policyId | String | Required | The id of the related policy that the claim is going to be opened| 50114975 |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| personId | String | Required | The person that is related to the claims and is covered | 12346329|
| description | String | Optional | A description | Lorem ipsum ... |
| medicalParts | List [MedicalPart]| Required | The participants of the claim, like the hospital, the surgeon, etc. | (*see MedicalPart entity*) |
| causes | List [ClaimCause] | Optional | The cause of the claim| (*see ClaimCause entity*)|
| status | ClaimStatus | Required | The detailed status of the claim | (*see ClaimStatus entity*)|
| notes | String | Optional | Optional extra information | - |
| subStatus | String | Optional | any action required from the medical provider | "pending submit" |
| claimHandlerEmail | String | Optional | The ClaimHandler's email | something@generali.gr (in the email is clear the ClaimHandler's fullname) |
| preApproved | String | Optional | if the claim has been preApproved | false |
### Example
####Input
```
000016
11515927
2020-01-10T00:00:00+02:00
12346329
########
surgery
sfdsdfds
doctor
Ασθένεια
sdfadfdsfs
J02.08
345435
simple
896515000
fdgdfsdfsdggd
```
####Output
```
11515927
000016
2020-01-10T00:00:00+02:00
12346329
Opended
Default
false
```
### updateClaim
#### Input
| Field | Type | Constraint | Description | Example |
| ---------------- | ------------- | -------------- | ------------ | -------- |
| claim | ClaimUpdateRequest | Required | Claim to be updated | (see ClaimUpdateRequest entity) |
#### Output (Claim)
| Field | Type | Constraints | Description | Example |
| ------------- | ------------- | --------------- | ------------ | -------- |
| id | String(9) | Required | Generali id of the created invoice. | '011122345' |
| providerClaimId| String | Optional | Provider's Claim id| CLAIM12345 |
| damageDate | Date | Required | The date of the damage, it may be in the future in some cases | 2019-09-20 |
| policyId | String | Required | The id of the related policy that the claim is going to be opened| 50114975 |
| collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
| personId | String | Required | The person that is related to the claims and is covered | 12346329|
| description | String | Optional | A description | Lorem ipsum ... |
| medicalParts | List [MedicalPart]| Required | The participants of the claim, like the hospital, the surgeon, etc. | (*see MedicalPart entity*) |
| causes | List [ClaimCause] | Optional | The cause of the claim| (*see ClaimCause entity*)|
| status | ClaimStatus | Required | The detailed status of the claim | (*see ClaimStatus entity*)|
| notes | String | Optional | Optional extra information | - |
| subStatus | String | Optional | any action required from the medical provider | "pending submit" |
| claimHandlerEmail | String | Optional | The ClaimHandler's email | something@generali.gr (in the email is clear the ClaimHandler's fullname) |
| preApproved | String | Optional | if the claim has been preApproved | false |
### Example
####Input
```
010101011
100973216
2020-05-20T00:00:00
########
surgery
Ασθένεια
Update Test
J31.01
simple
885515000
```
####Output
```
010101011
11524210
2020-05-20T00:00:00+03:00
12439136
hospital
885515000
J31.01
Μη Σοβαρή Ασθένεια
false
Opended
On document exchange
Assignee
george.stathopoulos@generali.gr
```
### listClaims
Returns a list of claims according to the search criteria. It is used to find opened claims.
We will limit the number of results to 20.
Search parameters:
* claimId
* providerClaimId
* personId
* policyId (when using this parameter, we need at least another one parameter to be given)
* damageDate
####Input (List[Param])
|Field | Type | Constraint | Description| Example |
|-------|-------|-------|-------|-------|
| policyId | Param | Optional (policyId needs at least another one param) | filter by policyId | ```11524210``` |
| damageDate | Param | Optional | filter by damageDate | ```2020-04-14``` |
| personId | Param | Optional | filter by personId | ```13011771``` |
| afm | Param | Optional | filter by afm | ```140735223``` |
| claimId | Param | Optional | filter by claimId | ```140735223``` |
| providerClaimId | Param | Optional | filter by providerClaimId | ```2345623755``` |
####Output (Claim)
| Field | Type | Constraint | Description | Example |
|-------|-------|-------|-------|-------|
| claims | List [Claim] | Required |The list of the claims | - |
### Example
####Input
```
11761845
101021131
13011771
2020-04-14
```
####Output
```
11000003
50121998
2020-04-23T00:00:00+03:00
10756330
881515000
J02.08
Μη Σοβαρή Ασθένεια
false
Opended
On document exchange
Assignee
pantelis.christopoulos@generali.gr
ΟΧΙ
```
### addDocumentToClaim
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
claimId | String(9) | Required | Generali id of the claim the document is going to be added to. | '011122345'
document | Document | Required. Document size <= 20MB | Document to be added to the claim. | -
### Example
####Input
```
100882831
testFile.pdf
147
application/pdf
the file in Byte array
```
####Output
```
```
### addMessageToClaim
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
claimId | String(9) | Required | Generali id of the claim the document is going to be added to. | '011122345'
title | String | Required | Title to be added to message regarding the Claim. | 'document upload.'
message | String | Required | Message to be added regarding the Claim. | 'I'm not sure about which document to upload.'
### Example
####Input
```
100777850
The message
message conent
```
####Output
```
```
### listClaimMessages
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
claimId | String(9) | Required | Generali id of the claim | '100973389'
####Output (Message)
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| messages | List [Message] | Required |The list of messages of the specific claim | - |
### Example
####Input
```
100973389
```
####Output
```
papapap
2020-05-15T12:57:55+03:00
ΥΓΕΙΑ Α.Ε
Hospital
George
Stathopoulos
george.stathopoulos@generali.gr
Claim's Adjuster
The message title
message conent
2020-05-15T15:49:47+03:00
ΥΓΕΙΑ Α.Ε
Hospital
George
Stathopoulos
george.stathopoulos@generali.gr
Claim's Adjuster
```
## Pendencies
###EntityId
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
code | String(9) | Required | Generali id of the entity. | '011122345'
type | String(9) | Required | the type of the entity | 'FA3'
###Pendency
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
id | EntityId | Required | Generali id of the pendency. | **See example in listPendencies below**
claimId | String(9) | Required | Generali id of the claim the pendency belongs to. | '011122345'
actionType | String | Required | Kind of action required in order to close the pendency. | 'UPLOAD_FILE'
creationDate | Date | Required | Date of creation of the pendency. | -
description | String | Required | Human readable description of the pendency. | 'Required upload of blood analysis'
status | String | Required | Current status of the pendency. **See Status types below**. | 'OPEN'
pendencyType | String | Required | Code of Pendency Type | '80566'
pendencyDescription | String | Required | Pendenc Note from claim handler | 'Claim Handler note'
**Status types**
* OPEN
* CLOSED
* IN PROGRESS
### listPendencies
Returns:
* a list of pedencies according to the search criteria.
* the **pendency type** if the pendency is FA3, in case it is a manual pendency (subTask - FHY) this field will not show.
* the **pendency description** which is the message the claim handler adds, on creation of a manual pendency (from
a list) in toolbox. If there isn't a message this field will not show.
The number of results is limited to 50.
Search parameter ids
* claimId
* beforeCreationDate
* afterCreationDate
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | ------
params | List[Param] | Required | List of parameters to filter the list. | -
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
results | List[Pendency] | Required | List of filtered pendencies. | -
### Example
####Input
```
101025281
```
####Output
```
106962464
FA3
101025281
2020-07-20T00:00:00+03:00
Έγγραφο εξόδου / έκθεση ελέγχου εξιτηρίου
CLOSED
60310
112708352
FA3
101025281
2023-07-14T00:00:00+03:00
Τιμολόγια ειδικών υλικών
OPEN
60630
δεν έχουμε λάβει το τιμολόγιο της medicare για το ΕΥ χ
```
### addDocumentToPendency
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
pendencyEntityId | EntityId | Required | Generali Entity id of the pendency the document is going to be added to. | -
document | Document | Required. Document size <= 20MB | Document to be added to the pendency. | -
### Example
####Input
```
105021429
FA3
testFile100883750.pdf
147
application/pdf
JVBERi0xLjQKJfjl...JSVFT0Y=
```
####Output
```
```
### addMessageToPendency
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
pendencyEntityId | EntityId | Required | Generali Entity id of the pendency the message is going to refer to. | -
message | String | Required | Message to be added to the pendency. | 'I'm not sure about which document to upload.'
### Example
####Input
```
000258573
FHY
Test on sending message to Pendency 1
Test message body 1
```
####Output
```
```
### listPendencyMessages
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
pendencyEntityId | EntityId | Required | Generali Entity id of the pendency the message is going to refer to. | -
####Output (Message)
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| messages | List [Message] | Required |The list of messages that refer to the specific pendency | - |
### Example
####Input
```
000258573
FHY
```
####Output
```
Test on sending message to Pendency 1
Test message body 1
2020-05-15T16:22:49+03:00
ΥΓΕΙΑ Α.Ε
Hospital
George
Stathopoulos
george.stathopoulos@generali.gr
Claim's Adjuster
```
### listDocuments
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
claimId | String(9) | Required | Generali id of the claim the pendency belongs to. | '011122345'
createdBy | String | Required | specifying the sender of hte documents | 'me' - 'generali' - 'all'
filenameRegex | String | Optional | filter documents their filename using regex | **".\*(foo\|bar).\*"**: matches filename containing either foo or bar, **"^foo"**: finds filename that starts with foo, **"regex$"**: finds filename that ends with foo,**"(?i)foo"**:matches the filename exactly (case insensitive)
####Output (Message)
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
|detailedDocuments | List [DetailedDocument] | Required |The list of Documents' info that refer to the specific claimId | - |
### Example
####Input
```
101010278
me
```
####Output
```
101010278
Admission2327083.pdf
127
Εισιτήριο νοσοκομείου
application/pdf
JVB...U9GDQ==
101010278
Admission2327085.pdf
124
Γνωμάτευση
application/pdf
JVB...U9GDQ==
101010278
Admission2327518.pdf
136
Εξιτήριο νοσοκομείου
application/pdf
JVB...U9GDQ==
101010278
ProformaInvoice-20200624-6265.pdf
197
Προτιμολόγιο
application/pdf
JVB...U9GDQ==
101010278
Audit-DIS-20200625-3028.pdf
101
Έγγραφo εξόδου από νοσοκομείο
application/pdf
JVB...U9GDQ==
```
### listNoContentDocuments
Similar to listDocuments, though it doesn't contain the content info of the files in DetailedDocument object
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
claimId | String(9) | Required | Generali id of the claim the pendency belongs to. | '011122345'
createdBy | String | Required | specifying the sender of hte documents | 'me' - 'generali' - 'all'
####Output (Message)
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
|detailedDocuments | List [DetailedDocument] | Required |The list of Documents' info that refer to the specific claimId | - |
### Example
####Input
```
101016545
all
```
####Output
```
101016545
TestSendingFileFromYgeiaWS.pdf
application/pdf
101016545
noFileType.pdf
application/pdf
000309746
FHY
```
## Bills
####BillItem
Field | Type | Constraints | Description | Example
----- | ---- | ------------| ----------- | ------
providerType | Property | Required | the type of the item as it is mutually agreed between Generali and the provider | 000000001 = ΝΟΣΗΛΕΙΑ LARGE SUITE, ΝΟΣΗΛΕΙΑ ΜΕΘ 5ου ΟΡΟΦΟΥ = 000000006
netAmount | Double | Required | tax free amount of the specific item requested by the provider to be paid by the customer. | 525.50
grossAmount | Double | Required | gross amount of the specific item requested by the provider to be paid by the customer. | 550.50
generaliProposedGrossAmount | Double | Optional | gross amount of the specific item requested by Generali. | 550.50
cutsAmount | Double | Optional (it gets filled in only by Generali) | In case the Claim Handler disagrees with the given gross amount and wants to proceed to a cut, this field describes the exact amount of the cut | 45
cutsType | Property | Optional (it gets filled in only by Generali) | In case the Claim Handler has proceeded to a cut on the item's gross amount he/she decides to whom Generali is going to charge the amount | **See Cut types below - check also Example 2 of listBills**
notes | String | Optional | Optional extra information | -
**Cut types**
* 108 = Hospital
* 265 = Customer
####AdditionalParam
Field | Type | Constraints | Description | Example
----- | ---- | ------------| ----------- | ------
paramType | Property |Additional Parameters of the Bill/Invoice| **See AdditionalParam types below** | ,
value | Value | The relative value to the paramType | 120.50 |
####DamageTypeInfoDetails
Field | Type | Constraints | Description | Example
----- | ---- | ------------| ----------- | ------
damageTypeId | String(5) | Required | Generali id of a damage type. **See Damage Type** | '10390'
params | List[AdditionalParam] | Required | Detailed list of params | **See AdditionalParam types**
items | List[BillItem] | Required | Detailed list of items | -
**AdditionalParam types**
* 102 = Υποβληθέντα ποσά - Αρχικό ποσό υποβολής νοσοκομείου/Ασφαλισμένου - Συμπληρώνεται από Generali
* 104 = Αλλο ταμείο/φορέας - Συμμετοχή ΕΟΠΠΥ, αφορά Κοινωνικό Φορέα - Συμπληρώνεται από provider/νοσοκομείο
* 255 = Αλλη Ασφαλιστική - Συμμετοχή 2ης Ασφαλιστικής (Ιδιωτικός Φορέας) - Συμπληρώνεται από provider/νοσοκομείο
* 103 = Αναγνωρισθέντα ποσά - Το ποσό που προκύπτει αφαιρώντας τη συμμετοχή του ταμείου και άλλης ασφαλιστικής (= 102 - (104 + 255)) - Συμπληρώνεται από Generali
* 108 = Μη καλυπτόμενο ποσό. Περικοπές χρεώσεων - Συμπληρώνεται από Generali
* 105 = Απαλλαγή/ποσό - Η απαλλαγή. Συμμετοχή ασφαλισμένου επί του κόστους νοσηλείας - Συμπληρώνεται από Generali
* 106 = Συμμετοχή εταιρίας/ποσοστό - Ποσοστό κάλυψης εξόδων νοσηλείας. Συγκεκριμένα ως προς το ποσό που προκύπτει αφαιρώντας το ταμείο και την απαλλαγή (= 102 – (104 + 105)) - Συμπληρώνεται από Generali
* 107 = Ορια κάλυψης - Όριο τρέχοντος κεφαλαίου που παρέχει το συμβόλαιο - Συμπληρώνεται από Generali
* 280 = Αποζημίωση - Το τελικό ποσό αποζημίωσης από Generali - Συμπληρώνεται από Generali
* 265 = Περικοπές Τμήμ. Αποζημιώσεων - Περικοπές χρεώσεων (Λοιπές περικοπές) - Συμπληρώνεται από Generali
####BillRequest
For every damageTypeId there should be applied a new billRequest from the provider/hospital. The analysis of the hospital's services will be given in the Items filed. Also in the params field should be given the info of the charging amount referring to the Insurer, the charging amount referring to the public Insurer, if any, and also the charging amount referring to a third party private Insurer, if any.
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
providerBillId | String | Optional | Provider's Bill id in order to easily track a bill | 'BILL12345567'
providerBillVersionId | String | Optional | Provider's version id of the specific providerBillId in order to easily track a bill | 'BILL12345567-01'
claimId | String(9) | Required | Generali id of the claim the bill is going to be added to. | '011122345'
damageTypeId | String(5) | Required | Generali id of a damage type. **See Damage Type** | '10000'
coverId | String(9) | Required | Generali id of the cover. | '881515315'
admissionDate | Date | Required | the admission Date. | -
dischargeDate | Date | Required | the discharge Date. | -
items | List[BillItem] | Required | Detailed list of items | -
amount | Double | Required | Total requested amount by the provider to be paid by the customer. | 525.50
params | List[AdditionalParam] | Required | Detailed list of params | 104 = Αλλο ταμείο/φορέας (Required. If not any public Insurer participates, just fill in 0 value on the amount), 255 = Αλλη Ασφαλιστική (Required. If not any other 3rd party private Insurer participates, just fill in 0 value on the amount)
notes | String | Optional | Optional extra information | -
####Bill
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
providerBillId | String | Optional | Provider's Bill id | 'BILL12345567'
id | String | Optional | Generali id of the bill. | '000157597'
versions | List[BillVersion] | the versions of the specific bill. | **See output in listBills example**
####BillVersion
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
providerBillVersionId | String | Optional | Provider's Bill versionId | 'BILL12345567-01'
versionId | String | Optional | Generali version id of a specific bill | '0001'
providerChargeAmount | Double | Required | Total amount to be paid by the customer. | 525.50
generaliProposedChargeAmount | Double | Optional | Proposed by Generali the total amount that should have been charged to the customer. | 525.50
generaliCompensationAmount | Double | Required | Total amount to be paid by Generali. | 300.00
claimId | String(9) | Required | Generali id of the claim the bill is going to be added to. | '011122345'
coverId | String (9) | Required | Generali id of a the cover which has been activated. | '881515315'
admissionDate | Date | Required | the admission Date. | -
dischargeDate | Date | Required | the discharge Date. | -
providerStatus | String | Required | Current status of the bill from provider's side. | **See Status types below**.
generaliStatus | String | Required | Current status of the bill from Generali's side. | **See Status types below**.
damageTypeInfoDetails | List[DamageTypeInfoDetails] | the detail info of the specific version of bill. | **See output in listBills example**
notes | String | Optional | Optional extra information | -
**Status types**
* ACCEPTED
* REJECTED
* PENDING
### listBills
Returns a list of bills according to the search criteria.
The number of results is limited to 50.
**Search parameter ids**
* id
* versionId
* providerBillId
* providerBillVersionId
* claimId
* damageTypeId
* coverId
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | ------
params | List[Param] | Required | List of parameters to filter the list. | -
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
results | List[Bill] | Required | List of filtered bills. | -
### Example 1
####Input
```
4444443
```
####Output
```
4444443
000160399
01
1
1315.58
545.0
100885637
984515000
2020-03-09T00:00:00+02:00
2019-03-10T00:00:00+02:00
ACCEPTED
ACCEPTED
10543
1070.0
500.0
Αλλο ταμείο/φορέας
140.24
Αλλη Ασφαλιστική
230.98
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
1000.0
whateverNoteItem1
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.0
70.0
whateverNoteItem2
10390
Αλλη Ασφαλιστική
10.98
45.0
245.58
Αλλο ταμείο/φορέας
110.24
-
ssfgfsgf
13.01
16.13
dbdbdbdb
-
sdfsdfsdfsdf
185.04
229.45
sdfsdffsds
whateverNoteInGeneral
```
### Example 2
####Input
```
101016426
```
####Output
```
16715777
000309504
01
1
2291.16
0.0
101016426
899515250
2020-08-03T00:00:00+03:00
2019-08-03T00:00:00+03:00
ACCEPTED
REJECTED
10543
Αλλο ταμείο/φορέας
110.24
Αλλη Ασφαλιστική
10.98
245.58
-
sdfsdfsdfsdf
185.04
229.45
sdfsdffsds
-
ssfgfsgf
13.01
16.13
dbdbdbdb
10390
Αλλο ταμείο/φορέας
110.24
Αλλη Ασφαλιστική
10.98
2045.58
-
sdfsdfsdfsdf
1085.04
2029.45
sdfsdffsds
-
ssfgfsgf
13.01
16.13
dbdbdbdb
whateverNoteInGeneral
01
2
2291.16
2204.13
704.13
101016426
899515250
2020-08-03T00:00:00+03:00
2019-08-03T00:00:00+03:00
PENDING
ACCEPTED
Counter proposal
10543
Απαλλαγή/ποσό
44.09
Αναγνωρισθέντα ποσά
124.36
Αποζημίωση
24.69
Υποβληθέντα ποσά
245.58
Ορια κάλυψης
989273.09
Περικοπές Τμήμ. Αποζημιώσεων
6.13
Συμμετοχή εταιρίας/ποσοστό
100.0
Αλλη Ασφαλιστική
10.98
Μη καλυπτόμενο ποσό
49.45
Αλλο ταμείο (φορέας)
110.24
-
sdfsdfsdfsdf
185.04
229.45
180.0
49.45
Hospital
-
ssfgfsgf
13.01
16.13
10.0
6.13
Customer
10390
Μη καλυπτόμενο ποσό
31.45
Απαλλαγή/ποσό
1213.47
Αναγνωρισθέντα ποσά
1924.36
Ορια κάλυψης
989273.09
Αποζημίωση
679.44
Περικοπές Τμήμ. Αποζημιώσεων
0.0
Συμμετοχή εταιρίας/ποσοστό
100.0
Αλλη Ασφαλιστική
10.98
Αλλο ταμείο (φορέας)
110.24
Υποβληθέντα ποσά
2045.58
-
sdfsdfsdfsdf
1085.04
2029.45
1998.0
31.45
Hospital
-
ssfgfsgf
13.01
16.13
whateverNoteInGeneral
```
### addBillToClaim
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
bill | BillRequest | Required | The bill to be added to the claim | -
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
bills | List[Bill] | Required | List of filtered bills. | -
### Example 1
####Input
```
4444443
01
100885637
10543
984515000
2020-03-09
2019-03-10
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
1000.00
whateverNoteItem1
2020-03-09
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.00
70.00
whateverNoteItem2
1070.00
Αλλο ταμείο/φορέας
140.24
Αλλη Ασφαλιστική
230.98
whateverNoteInGeneral
```
####Output
```
4444443
000160399
01
1
1070.0
0.0
100885637
984515000
2020-03-09T00:00:00+02:00
2019-03-10T00:00:00+02:00
ACCEPTED
PENDING
10543
Αλλο ταμείο/φορέας
140.24
Αλλη Ασφαλιστική
230.98
1070.0
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.0
70.0
whateverNoteItem2
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
1000.0
whateverNoteItem1
2020-03-09
whateverNoteInGeneral
```
### Example 2
####Input
```
4444443
01
100885637
10390
984515000
2020-03-09
2019-03-10
-
sdfsdfsdfsdf
185.04
229.45
sdfsdffsds
-
ssfgfsgf
13.01
16.13
dbdbdbdb
245.58
Αλλο ταμείο/φορέας
110.24
Αλλη Ασφαλιστική
10.98
whateverNoteInGeneral
```
####Output
```
4444443
000160399
01
1
1315.58
0.0
100885637
984515000
2020-03-09T00:00:00+02:00
2019-03-10T00:00:00+02:00
ACCEPTED
PENDING
10543
Αλλο ταμείο/φορέας
140.24
Αλλη Ασφαλιστική
230.98
1070.0
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.0
70.0
whateverNoteItem2
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
1000.0
whateverNoteItem1
10390
245.58
Αλλη Ασφαλιστική
10.98
Αλλο ταμείο/φορέας
110.24
-
sdfsdfsdfsdf
185.04
229.45
sdfsdffsds
-
ssfgfsgf
13.01
16.13
dbdbdbdb
whateverNoteInGeneral
```
### setBillEOPYY
Provider can optionally set global EOPPY amount for selected bill,
that - when provided - will override at bill submit each related d/t EOPYY param amount. (will split them equally to existing damage types)
- Preconditions: bill pendency status OPEN, Generali status "PENDING" & Provider status ACCEPTED
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
billId | String(9) | Required | Generali id of the bill we are going to edit. | '000802061'
### Example
####Input
```
000802061
```
####Output
```
OK
```
### approveBill
#### Input
Field | Type | Description | Example
----- | ---- | ----------- | -------
billId | String(9) | Required | Generali id of bill to be approved. | '011122345'
billVersionId | String(4) | Required | Generali version id of a specific bill to be rejected. | '0001'
message | String | Optional | The reasoning written in a short message |
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
bill | Bill | Required | The new bill that was created during the rejection | **See Status types below**.
### Example
####Input
```
000159947
0001
```
####Output
```
1234567
000159947
01
0002
1315.58
0.0
100883263
881515315
2019-10-29T00:00:00+02:00
2019-11-03T00:00:00+02:00
ACCEPTED
PENDING
10390
Αλλη Ασφαλιστική
10.98989
Αλλο ταμείο/φορέας
110.24546
-
sdfsdfsdfsdf
185.04
229.45
sdfsdffsds
-
ssfgfsgf
13.01
16.13
dbdbdbdb
10347
Αλλο ταμείο/φορέας
140.24546456456
Αλλη Ασφαλιστική
230.98989
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.0
70.0
whateverNoteItem2
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
1000.0
whateverNoteItem1
whateverNoteInGeneral
```
### rejectBill
#### Input
Field | Type | Description | Example
----- | ---- | ----------- | -------
billId | String(9) | Required | Generali id of bill to be approved. | '011122345'
billVersionId | String(4) | Required | Generali version id of a specific bill to be approved. | '0001'
message | String | Optional | The reasoning written in a short message | 'Δε συμφωνούμε στα ποσά των Items'
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
bill | Bill | Required | The new bill that was created during the approve | **See Status types below**.
### Example
####Input
```
000159947
0001
Δε συμφωνούμε στα ποσά των Items
```
####Output
```
1234567
000159947
01
0002
1315.58
0.0
100883263
881515315
2019-10-29T00:00:00+02:00
2019-11-03T00:00:00+02:00
REJECTED
Δε συμφωνούμε στα ποσά των Items
PENDING
10390
Αλλη Ασφαλιστική
10.98989
Αλλο ταμείο/φορέας
110.24546
-
sdfsdfsdfsdf
185.04
229.45
sdfsdffsds
-
ssfgfsgf
13.01
16.13
dbdbdbdb
10347
Αλλο ταμείο/φορέας
140.24546456456
Αλλη Ασφαλιστική
230.98989
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.0
70.0
whateverNoteItem2
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
1000.0
whateverNoteItem1
whateverNoteInGeneral
```
## Invoices
####InvoiceItem
Field | Type | Constraints | Description | Example
----- | ---- | ------------| ----------- | ------
providerType | Property | Required | the type of the item as it is mutually agreed between Generali and the provider | 000000001 = ΝΟΣΗΛΕΙΑ LARGE SUITE, ΝΟΣΗΛΕΙΑ ΜΕΘ 5ου ΟΡΟΦΟΥ = 000000006
amount | Double | Required | Amount of the specific item to be paid by the customer. | 525.50
notes | String | Optional | Optional extra information | -
####AdditionalParam
Field | Type | Constraints | Description | Example
----- | ---- | ------------| ----------- | ------
paramType | Property |Additional Parameters of the Bill/Invoice| **See AdditionalParam types below** | ,
value | Value | The relative value to the paramType | 120.50 |
**AdditionalParam types**
* 102 = Υποβληθέντα ποσά (It get's filled in only by Generali. It refers to the total charging amount of the hospital's services. On the same value refer the fields RequestAmount and ResponseAmount of Bill object, and the field Amount of the Invoice object)
* 104 = Αλλο ταμείο/φορέας (It get's filled by provider/hospital)
* 255 = Αλλη Ασφαλιστική (It get's filled by provider/hospital)
* 108 = Μη καλυπτόμενο ποσό. Οι περικοπές (Rejected Bill Items) (It get's filled in only by Generali)
* 105 = Απαλλαγή/ποσό: Η απαλλαγή (It get's filled in only by Generali)
* 106 = Συμμετοχή εταιρίας/ποσοστόΤο ποσοστό συμμετοχής (It get's filled in only by Generali)
* 107 = Ορια κάλυψης (It get's filled in only by Generali)
* 280 = Αποζημίωση.Το τελικό ποσό αποζημίωσης (The fianl amount Generali is willing to pay. It get's filled in only by Generali)
####InvoiceRequest
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
invoiceId | String | Required | Provider's Invoice id | '12345567'
providerBillVersionId | String | Optional | Provider's version id of the specific providerBillId in order to easily track a bill | 'BILL12345567-01'
claimId | String(9) | Required | Generali id of the claim the bill is going to be added to. | '011122345'
damageTypeId | String(5) | Required | Generali id of a damage type. **See Damage Type** | '10000'
coverId | String(9) | Required | Generali id of the cover. | '881515315'
admissionDate | Date | Required | the admission Date. | -
dischargeDate | Date | Required | the discharge Date. | -
items | List[BillItem] | Required | Detailed list of items | -
amount | Double | Required | Total requested amount by the provider to be paid by the customer. | 525.50
params | List[AdditionalParam] | Required | Detailed list of params | 104 = Αλλο ταμείο/φορέας (Required. If not any public Insurer participates, just fill in 0 value on the amount), 255 = Αλλη Ασφαλιστική (Required. If not any other 3rd party private Insurer participates, just fill in 0 value on the amount)
notes | String | Optional | Optional extra information | -
####Invoice
Field | Type | Constraints | Description | Example
----- | ---- | ------------------ | ----------- | ------
id | String | Required | The id of the Invoice | 'INVOICE12345567'
claimId | String(9) | Required | Generali id of the claim the bill is going to be added to. | '011122345'
coverId | String (9) | Required | Generali id of a the cover which has been activated. | '881515315'
providerChargeAmount | Double | Required | Total amount to be paid by the customer. | 525.50
generaliCompensationAmount | Double | Required | Total amount to be paid by Generali. | 300.00
admissionDate | Date | Required | the admission Date. | -
dischargeDate | Date | Required | the discharge Date. | -
status | String | Required | Current status of the invoice. **See Status types below**. | '101'
damageTypeInfoDetails | List[DamageTypeInfoDetails] | the detail info of the specific version of bill. | **See output in listBills example**
notes | String | Optional | Optional extra information | -
**Status types**
* blank (meaning there is no payment yet)
* 101 (meaning it has bean a virtual payment)
* 102 (meaning it has bean a regular payment)
### listInvoices
Returns a list of invoices according to the search criteria.
The number of results is limited to 50.
**Search parameters**
* id
* claimId
* status (it could be ''/blank, 101 or 102)
* beforeCreationDate
* afterCreationDate
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | ------
collaboratorId | String | Required for Hospitals | The collaborator's Id | see listCollaborators |
params | List[Param] | Required | List of parameters to filter the list. | -
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
results | List[Invoice] | Required | List of filtered invoices. | -
### Example
####Input
```
########
011122400
```
####Output
```
100883263
881515315
1315.58
545.00
2019-10-29T00:00:00+02:00
2019-11-03T00:00:00+02:00
10390
Αποζημίωση
45.00
Ημερομηνία δικαιολογητικών
2019-10-29T00:00:00+02:00
Εως ημερομηνία
2019-11-03T00:00:00+02:00
Αναγνωρισθέντα ποσά
0.00
Περικοπές Τμήμ. Αποζημιώσεων
0.00
Αλλο ταμείο (φορέας)
110.25
Ορια κάλυψης
0.00
Μη καλυπτόμενο ποσό
0.00
Από ημερομηνία
2019-10-29T00:00:00+02:00
Περικοπές Ιατρείου
0.00
Ημέρες νοσηλείας
0.00
Υποβληθέντα ποσά
245.58
Ημ/νία εισόδου δικαιολογητικών
0.00
Αλλη Ασφαλιστική
10.99
Οριο Κάλυψης Δ/Τ
0.00
Απαλλαγή/ποσό
0.00
Συμμετοχή εταιρίας/ποσοστό
0.00
-
-
10347
Ημερομηνία δικαιολογητικών
2019-10-29T00:00:00+02:00
Υποβληθέντα ποσά
1070.00
Εως ημερομηνία
2019-11-03T00:00:00+02:00
Αλλη Ασφαλιστική
230.99
Από ημερομηνία
2019-10-29T00:00:00+02:00
Αποζημίωση
500.00
Αλλο ταμείο (φορέας)
140.25
-
ΜΙΚΡΟΕΠΕΜΒΑΣΕΙΣ ΜΕ ΡΑΜΜΑΤΑ
67.00
-
ΝΟΣΗΛΕΙΑ LARGE SUITE
910.03
```
### addInvoiceToClaimFromBillId
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
billId | String(9) | Required | Generali id of the bill is going to be added to. | '011122345'
billVersionId | String(4) | Required | Generali version id of a specific bill to be approved. | '0001'
invoiceId | String(9) | Required | Generali id of the created invoice. | '011122345'
### Example
####Input
```
000158711
0005
011111113
```
####Output
```
```
### addInvoiceToClaimFromProviderBillId
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
providerBillId | String | Required | Provider's id of the bill is going to be added to. | '011122345'
providerBillVersionId | String | Required | Provider's version id of a specific bill to be approved. | '0001'
invoiceId | String(9) | Required | Generali id of the created invoice. | '011122345'
### Example
####Input
```
21111111
21111111-01
123435534536
```
####Output
```
```
### submit
The Medical Provider informs the claim handler that he has completed the required tasks
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
claimId | String | Required | claim's Id | '100884345' |
### Example
####Input
```
100884345
```
####Output
```
```
### unsubmitBill
Medical Provider unsubmits it's previously submitted bill, for further edit (related bill pendency changes status from "closed" to "open")
- bill should be already submitted, generali status should be PENDING & medical provider status should be ACCEPTED
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
billId | String(9) | Required | Generali id of the bill is going to be added to. | '000802061'
### Example
####Input
```
000802061
```
####Output
```
OK
```
### listCollaborators
#### Input
Field | Type | Constraints | Description | Example
----- | ---- | ----------- | ----------- | -------
No input
#### Output
Field | Type | Description | Example
----- | ---- | ----------- | -------
| collaborators | List[Property] | Optional | which hospitals the user can use| - |
### Example
####Input
```
```
####Output
```
S:Envelope xmlns:S="http://schemas.xmlsoap.org/soap/envelope/">
ΥΓΕΙΑ Α.Ε
```
## Appointments
####AppointmentRequest
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| id | String | Required | The id of the appointment request | - |
| entityType | String | Required | The user type of the insured person | - |
| entityCode | String | Required | The user id of the insured person | - |
| requestDates | List[ AppointmentTimeRange] | Required | (*see AppointmentTimeRange entity*) | - |
| city | String | Required | The city of the insured person | "ΑΘΗΝΑ" |
| district | String | Required | The district of the insured person | "ΜΑΡΟΥΣΙ" |
| responses | List[AppointmentResponse] | Optional | (*see AppointmentResponse entity*) | - |
| appointment | Appointment | Optional | (*see Appointment entity*) | - |
| notes | List[String] | Optional | Optional extra information | - |
| requestType | MedicalAppointmentRequestType | Required | The type of the request (*see MedicalAppointmentRequestType entity*) | - |
####MedicalAppointmentRequestType
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| hospital | String | Optional | the hospital requested for the appointment | - |
| documentContent | byte[] | Optional | the referral document in case of hospitalization| - |
| doctorSpecialty | String | Optional | The doctor specialty requested | - |
| checkUp | CheckUp | Optional | the checkUp information requested | - |
| lobCode | String | Required | line of bussiness code of the policy | 410 |
| lobName | String | Required | line of bussiness description of the policy| GL Ομαδικών Ζωής |
| policyCode | String | Required | the policy code of the insured person | - |
| claimantType | String | Required | the claimant type | 116 |
| claimantCode | String | Required | the claimant code | 01234567 |
| claimantLabel | String | Required | the customer code | 01234567 |
| claimantName | String | Required | the claimant name | - |
| claimantPhone | String | Required | the claimant phone | - |
####CheckUp
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| code | String | Required | the code of the check up | 000553679 |
| name | String | Required | the name of the check up| CU3-ΕΤ.SAFETY ΓΥΝΑΙΚ.40+ |
| hospital | String | Required | The hospital the customer should be attended for the check up | - |
####AppointmentTimeRange
| Field | Type | Constraint |Description | Example |
| --------------- | ------------- | ------------ |------------ | -------- |
| date | Date | Required | The date of the appointment | - |
| from | String | Required | The time from which the insured person is available | - |
| to | String | Required | The time until which the insured person is available | - |
####AppointmentResponse
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| id | String | Required | The id of the appointment response | - |
| responseDate | Date | Required | The date and Time of the appointment suggested | - |
| modifiedDate | Date | Required | Modification date of the appointment response | - |
| status | Property | Required | The status of the appointment response | 110=pending,111=accepted,112=rejected |
| provider | String | Required | The provider suggesting the appointment response | - |
| createdBy | String | Required | The user creating the appointment response | - |
| name | String | Required | The name of the medical center or doctor the insured person should be attended | "ΥΓΕΙΑ" |
| address | Address | Required | The address information of the medical center or doctor the insured person should attend to (*see Address entity*)| - |
| notes | List[String] | Optional | Optional extra information | - |
####Address
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| code | String | Required | The postal code | "15341" |
| city | String | Required | The city | "ΑΘΗΝΑ" |
| district | String | Required | the district | "ΜΑΡΟΥΣΙ" |
| streetName | String | Required | The street name | "ΕΡΥΘΡΟΥ ΣΤΑΥΡΟΥ" |
| streetNo | String | Required | The street number | "4" |
####Appointment
| Field | Type | Constraint |Description | Example |
| --------------- | ------------- | ------------ |------------ | -------- |
| date | Date | Required | The date and time of the appointment | - |
| modifiedDate | Date | Required | Modification date of the appointment | - |
| createdDate | Date | Required | The date the appointment was created in the system| - |
| status | Property | Required | The status of the appointment | 100=created,101=missed,102=visited,103=fixed,104=rejected |
| createdBy | String | Required | The user created the appointment | - |
| notes | List[String] | Optional | Optional extra information | - |
### Provider Services
### findAppointmentRequest
Return an appointment request
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| requestId | String | Required | The id of Appointment Request| - |
####Output
| Field | Type |Description | Example |
| ------------- | ------------- |------------ | -------- |
| id | String | The id of the appointment request | - |
| city | String | The city of the insured person | - |
| district | String | The district of the insured person | - |
| requestDates | List[ AppointmentTimeRange] | (*see AppointmentTimeRange entity*) | - |
| responses | List[AppointmentResponse] | (*see AppointmentResponse entity*) | - |
| medical | MedicalAppointmentRequestType | The medical appointment information | - |
| notes | List[String] | Optional extra information | - |
### Example
####Input
```
64f88b616506fe7ea9b78db7
```
####Output
```
64f88b616506fe7ea9b78db7
2023-09-06
{titleUp=ΑΡΚΑΔΙΑ}
ΑΓΙΟΣ ΠΕΤΡΟΣ
2023-09-06
0:00
24:00
2023-09-06
0:00
24:00
Αγγειοχειρουργός
11752638
116
13395302
12147751
ΑΓΓΕΛΙΝΑ ΜΠΟΥΝΤΑΛΗ
6945386785
Cholera
```
### listAppointmentRequests
Return an appointment request for different criteria.
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| hasAppointment | Boolean | Optional | if this request has an appointment | - |
| day | Date | Optional | Request day to search | - |
| lobCode | String | Optional | the line of bussiness | 410 |
####Output
| Field | Type |Description | Example |
| ------------- | ------------- |------------ | -------- |
| id | String | The id of the appointment request | - |
| city | String | The city of the insured person | - |
| district | String | The district of the insured person | - |
| requestDates | List[ AppointmentTimeRange] | (*see AppointmentTimeRange entity*) | - |
| responses | List[AppointmentResponse] | (*see AppointmentResponse entity*) | - |
| medical | MedicalAppointmentRequestType | The medical appointment information | - |
| notes | List[String] | Optional extra information | - |
### Example
####Input
```
410
false
```
####Output
```
5e5f875f5ec22d624fe525db
ΑΘΗΝΑ
ΒΟΥΛΑ
2020-03-08
9:15
16:45
2020-03-09
9:15
16:45
ΔΙΚΤΥΟ ΔΙΑΓΝΩΣΤΙΚΩΝ CALL NET
+CjxkYzpjcmVhdG9yPjxyZGY6U2VxPjxyZGY6bGk+SW9hbm5hIE50YWtvdTwvcmRmOmxpPj
11314676
116
11806233
11302807
ΕΛΕΥΘΕΡΙΟΣ ΦΛΩΡΟΣ
6989831633
```
### addAppointmentResponse
Create an appointment response. User is not allowed to add appointment responses for request with an appointment already created.
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| requestId | String | Required | The id of Appointment Request| - |
| responseDate | Date | Required | The date of the appointment suggested | - |
| provider | String | Required | The provider suggesting the appointment response | - |
| name | String | Required | The name of the medical center or doctor the insured person should be attended | "ΥΓΕΙΑ" |
| address | Address | Required | The address information of the medical center or doctor the insured person should attend to (*see Address entity*)| - |
| notes | List[String] | Optional | Optional extra information | - |
####Output
| Field | Type |Description | Example |
| ------------- | ------------- |------------ | -------- |
| id | String | The id of the appointment response | - |
###Example
####Input
```
5de783c53d4bad6bf379d6f2
2019-12-23 10:00:00
healthwatch
ΥΓΕΙΑ
15123
ΑΘΗΝΑ
ΜΑΡΟΥΣΙ
ΕΡΥΘΡΟΥ ΣΤΑΥΡΟΥ
4
διαθεσιμο ραντεβου
```
####Output
```
5e187782f298b6d2446f189a
```
### deleteAppointmentResponse
Delete an appointment response
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| responseId | String | Required | The id of Appointment Response| - |
###Example
####Input
```
5dbafb66162d694f513f5188
```
### findAppointmentResponses
Return all appointment responses for an appointment request
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| requestId | String | Required | The id of Appointment Request| - |
####Output
| Field | Type |Description | Example |
| ------------- | ------------- |------------ | -------- |
| id | String | The id of Appointment Response| - |
| responseDate | Date | The date and time of the appointment suggested | - |
| provider | String | The provider suggesting the appointment response | - |
| notes | List[String] | Optional extra information | - |
| name | String | The name of the medical center or doctor the insured person should be attended | "ΥΓΕΙΑ" |
| address | Address | The address information of the medical center or doctor the insured person should attend to (*see Address entity*)| - |
| status | Property | The status of the response | 111 - accept, 112 - reject, 110 - pending |
###Example
####Input
```
5de783c53d4bad6bf379d6f2
```
####Output
```
5de7852d3d4bad6bf379d6f4
2019-12-23 10:00:00
healthwatch
111
accept
ΥΓΕΙΑ
15123
ΑΘΗΝΑ
ΜΑΡΟΥΣΙ
ΕΡΥΘΡΟΥ ΣΤΑΥΡΟΥ
4
διαθεσιμο ραντεβου
```
### listAppointmentResponses
Return all appointment responses for an appointment request
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| provider | String | Optional | The provider suggesting the appointment response | - |
| createdBy | String | Optional | The user that created the response | - |
| status | Property | Optional | The status of the response | - |
####Output
| Field | Type | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| id | String | The id of Appointment Response| - |
| responseDate | Date | The date and time of the appointment suggested | - |
| provider | String | The provider suggesting the appointment response | - |
| notes | List[String] | Optional extra information | - |
| status | Property | The status of the response | 111 - accept, 112 - reject, 110 - pending |
###Example
####Input
```
ws-medical
```
####Output
```
5de7852d3d4bad6bf379d6f4
2019-12-23 10:00:00
healthwatch
111
accept
ΥΓΕΙΑ
15123
ΑΘΗΝΑ
ΜΑΡΟΥΣΙ
ΕΡΥΘΡΟΥ ΣΤΑΥΡΟΥ
4
διαθεσιμο ραντεβου
```
### updateAppointmentResponseStatus
Update the status of an appointment response. User is not allowed to update the status of a response if an appointment is already created.
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| responseId | String | Required |The id of Appointment Response| - |
| status | Property | Required | The new status of Appointment Response| - |
###Example
####Input
```
5dbafb66162d694f513f5188
112
reject
```
### addAppointmentResponseNote
Add a note to an appointment response
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| responseId | String | Required |The id of Appointment Response| - |
| note | String | Required | The note with the extra information | - |
###Example
####Input
```
5dbc28c73d4b0a8b50277b88
take a note
```
### createAppointment
Create a new appointment. User is not allowed to create an appointment if it already exists.
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| responseId | String | Required |The id of Appointment Response| - |
###Example
####Input
```
5dbafbfc162d694f513f518b
```
### updateAppointmentStatus
Update the status of an appointment
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| requestId | String | Required | The id of Appointment Request| - |
| status | Property | Required |The new status of Appointment Response| - |
###Example
####Input
```
5dbafaa1162d694f513f5184
102
visited
```
### listAppointments
####Input
| Field | Type | Constraint | Description | Example |
| ------------- | ------------- | ------------ | -------- |
| createdBy | String | Required | The user created the appointment | - |
####Output
| Field | Type | Description | Example |
| ------------- | ------------- | -------- |
| requestId | String | The id of Appointment Request| - |
| date | Date | The date and time of the appointment | - |
| appointmentTime| String | The time of the appointment| - |
| createdDate | Date | The date the appointment was created | - |
| status | Property | The status of the appointment | - |
| createdBy | String | The user that created the appointment| - |
| notes | List[String] | The notes of the appointment| - |
###Example
####Input
```
ws-medical
```
####Output
```
5de658283d4b44eb98f830d7
2019-12-20 08:00:00
2019-12-03
100
created
ws-medical
```
### addAppointmentNote
Add a note to an Appointment
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| requestId | String | Required | The id of Appointment Request| - |
| note | String | Required | The note with the extra information | - |
###Example
####Input
```
5dbafaa1162d694f513f5184
this appointment needs a note
```
### createAppointmentByPhone
Create appointment when communication with customer is exclusively by phone.
####Input
| Field | Type | Constraint |Description | Example |
| ------------- | ------------- | ------------ |------------ | -------- |
| city | String | Required | The city of the customer| - |
| district | String | Required | The district of the customer | - |
| provider | String | Required | The provider | - |
| hospital | String | Optional | The hospital the customer requests the appointment | - |
| doctorSpecialty | String | Optional | The doctor specialty the customer requests the appointment | - |
| checkUp | CheckUp | Optional | The check up the customer requests the appointment | - |
| policyCode | String | Required | The policy number of the customer | - |
| claimantLabel | String | Required | The customer number | - |
| claimantName | String | Required | The name of the customer | - |
| claimantPhone | String | Required | The phone of the customer | - |
| collaborator | String | Required | The collaborator with whom the appointment will be scheduled | - |
| address | Address | Required | The address information of the medical center or doctor the insured person should attend to (*see Address entity*)| - |
| note | String | Optional | The note with some extra information | - |
###Example
####Input
```
ΑΘΗΝΑ
ΠΑΓΚΡΑΤΙ
CALLNET
ΥΓΕΙΑ
123456
123456789
ΜΑΡΙΑ ΠΑΠΠΑ
6938755233
ΥΓΕΙΑ
215369
ΑΘΗΝΑ
ΜΑΡΟΥΣΙ
ΕΡΥΘΡΟΥ ΣΤΑΥΡΟΥ
4
2020-01-20 10:00:00
επικοινωνία με πελάτη μετά τις 10.00
```