Upcoming Changes to Claim Actions and Claim Inquiry APIs

This communication outlines upcoming changes to the Real Claim Actions API (SubmitClaimTicket) and Real Claim Inquiry API (Get Claim Line Actions).

Please review the details below and assess any required updates to your systems.

Real Claim Actions API (SubmitClaimTicket)

For ticket type RECON (Reconsideration), the providerComments field will become required.

June 5, 2026 (Sandbox) and June 10, 2026 (Production):The providerComments field will be required for all RECON submissions.
Requests submitted without providerComments for ticket type RECON will not be processed/fail.

Real Claim Inquiry API (Get Claim Line Actions)

The allowedReconsiderationReasons field is being deprecated.

June 5, 2026 (Sandbox) and June 10, 2026 (Production):The field will be marked as deprecated.
August 17, 2026 (Production):The field will return no values and will no longer be supported.

Action Required

To ensure uninterrupted processing, please update your implementations as follows:

Real Claim Actions API (SubmitClaimTicket)- Include providerComments when submitting RECON ticket types starting June 5, 2026 (Sandbox) and June 10, 2026 (Production).
Real Claim Inquiry API (Get Claim Line Actions)- Remove dependency on allowedReconsiderationReasons prior to August 17, 2026.