canonical: https://jentic.com/apis/curacel.co/curacel

# Curacel Health Developer API

The Curacel Health API submits health insurance claims to insurers for auto-adjudication and manages the records around them. It lets electronic medical record systems and insurer platforms create claims, raise pre-authorization requests, register enrollees, and look up their benefits and utilisation. Insurer plans, plan benefits, providers, and encounters round out a workflow that moves a claim from submission to a tracked decision.

## For AI agents

Submit health insurance claims to insurers and track their adjudication: raise pre-authorization requests, register enrollees, and check benefits and utilisation. Configure insurer plans, plan benefits, providers, and encounters.

## Scope

Does not handle appointment scheduling, clinical charting, or pharmacy dispensing. Use for health insurance claims, pre-authorization, and enrollee administration only.

## Capabilities

- Submit health insurance claims to insurers for auto-adjudication
- Create and track pre-authorization requests and their decisions
- Register and update enrollees, including facial verification and check-ins
- Look up an enrollee's benefits and utilisation over a period
- Configure insurer plans, plan benefits, and care-type mappings
- List providers, encounters, and active insurer clients

## Use cases

### Agent-Submitted Insurance Claims

An AI agent embedded in an electronic medical record system can file claims through Jentic without a developer wiring the calls: it creates a claim for an enrollee, links supporting attachments, and reads the claim's details to confirm it reached the insurer for adjudication. The same flow surfaces pre-authorization status so the agent knows whether a procedure is covered before submitting.

Example prompt: Create a claim for an enrollee, link a supporting attachment, and fetch the claim details to confirm it was received

### Pre-Authorization Workflows

Providers often need approval before delivering a procedure, and Curacel handles the round trip. A pre-authorization request is created against an enrollee and plan, and its status can be polled until the insurer approves or declines. This lets a clinic confirm coverage up front and attach the authorization to the eventual claim.

Example prompt: Create a pre-authorization request for a procedure and retrieve its approval status

### Enrollee Benefits and Eligibility

Before treatment, staff need to know what an enrollee's plan covers and how much they have already used. Curacel returns an enrollee's benefits and sums their utilisation over a period, so an agent can confirm remaining coverage and the right plan benefit before a claim is filed.

Example prompt: Fetch an enrollee's benefits and sum their utilisation over the current period to confirm remaining coverage

## Key endpoints

| Method | Path | Description |
| --- | --- | --- |
| POST | `/v1/claims` | Create a claim |
| GET | `/v1/claims` | Fetch a list of claims |
| GET | `/v1/claims/{id}` | Get the details of a single claim |
| POST | `/v1/pa-requests` | Create a pre-authorization request |
| POST | `/v1/enrollees` | Create or update an enrollee |
| GET | `/v1/encounters` | List encounters |
| GET | `/v1/providers` | Get providers |

## Key resources

- **Claims** — Create claims, list them, fetch details, and link attachments for adjudication.
- **Pre-authorization Requests** — Create pre-authorization requests and read their approval status.
- **Enrollees** — Register and update enrollees, verify them, and read benefits and utilisation.
- **Insurer Plans** — Configure plans, plan benefits, diagnoses, and care-type mappings.
- **Providers and Encounters** — List providers, read provider details, and list encounters.

## AI readiness

This API is usable in Jentic One now. Its AI-readiness score against Jentic's framework shows where it stands today and where improvements would make it even easier for agents to use.

- **Score:** 56 / 100
- **Maturity:** Foundational
- **Dimensions:**
  - Foundational Compliance: 48 / 100
  - Developer Experience & Jentic Compatibility: 63 / 100
  - AI-Readiness & Agent Experience: 39 / 100
  - Agent Usability: 94 / 100
  - Security: 60 / 100
  - AI Discoverability: 72 / 100
- **View full report:** https://jentic.com/apis/curacel.co/curacel/scorecard
- **How the score is calculated:** https://docs.jentic.com/reference/api-readiness-framework/overview/
- **More about the dimensions:** https://docs.jentic.com/reference/api-readiness-framework/specification/#dimensional-model-overview

### Score it yourself

Every API in the directory is allowlisted, so you can re-score it with no key required.

- **Score your own API:** https://jentic.com/scorecard.md
- **Scoring CLI agent skill:** https://github.com/jentic/jentic-api-scorecard/blob/main/skills/jentic-api-scorecard/SKILL.md

```sh
npx @jentic/api-scorecard-cli score <openapi-url>
```

## Why Jentic

- **Setup:** Wiring the Curacel Health API by hand means handling its bearer token, the login exchange for a temporary access token, and the split between its production and sandbox hosts. Through Jentic you install once, import Curacel from the API Directory, store the token once, and your agent calls it.
- **Permission scoping:** Curacel puts the claim id, enrollee id, and plan id in the URL path, so a rule can pin your agent to the claim and enrollee reads and writes it needs. Destructive operations like attachment deletion or enrollee status changes stay out of that set unless you add them.
- **Credential handling:** Your Curacel token is stored once, encrypted, by your own Jentic One instance and injected at execution time. It never enters the agent's prompt, logs, or context.
- **Discovery method:** Agents search Jentic by intent such as 'file a claim' or 'check enrollee benefits', and Jentic returns the matching Curacel operation with its input schema so the agent calls the right endpoint without browsing the reference docs.

## Related APIs

- **Claim.MD** — US medical claims clearinghouse for submitting and tracking claims to payers.
- **Availity** — Payer connectivity and claims clearinghouse for eligibility, claims, and remittances.
- **DrChrono** — Electronic health records and practice management that produce the clinical data a claim references.

## FAQ

### What authentication does the Curacel Health API use?

The Curacel Health API authenticates with a bearer token per its OpenAPI spec: you send an Authorization header carrying the API key from your account dashboard, and you can exchange login credentials for a temporary access token through the auth endpoint. Through Jentic the token is stored once, encrypted, by your own Jentic One instance and injected at call time.

### Can I submit insurance claims with the Curacel Health API?

Yes. You can create a claim for an enrollee, link supporting attachments to it, list claims, and fetch a single claim's details to track adjudication. Pre-authorization requests and enrollee benefit lookups round out the claims workflow.

### What are the rate limits for the Curacel Health API?

The OpenAPI spec does not define rate limits for the Curacel Health API. Check the Curacel documentation at https://docs.curacel.co for current limits.

### Is there a Curacel MCP server?

You don't need an MCP server to connect your agent to the Curacel Health API. Jentic imports it directly from the API Directory: store your key once and your agent can submit claims, create pre-authorization requests, and look up enrollee benefits. Operations are discovered on demand without loading another server's tool definitions into context.

### Can I limit what my agent is allowed to do with the Curacel Health API?

Yes. Write a rule that allows only the operations the task needs, such as creating claims and reading claim details, so destructive operations like deleting attachments or changing enrollee status are not included unless you add them. Every call the agent makes is logged.

### How do I submit a claim with the Curacel Health API through Jentic?

Search Jentic for 'submit a health insurance claim', and it returns the matching Curacel operations with their input schemas. Your agent creates the claim, links any attachments, and reads the claim details to confirm receipt. To run it on your own infrastructure, install Jentic One from its GitHub repo.