Print JSON Specification
Outlines the print JSON specification used to print statements/letters with print vendor
Updated at April 13th, 2025
The following outlines the specifications of the print JSON that is sent from PatientPay to print vendors to print statements and letters sent to the patient.
| Object | Field | Required | Data Type | Description |
| schema | Y | string (13) | Identifies this as a payment update file; hard-coded to "ppay-payment-updates" | |
| version | Y | string (5) | Identifies the version of the payment update file; hard-coded to current schema version of "1.0.0" | |
| statements | The statements array contains one or more statement objects separated by comma | |||
| statement | A statement object is a nested object that contains fields and nested objects pertaining to the statement or bill | |||
| statementId | Y | string (32) | This unique statementId should match an existing statementId for which bill that is being updated | |
| clientId | Y | string (10) | Unique identifier for the organization for which bill belongs to that is being updated. NOTE: Case sensitive. | |
| partnerTransactionsOnly | Y | boolean | This flag indicates whether to process the partnerTransactions array as an update instead of validating as a complete statement; it should always be true for payment updates | |
| statement.patients | The patients array contains one or more patient objects separated by the comma | |||
| patient | The patient object is a nested object that contains fields pertaining to the patient record | |||
| accountId | Y | string (55) | Uniquely identified the patient account ID for which you are updating a bill | |
| statement.partnerTransactions | The partnerTransactions array contains one or more transactions that are added/subtracted from the bill | |||
| transactionId | N | string (55) | A unique identifier for each transaction | |
| transactionDate | Y | date | The date of the transaction in the format YYYY-MM-DD. | |
| transactionAmt | Y | Amount of transaction to be recorded in system. The amount should be negative if deducting from the bill and positive if adding to the bill. Transaction amount cannot be greater than bill amount. | ||
| transactionDesc | N | string | Description for the transaction | |
| payerId | N | string (10) | Identifies the payer from the payer table, if applicable. Pass null if not providing a value | |
| transactionType | N | string | Specifies the type of transaction (“SALE” or “DEBIT”); default is “DEBIT” if not provided | |
| transactionPaymentMethodType | Y | string | Specifies payment method (“CARD” or “CHECK”); Use "CHECK" for lockbox payment | |
| transactionSource | N | string | Specifies the source of the payment. Use "LOCKBOX" for lockbox payment | |
Example Print JSON:
{
"header": {
"totalBillCount": "4",
"totalBillAmount": 650.00,
"totalCustomerCount": "3",
"sysNumCount": "1",
"prnNumCount": "3"
},
"bills": [{
"billId": "669615",
"statementId":"202108180855",
"customerId": "506",
"partnerId": null,
"partnerName": null,
"billExpireDate": "2018-02-22",
"billUrl": "https://www.patientpay.net/console/public/code",
"billToken": "9876543210",
"statementNumber": 1,
"dunningMessage": "Thank you for your prompt payment",
"billDate": "2017-12-20",
"totalCharges": 400.00,
"totalDueAmount": 125.00,
"totalPatientPaymentsAmount": 50.0,
"payerAdjustmentTotal": 25.0,
"payerPortionTotal": 100.0,
"patientPaymentsCount": 1,
"printRules": {
"mailerId": "",
"templateID": "0002",
"serviceTypeId": "",
"groupingId": null,
"groupingName": null,
"sysNum": "7555",
"prnNum": "00020",
"logoId": "TestPracticelogo.jpeg",
"insertRule": {
"asset": "",
"envelope": "",
"envelopeStyle": ""
},
"onsertRules": [{
"asset": "TestPracticelogo.jpeg",
"location": "onsert.Location1"
},
{
"asset": "icongraph1.jpeg",
"location": "onsert.Location2"
},
{
"asset": "icongraph2.jpeg",
"location": "onsert.Location3"
},
{
"asset": "icongraph3.jpeg",
"location": "onsert.Location4"
},
{
"asset": "BackPage1.jpeg",
"location": "onsert.Location5"
}
]
},
"guarantor": {
"accountNumber": "1103",
"name": "JACK KATES",
"addressLine1": "2425 GLENDALE STREET",
"addressLine2": null,
"addressLine3": null,
"city": "CHESTER",
"state": "VA",
"region": null,
"zip": "66666",
"country": "US",
"isForeignAddress": 0
},
"practice": {
"name": "Urgent Specialty Associates",
"addressLine1": "15851 Dallas Pkwy",
"addressLine2": "STE 530",
"city": "Addison",
"state": "TX",
"zip": "75001",
"country": "US",
"email": "urgentspecialtyassociates@patientpay.net",
"phone": "(804)555-7758",
"remitAddressLine1": "P.O. BOX 268934",
"remitAddressLine2": "DEPT # 1019",
"remitCity": "OKLAHOMA CITY",
"remitState": "OK",
"remitZip": "73126-8934",
"remitCountry": "US",
"ivrPhoneNumber": null,
"locationId": null,
"locationName": "CHIPPENHAM HOSPITAL - INPATIENT"
},
"payers": [{
"payerIndex": 1,
"payerId": "791",
"name": "Primary Name",
"memberId": "M123"
},
{
"payerIndex": 2,
"payerId": "882",
"name": "Secondary Name",
"memberId": "M235"
}
],
"patients": [{
"patientId": "1234",
"accountNumber": "1103",
"name": "LANDON KEATTS",
"dob": "1970-10-04",
"phone": "8045438687",
"addressLine1": "2425 GLENDALE STREET",
"addressLine2": null,
"addressLine3": null,
"city": "CHESTER",
"state": "VA",
"region": null,
"zip": "23831",
"country": null,
"isForeignAddress": 0,
"physicianName": "Katherine Trahan",
"services": [{
"lineNumber": "1",
"claimNumber": "123",
"visitNumber": "12",
"paymentPlanStatus": "",
"serviceDate": "2017-01-11",
"serviceEndDate": null,
"serviceProvider": "Tara Woods MD",
"serviceProviderNPI": "0987654321",
"serviceCode": "70547",
"serviceDesc": "MR ANGIOGRAPHY NECK W/O DYE",
"serviceClass": "",
"charge": 200.00,
"allowedAmount": 100.0,
"amount": 100.0,
"patientDueAmount": 25.0,
"ppayCollectedAmount": 0.0,
"adjustment": 0.0,
"writeoffAmount": 0.0,
"ineligibleAmt":"100.00",
"ineligibleCode":"1234",
"payments": [{
"type": "payer",
"payerId": "791",
"coInsurance": 0.0,
"copay": 50.0,
"deductible": 50.0,
"paidAmount": 25.0,
"writeoffAmount": 0.0,
"adjustment": 25.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "payer",
"payerId": "882",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 25.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "patient",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 25.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
},
{
"lineNumber": "2",
"claimNumber": "123",
"visitNumber": "123",
"paymentPlanStatus": "",
"serviceDate": "2017-01-11",
"serviceEndDate": null,
"serviceProvider": "Tara Woods MD",
"serviceProviderNPI": "0987654321",
"serviceCode": "3100F",
"serviceDesc": "IMAGE TEST REF CAROT DIAM",
"charge": 200.00,
"allowedAmount": 200.0,
"amount": 100.0,
"patientDueAmount": 100.0,
"ppayCollectedAmount": 0.0,
"adjustment": 25.0,
"writeoffAmount": 0.0,
"ineligibleAmt":"100.00",
"ineligibleCode":"1234",
"payments": [{
"type": "payer",
"payerId": "791",
"coInsurance": 0.0,
"copay": 25.0,
"deductible": 175.0,
"paidAmount": 50.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "patient",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 25.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
}
],
"transactions": [{
"lineNumber": "",
"claimNumber": "",
"visitNumber": "",
"transactionId": "",
"transactionDate": "",
"transactiontype": "",
"transactionDesc": "",
"transactionAddDesc": "",
"paymentPlanStatus": "",
"amount": 0.0,
"payerAmounts": [{
"type": "",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "type",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
}]
}]
},
{
"billId": "769615",
"statementId":"202108180856",
"customerId": "1507",
"partnerId": null,
"partnerName": null,
"billExpireDate": "2018-10-02",
"billUrl": "https://www.patientpay.net/console/public/code",
"billToken": "PP8765432",
"statementNumber": 1,
"dunningMessage": "THIS IS AN EXAMPLE OF A Template0002 STATEMENT WHEN CLIENTS DON'T SEND PAYERID OF A TRANSACTION. Thank you for your prompt payment..",
"billDate": "2018-01-20",
"totalCharges": 200.00,
"totalDueAmount": 125.00,
"totalPatientPaymentsAmount": 25.0,
"payerAdjustmentTotal": 0.0,
"payerPortionTotal": 50.0,
"patientPaymentsCount": 1,
"printRules": {
"mailerId": "",
"templateID": "0002",
"serviceTypeId": "",
"groupingId": 7555,
"groupingName": null,
"sysNum": "1164",
"prnNum": "00010",
"logoId": "NUCarePracticelogo.jpeg",
"insertRule": {
"asset": "",
"envelope": "",
"envelopeStyle": ""
},
"onsertRules": [{
"asset": "NUCarePracticelogo.jpeg",
"location": "onsert.Location1"
},
{
"asset": "icongraph1.jpeg",
"location": "onsert.Location2"
},
{
"asset": "icongraph2.jpeg",
"location": "onsert.Location3"
},
{
"asset": "icongraph3.jpeg",
"location": "onsert.Location4"
},
{
"asset": "BackPage1.jpeg",
"location": "onsert.Location5"
}
]
},
"guarantor": {
"accountNumber": "1203",
"name": "JEFF SMITH",
"addressLine1": "1234 MAIN STREET",
"addressLine2": null,
"addressLine3": null,
"city": "DURHAM",
"state": "NC",
"region": null,
"zip": "27713",
"country": "US",
"isForeignAddress": 0
},
"practice": {
"name": "Non Urgent Care",
"addressLine1": "1234 Cary Pkwy",
"addressLine2": "STE 530",
"city": "Cary",
"state": "NC",
"zip": "27513",
"country": "US",
"email": "noturgent@patientpay.net",
"phone": "(888)555-7758",
"remitAddressLine1": "P.O. BOX 12345",
"remitAddressLine2": "DEPT # 1019",
"remitCity": "RALEIGH",
"remitState": "NC",
"remitZip": "27560-1234",
"remitCountry": "US",
"ivrPhoneNumber": null,
"locationId": null,
"locationName": "WAKE MED - INPATIENT"
},
"payers": [{
"payerIndex": 1,
"payerId": "1791",
"name": "Primary Name",
"memberId": "M1234"
}],
"patients": [{
"patientId": "P1234",
"accountNumber": "P1103",
"name": "JANE SMITH",
"dob": "1989-10-04",
"phone": "9195558687",
"addressLine1": "1234 MAIN STREET",
"addressLine2": null,
"addressLine3": null,
"city": "DURHAM",
"state": "NC",
"region": null,
"zip": "27713",
"country": "US",
"isForeignAddress": 0,
"physicianName": "Jack Patel MD",
"services": [{
"lineNumber": "1",
"claimNumber": "23",
"visitNumber": "1",
"paymentPlanStatus": "",
"serviceDate": "2018-01-11",
"serviceEndDate": null,
"serviceProvider": "Jack Patel MD",
"serviceProviderNPI": "0987654321",
"serviceCode": "70547",
"serviceDesc": "MR ANGIOGRAPHY NECK W/O DYE",
"serviceClass": "",
"charge": 200.00,
"allowedAmount": 200.0,
"amount": 200.0,
"patientDueAmount": 125.0,
"ppayCollectedAmount": 0.0,
"adjustment": 0.0,
"writeoffAmount": 0.0,
"ineligibleAmt":"100.00",
"ineligibleCode":"1234",
"payments": [{
"type": "payer",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 50.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "patient",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 25.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
}],
"transactions": [{
"lineNumber": "",
"claimNumber": "",
"visitNumber": "",
"transactionId": "",
"transactionDate": "",
"transactiontype": "",
"transactionDesc": "",
"transactionAddDesc": "",
"paymentPlanStatus": "",
"amount": 0.0,
"payerAmounts": [{
"type": "",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "type",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
}]
}]
},
{
"billId": "999615",
"statementId":"202108180857",
"customerId": "1599",
"partnerId": null,
"partnerName": null,
"billExpireDate": "2018-10-02",
"billUrl": "amg.patientpay.net",
"billToken": "PP8765432",
"statementNumber": 1,
"dunningMessage": "Thank you for your prompt payment",
"billDate": "2018-01-20",
"totalCharges": 900.00,
"totalDueAmount": 200.00,
"totalPatientPaymentsAmount": 100.0,
"payerAdjustmentTotal": 200.0,
"payerPortionTotal": 400.0,
"patientPaymentsCount": 1,
"printRules": {
"mailerId": "",
"templateID": "0001",
"serviceTypeId": "",
"groupingId": null,
"groupingName": null,
"sysNum": "7555",
"prnNum": "00001",
"logoId": "NUCarePracticelogo.jpeg",
"insertRule": {
"asset": "",
"envelope": "",
"envelopeStyle": ""
},
"onsertRules": [{
"asset": "NUCarePracticelogo.jpeg",
"location": "onsert.Location1"
},
{
"asset": "icongraph1.jpeg",
"location": "onsert.Location2"
},
{
"asset": "icongraph2.jpeg",
"location": "onsert.Location3"
},
{
"asset": "icongraph3.jpeg",
"location": "onsert.Location4"
},
{
"asset": "BackPage1.jpeg",
"location": "onsert.Location5"
}
]
},
"guarantor": {
"accountNumber": "1203",
"name": "JEFF SMITH",
"addressLine1": "1234 MAIN STREET",
"addressLine2": null,
"addressLine3": null,
"city": "DURHAM",
"state": "NC",
"region": null,
"zip": "27713",
"country": "US",
"isForeignAddress": 0
},
"practice": {
"name": "SLEEP CENTER OF RALIEGH",
"addressLine1": "1234 Cary Pkwy",
"addressLine2": "STE 530",
"city": "Cary",
"state": "NC",
"zip": "27513",
"country": "US",
"email": "SLEEPCENTERNC@patientpay.net",
"phone": "(888)555-7758",
"remitAddressLine1": "P.O. BOX ZZZ",
"remitAddressLine2": "DEPT # 1019",
"remitCity": "RALEIGH",
"remitState": "NC",
"remitZip": "27560-1234",
"remitCountry": "US",
"ivrPhoneNumber": null,
"locationId": null,
"locationName": "WAKE UP - INPATIENT"
},
"payers": [{
"payerIndex": 1,
"payerId": "1022",
"name": "Primary Name",
"memberId": "Z9221"
}],
"patients": [{
"patientId": "Z921",
"accountNumber": "Z99103",
"name": "JOHNNY APPLE",
"dob": "1989-10-04",
"phone": "9195559843",
"addressLine1": "12334 MAIN STREET",
"addressLine2": null,
"addressLine3": null,
"city": "DURHAM",
"state": "NC",
"region": null,
"zip": "27713",
"country": "US",
"isForeignAddress": 0,
"physicianName": "Jack CPAP MD",
"services": [{
"lineNumber": "1",
"claimNumber": "23",
"visitNumber": "1",
"paymentPlanStatus": "",
"serviceDate": "2018-01-11",
"serviceEndDate": null,
"serviceProvider": "Jack CPAP MD",
"serviceProviderNPI": "0987659991",
"serviceCode": "95800",
"serviceDesc": "Sleep study, unattended, simultaneous recording, and sleep time.",
"serviceClass": "",
"charge": 900.00,
"allowedAmount": 0.0,
"amount": 0.0,
"patientDueAmount": 900.00,
"ppayCollectedAmount": 0.0,
"adjustment": 0.0,
"writeoffAmount": 0.0,
"ineligibleAmt":"100.00",
"ineligibleCode":"1234",
"serviceUnits": "",
"employerDesc": "",
"payments": [{
"type": "payer",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "patient",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
}],
"transactions": [{
"lineNumber": "1",
"claimNumber": "23",
"visitNumber": "1",
"transactionId": "982211122211",
"transactionDate": "2018-10-01",
"transactiontype": "Insurance Adjustment",
"transactionDesc": "AETNA Adjustment",
"transactionAddDesc": "",
"paymentPlanStatus": "",
"amount": -200.0,
"payerAmounts": [{
"type": "",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "type",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
},
{
"lineNumber": "2",
"claimNumber": "23",
"visitNumber": "1",
"transactionId": "982211122212",
"transactionDate": "2018-10-01",
"transactiontype": "Insurance Payment",
"transactionDesc": "AETNA Payment",
"transactionAddDesc": "ACH DEPOSIT",
"paymentPlanStatus": "",
"amount": -400.0,
"payerAmounts": [{
"type": "",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "type",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
},
{
"lineNumber": "3",
"claimNumber": "23",
"visitNumber": "1",
"transactionId": "982211122211",
"transactionDate": "2018-10-11",
"transactiontype": "Patient Payment",
"transactionDesc": "SELF PAY",
"transactionAddDesc": "CHECK 1018",
"paymentPlanStatus": "",
"amount": -100.0,
"payerAmounts": [{
"type": "",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
},
{
"type": "type",
"payerId": "",
"coInsurance": 0.0,
"copay": 0.0,
"deductible": 0.0,
"paidAmount": 0.0,
"writeoffAmount": 0.0,
"adjustment": 0.0,
"other": 0.0,
"description": "",
"paymentPlanStatus": ""
}
]
}
]
}]
},
{
"billId": "999616",
"statementId":"202108180858",
"customerId": "1599",
"partnerId": null,
"partnerName": null,
"billExpireDate": "2018-10-03",
"billUrl": "https://www.patientpay.net/console/public/code",
"billToken": "PP8765433",
"statementNumber": 1,
"dunningMessage": "<p>THIS IS AN EXAMPLE OF A LETTER WHEN CLIENTS SEND TRANSACTION ONLY INFO, USED FOR TEMPLATE 5.</p> <br /><p>Thank you for your prompt payment..</p>",
"billDate": "2018-01-20",
"totalCharges": 900.00,
"totalDueAmount": 200.00,
"totalPatientPaymentsAmount": 100.0,
"payerAdjustmentTotal": 200.0,
"payerPortionTotal": 400.0,
"patientPaymentsCount": 1,
"printRules": {
"mailerId": "",
"templateID": "0900",
"serviceTypeId": "",
"groupingId": null,
"groupingName": null,
"sysNum": "7555",
"prnNum": "00001",
"logoId": "NUCarePracticelogo.jpeg",
"insertRule": {
"asset": "",
"envelope": "",
"envelopeStyle": ""
},
"onsertRules": [{
"asset": "NUCarePracticelogo.jpeg",
"location": "onsert.Location1"
},
{
"asset": "icongraph1.jpeg",
"location": "onsert.Location2"
},
{
"asset": "icongraph2.jpeg",
"location": "onsert.Location3"
},
{
"asset": "icongraph3.jpeg",
"location": "onsert.Location4"
},
{
"asset": "BackPage1.jpeg",
"location": "onsert.Location5"
}
]
},
"guarantor": {
"accountNumber": "1203",
"name": "JEFF SMITH",
"addressLine1": "1234 MAIN STREET",
"addressLine2": null,
"addressLine3": null,
"city": "DURHAM",
"state": "NC",
"region": null,
"zip": "27713",
"country": "US",
"isForeignAddress": 0
},
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