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Accepts the same JSON request body as POST /api/claim/professional/v1. The server matches on key fields to update each related entity (Claim, Patient, Provider, etc.) You should use this endpoint when you’ve already sent a claim through POST /api/claim/professional/v1 and you want to make modifications to any part of the claim.

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Pre-flight Validation

Before processing the transaction, the server verifies that each target resource already exists for the provided identifier(s).
If no resource matches any required lookup, the API returns a 404.

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Fields Used to Determine Which Existing FHIR Resource Is Updated

  • Claim:
    Uses id (claim control / CMS id) — the Cair claim id identifier.
  • Patient:
    Uses patient.id (provider patient id) as the Cair provider-patient identifier;
    OR, if patient.id is absent, uses first_name, last_name, and dob to resolve to a unique patient.
  • Service Location:
    When service_location is present, uses service_location.name.
  • Billing Provider:
    Uses both billing_provider.npi and billing_provider.tax_id (NPI + EIN identifiers).
  • Rendering Provider:
    Uses rendering_provider.npi.
  • **Payer Organization **:
    Uses insurance_plan.payer_id on each policy (EDI payer identifier).
  • Coverage:
    Matched server-side to existing coverage for the patient using the policy’s group and member (num / id); the update targets the matched Coverage/{id} on the server.
Note:
The optional query parameter attachmentId behaves the same as for POST.
This links DocumentReference resources to the claim.