All endpoints accept POST with a gzip-compressed JSON body and require both auth headers (Authorization and x-api-key).
POST /v1/review
Primary endpoint. Submit a bill and receive a full pricing decision with RuleTrace™ calculation detail.
POST /v1/validate
Verify that the codes on the bill are valid, as well as determine which state the bill should be reviewed in.
POST /v1/facility
Return a list of hospitals or outpatient/surgery centers to select from in order to accurately price the bill.
POST /v1/duplicates
Determine if any of the service lines are duplicates or potential duplicates.
POST /v1/customcodes
Get a list of custom codes not included in the CPT/HCPCS list, but still sometimes required to accurately review a bill.
All paths are appended to your API Endpoint URL — e.g. {your_api_endpoint}/v1/review.
Request Body — Bill Review
The /v1/review endpoint accepts a JSON object describing the bill. Contact BillSentry for the full request schema specific to your bill types.
{
"controlNumber": "string", // Your internal claim/bill identifier
"billType": "professional", // "professional" | "institutional" | "dental"
"jurisdiction": "CA", // Two-letter state code (e.g. "CA", "NY", "TX")
"providerTaxId": "123456789", // Provider federal tax ID (no dashes)
"providerZip": "90210", // Provider ZIP code (used for GPCI locality)
"lines": [
{
"lineNumber": 1,
"cpt": "99213", // CPT / HCPCS procedure code
"serviceDate": "2025-07-15", // ISO 8601 date
"charge": 175.00, // Billed charge amount
"units": 1 // Units / quantity
}
]
}
Response Structure
A successful review returns HTTP 200 with a JSON body.
{
"qrCodeID": "3868-4256",
"qrCodeURL": "https://app.billsentry.net/ID/3868-4256",
"logHTML": "<html>...</html>", // Full RuleTrace™ HTML report (Bootstrap 5)
"bill": {
"billReviewState": "CA",
"isPriorAuthorizationRequired": false,
"totalCharge": 82033.40,
"totalAllowance": 42150.11,
"totalReduction": 39883.29,
"fromServiceDate": "2025-07-14T00:00:00Z",
"toServiceDate": "2025-07-15T00:00:00Z",
"processedDate": "2026-04-06T14:44:16Z",
"bucketTotalList": [ /* bucket-level totals */ ],
"bucketList": [ /* rule trace bucket entries */ ]
},
"services": [
{
"lineNumber": 1,
"cpt": "99213",
"charge": 175.00,
"allowance": 107.90,
"reduction": 67.10,
"reasonCodesDTO": {
"reasonCodes": [
{ "code": "1391", "description": "The total inpatient allowance has been calculated..." },
{ "code": "CARC-P12", "description": "Workers' compensation jurisdictional fee schedule adjustment." }
]
},
"bucketTotalList": [ /* service-level bucket totals */ ],
"bucketList": [ /* service-level rule trace */ ]
}
]
}
Key response fields
| Field | Description |
|---|
qrCodeID | Unique review identifier. Use for audit trails and dispute tracking. |
qrCodeURL | Shareable link to the hosted RuleTrace™ report |
logHTML | Self-contained Bootstrap 5 HTML report showing full calculation logic |
bill.totalAllowance | Total approved reimbursement for the bill |
bill.totalReduction | Total reduction from billed charges |
services[].allowance | Approved reimbursement per service line |
services[].reasonCodesDTO.reasonCodes | Reason codes explaining the pricing decision |
