接口名称: 理赔接口

接口地址: http://way.sddep.com/api/insurance/settlement

请求方式: POST

返回格式: JSON

请求参数(Headers):

参数名称	类型	长度限制	是否必填	参数说明
Content-Type	String	50	是	application/json
appKey	String	200	是	调用令牌信息
appCode	String	200	是	调用令牌信息

请求参数(Body):

参数名称	类型	长度限制	是否必填	参数说明
appkey	string	200	是	个人appkey，请在账户管理，安全设置下查看
timestamp	string	200	是	当前时间时间戳
sign	string	200	是	签名
businessTransaction	String	300	是	交易流水号
timestamp	String	50	是	交易发送时间
data	object	1000	是	业务属性，包含下属所有字段
insurerId	String	20	是	保司编码
investigateHospital	String	50	是	医院代码
treatBeginDate	String	50	是	查询开始时间，闭区间
treatEndDate	String	50	是	查询结束时间，闭区间
insuredCertType	String	10	是	被保险人证件类型
insuredCertNo	String	50	是	被保险人证件号码
insuredName	String	10	是	被保险人姓名
businessType	String	10	是	业务类型（验真、历史核保、调查等）
authNo	String	50	是	授权标识号，包括但不限于投保单号、保单号、理赔业务号等

返回参数说明:

参数名称	类型	长度限制	标签	参数说明
code	String	10	status	响应码
msg	String	200	message	响应描述
data	object	1000	data	响应业务数据，包括businessTransaction、positive、jzjs、zdxx、jsmx、ylfyfxzc、tcfdxx

正确返回示例:

{
  "status": "2818",
  "message": "success",
  "data": {
    "businessTransaction": "1200175833142514",
    "positive": "true",
    "jzjs": {
      "patientNo": "2023061312547",
      "visitType": "住院",
      "patientName": "张三",
      "admissionNo": "0205414",
      "orgCode": "493000673",
      "orgName": "济南市中心医院",
      "admissionTime": "2023-06-13 09:13:12",
      "dischargeTime": "2023-06-20 11:25:45",
      "visitingDeptCode": "A03.02",
      "visitingDeptName": "消化内科专业",
      "insuranceNo": "370102197512141001",
      "insurTypeCode": "城镇职工基本医疗保险",
      "inpatDays": "7",
      "settleNo": "2023061900154",
      "insurSettleNo": "110121546134651",
      "chargeTot": "6280.28",
      "insuranceFund": "4367.62",
      "chargeSelf": "1912.66",
      "invoiceTypeCode": "37060221",
      "invoiceNo": "0000335713",
      "checkCode": "845237",
      "settleDate": "2023-06-20",
      "socialCreditCode": "370725195108175412"
    },
    "zdxx": [
      {
        "diagnosisTypeCode": "32",
        "diagnosisMainCode": "K29.100x001",
        "diagnosisName": "急性胃炎",
        "diagnosisDate": "2023-06-13",
        "isMainFlag": "0",
        "diagnosisId": "0"
      },
      {
        "diagnosisTypeCode": "35",
        "diagnosisMainCode": "K29.100x001",
        "diagnosisName": "急性胃炎",
        "diagnosisDate": "2023-06-20",
        "isMainFlag": "1",
        "diagnosisId": "1"
      }
    ],
    "jsmx": [
      {
        "chargeItemTypeCode": "12",
        "chargeItemTypeName": "床位费",
        "insurChargeTypeCode": "07",
        "insurChargeTypeName": "服务设施",
        "projectCode": "0000001",
        "projectName": "床位费（四人及以上间）",
        "insuranceProjCode": "0000001",
        "insuranceProjName": "床位费",
        "projectSpec": "/",
        "projectNum": "7",
        "projectPrice": "50.00",
        "itemUnit": "床日",
        "projectTotAmt": "350.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "08",
        "chargeItemTypeName": "检验费",
        "insurChargeTypeCode": "02",
        "insurChargeTypeName": "检验",
        "projectCode": "0000002",
        "projectName": "粪便沉渣分析加收",
        "insuranceProjCode": "000002",
        "insuranceProjName": "大便常规",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "10.00",
        "itemUnit": "次",
        "projectTotAmt": "10.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "08",
        "chargeItemTypeName": "检验费",
        "insurChargeTypeCode": "02",
        "insurChargeTypeName": "检验",
        "projectCode": "0000003",
        "projectName": "纤维蛋白（原）降解产物测定（FDP）（仪器法）",
        "insuranceProjCode": "00000003",
        "insuranceProjName": "纤维蛋白降解产物测定",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "100.00",
        "itemUnit": "项",
        "projectTotAmt": "100.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "08",
        "chargeItemTypeName": "检验费",
        "insurChargeTypeCode": "02",
        "insurChargeTypeName": "检验",
        "projectCode": "0000004",
        "projectName": "葡萄糖测定",
        "insuranceProjCode": "0000004",
        "insuranceProjName": "葡萄糖测定",
        "projectSpec": "/",
        "projectNum": "35",
        "projectPrice": "8.00",
        "itemUnit": "项",
        "projectTotAmt": "280.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "07",
        "chargeItemTypeName": "检查费",
        "insurChargeTypeCode": "03",
        "insurChargeTypeName": "检查",
        "projectCode": "00000005",
        "projectName": "心脏彩色多普勒超声",
        "insuranceProjCode": "00000005",
        "insuranceProjName": "心脏彩色多普勒超声",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "150.00",
        "itemUnit": "次",
        "projectTotAmt": "150.00",
        "selfPayRatio": "0.2",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "07",
        "chargeItemTypeName": "检查费",
        "insurChargeTypeCode": "03",
        "insurChargeTypeName": "检查",
        "projectCode": "00000006",
        "projectName": "神经传导速度测定",
        "insuranceProjCode": "00000006",
        "insuranceProjName": "肌电图",
        "projectSpec": "/",
        "projectNum": "6",
        "projectPrice": "50.00",
        "itemUnit": "每条",
        "projectTotAmt": "300.00",
        "selfPayRatio": "0.2",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "02",
        "chargeItemTypeName": "西药费",
        "insurChargeTypeCode": "01",
        "insurChargeTypeName": "药品",
        "projectCode": "00000007",
        "projectName": "0.9%氯化钠注射液（250ml:2.25g）",
        "insuranceProjCode": "00000007",
        "insuranceProjName": "氯化钠注射液",
        "projectSpec": "250ml:2.25g",
        "projectNum": "8",
        "projectPrice": "6.47",
        "itemUnit": "袋",
        "projectTotAmt": "51.76",
        "selfPayRatio": "0.4",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "08",
        "chargeItemTypeName": "检验费",
        "insurChargeTypeCode": "02",
        "insurChargeTypeName": "检验",
        "projectCode": "0000008",
        "projectName": "检验费其他",
        "insuranceProjCode": "0000008",
        "insuranceProjName": "检验费其他",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "1693.90",
        "itemUnit": "次",
        "projectTotAmt": "1693.90",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "07",
        "chargeItemTypeName": "检查费",
        "insurChargeTypeCode": "03",
        "insurChargeTypeName": "检查",
        "projectCode": "00000009",
        "projectName": "检查费其他",
        "insuranceProjCode": "00000009",
        "insuranceProjName": "检查费其他",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "1205.00",
        "itemUnit": "项",
        "projectTotAmt": "1205.00",
        "selfPayRatio": "0.2",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "02",
        "chargeItemTypeName": "西药费",
        "insurChargeTypeCode": "01",
        "insurChargeTypeName": "药品",
        "projectCode": "00000010",
        "projectName": "药品费其他",
        "insuranceProjCode": "00000010",
        "insuranceProjName": "药品费其他",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "335.39",
        "itemUnit": "盒",
        "projectTotAmt": "335.39",
        "selfPayRatio": "0.4",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "16",
        "chargeItemTypeName": "治疗费",
        "insurChargeTypeCode": "04",
        "insurChargeTypeName": "治疗",
        "projectCode": "00000011",
        "projectName": "Ⅱ级护理",
        "insuranceProjCode": "00000011",
        "insuranceProjName": "Ⅱ级护理",
        "projectSpec": "/",
        "projectNum": "7",
        "projectPrice": "30.00",
        "itemUnit": "日",
        "projectTotAmt": "210.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "16",
        "chargeItemTypeName": "治疗费",
        "insurChargeTypeCode": "04",
        "insurChargeTypeName": "治疗",
        "projectCode": "00000012",
        "projectName": "治疗费其他",
        "insuranceProjCode": "00000012",
        "insuranceProjName": "治疗费其他",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "1088.00",
        "itemUnit": "次",
        "projectTotAmt": "1088.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "20",
        "chargeItemTypeName": "材料费",
        "insurChargeTypeCode": "06",
        "insurChargeTypeName": "医用耗材",
        "projectCode": "00000013",
        "projectName": "延长管（一次性使用输注避光泵用管路）",
        "insuranceProjCode": "00000013",
        "insuranceProjName": "延长管",
        "projectSpec": "YB-20B/5",
        "projectNum": "8",
        "projectPrice": "27.00",
        "itemUnit": "支",
        "projectTotAmt": "216.00",
        "selfPayRatio": "0",
        "remark": ""
      },
      {
        "chargeItemTypeCode": "20",
        "chargeItemTypeName": "材料费",
        "insurChargeTypeCode": "06",
        "insurChargeTypeName": "医用耗材",
        "projectCode": "00000014",
        "projectName": "材料费其他",
        "insuranceProjCode": "00000014",
        "insuranceProjName": "医用耗材其他",
        "projectSpec": "/",
        "projectNum": "1",
        "projectPrice": "290.23",
        "itemUnit": "套",
        "projectTotAmt": "290.23",
        "selfPayRatio": "0",
        "remark": ""
      }
    ],
    "ylfyfxzc": [
      {
        "insurChargeTypeCode": "01",
        "insurChargeTypeName": "药品",
        "selfFund": "0.00",
        "partialSelfFund": "15.90",
        "partialAmountFund": "301.01",
        "fullAmountFund": "70.24",
        "chargeTot": "387.15",
        "remark": ""
      },
      {
        "insurChargeTypeCode": "02",
        "insurChargeTypeName": "检验",
        "selfFund": "0.00",
        "partialSelfFund": "0.00",
        "partialAmountFund": "0.00",
        "fullAmountFund": "2083.90",
        "chargeTot": "2083.90",
        "remark": ""
      },
      {
        "insurChargeTypeCode": "03",
        "insurChargeTypeName": "检查",
        "selfFund": "30.00",
        "partialSelfFund": "96.00",
        "partialAmountFund": "864.00",
        "fullAmountFund": "665.00",
        "chargeTot": "1655.00",
        "remark": ""
      },
      {
        "insurChargeTypeCode": "04",
        "insurChargeTypeName": "治疗",
        "selfFund": "0.00",
        "partialSelfFund": "0.00",
        "partialAmountFund": "0.00",
        "fullAmountFund": "1298.00",
        "chargeTot": "1298.00",
        "remark": ""
      },
      {
        "insurChargeTypeCode": "06",
        "insurChargeTypeName": "医用耗材",
        "selfFund": "0.00",
        "partialSelfFund": "0.00",
        "partialAmountFund": "0.00",
        "fullAmountFund": "506.23",
        "chargeTot": "506.23",
        "remark": ""
      },
      {
        "insurChargeTypeCode": "07",
        "insurChargeTypeName": "服务设施",
        "selfFund": "0.00",
        "partialSelfFund": "0.00",
        "partialAmountFund": "0.00",
        "fullAmountFund": "350.00",
        "chargeTot": "350.00",
        "remark": ""
      }
    ],
    "tcfdxx": [
      {
        "insurTypeCode": "0",
        "insurTypeName": "起付线",
        "inInsurCharge": "1000.00",
        "medAmount": "0.00",
        "chargeSelf": "1000.00",
        "selfPayRatio": "0",
        "chargeLower": "0.01",
        "chargeUpper": "1000.00"
      },
      {
        "insurTypeCode": "1",
        "insurTypeName": "基本统筹",
        "inInsurCharge": "5138.38",
        "medAmount": "4367.62",
        "chargeSelf": "770.86",
        "selfPayRatio": "0.85",
        "chargeLower": "0.01",
        "chargeUpper": "9000.00"
      },
      {
        "insurTypeCode": "2",
        "insurTypeName": "大额统筹",
        "inInsurCharge": "0.00",
        "medAmount": "0.00",
        "chargeSelf": "0.00",
        "selfPayRatio": "0.88",
        "chargeLower": "9000.01",
        "chargeUpper": "400000.00"
      }
    ]
  }
}

返回码	说明
10001	错误的请求appkey
10004	URL上appkey参数不能为空
10010	接口有效期已过，请充值
10011	接口有效次数已用尽，请充值
10020	系统繁忙，请稍后再试
11010	接口调用异常，请稍后再试
11030	接口返回格式有误
10404	第三方服务返回404
404	API网关处理过程中发生错误 [GET http://xxx.xx.xxx.xx/]: 404 NOT_FOUND
500	API网关处理过程中发生错误 [GET http://xxx.xx.xxx.xx/]:500 xxxxx
10002	您的IP不具备使用该商品的权限，请联系相关人员添加相应权限
10021	请求失效！
10022	重复请求！
10023	签名参数填写错误
10024	请求失效,请检查参数
10025	签名认证失败

返回码	说明
200	返回成功
400	请求参数错误
401	权限错误
403	禁止访问
404	资源找不到
500	服务器内部错误，请联系管理员