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请求地址：

环境	HTTP请求地址	HTTPS请求地址
正式环境	http://gw.api.taobao.com/router/rest	https://eco.taobao.com/router/rest

公共请求参数：

名称	类型	是否必须	描述
method	String	是	API接口名称。
app_key	String	是	TOP分配给应用的AppKey。
target_app_key	String	否	被调用的目标AppKey，仅当被调用的API为第三方ISV提供时有效。
sign_method	String	是	签名的摘要算法，可选值为：hmac，md5。
sign	String	是	API输入参数签名结果，签名算法介绍请点击这里。
session	String	否	用户登录授权成功后，TOP颁发给应用的授权信息，详细介绍请点击这里。当此API的标签上注明：“需要授权”，则此参数必传；“不需要授权”，则此参数不需要传；“可选授权”，则此参数为可选。
timestamp	String	是	时间戳，格式为yyyy-MM-dd HH:mm:ss，时区为GMT+8，例如：2015-01-01 12:00:00。淘宝API服务端允许客户端请求最大时间误差为10分钟。
format	String	否	响应格式。默认为xml格式，可选值：xml，json。
v	String	是	API协议版本，可选值：2.0。
partner_id	String	否	合作伙伴身份标识。
simplify	Boolean	否	是否采用精简JSON返回格式，仅当format=json时有效，默认值为：false。

名称	类型	是否必须	示例值	更多限制	描述
query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request	QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest	必须			查询理赔请求
└ biz_claim_settlement_report_id String 可选 45000 isv侧预约id/健康测预约id

名称	类型	示例值	描述
result_status	String	SUCCESS	SUCCESS:成功 FAIL:失败
query_claim_settlement_record_top_response	QueryClaimSettlementRecordTopResponse		查询理赔记录请求
claim_settlement_records ClaimSettlementRecordTopModel [] 理赔记录ClaimSettlementRecordTopModel model └ alihealth_claim_settlement_record_id String 1000223312xx123213 理赔记录Id └ biz_claim_settlement_report_id String 439202 业务理赔报案号（预约id） insured_info InsuredInfoTopModel 被保人信息 └ mobile String ***8578 被保人手机号（仅展示后四位） └ id_no String **2533 被保人证件号（仅展示后四位） └ status String CLAIMING 理赔状态:ACCIDENT_OCCURRED("已出险"),WAIT_CLAIM("待理赔"),CLAIMING("理赔中"), SETTLED("理赔完成"),CANCELLED("取消理赔"),INVALID("失效") service_infos ClaimSettlementServiceInfo [] 服务信息 └ occurrence_time Date 2022-11-01 22:00:00 就诊日期 └ department_name String 口腔科科室名称 └ doctor_name String 李三医生名称 └ store_name String xx牙科医院门店名称 └ service_type_codes String [] 就诊项目 └ service_credentials String [] 病例url claim_settlement_items ClaimSettlementItemInfo [] 理赔item └ insurer_insurance_item_id String CG00.000 保司保险项目ID └ item_name String 种植保健治疗保险项目名称 └ compensation_ratio BigDecimal 90 赔付比例（百分比） └ left_insurance_amount_before_compensation Number 1000000 本次理赔前，剩余保险金额（单位分） └ service_total_price Number 10000 本次服务的价格（单位分） └ insured_pay_amount_inside_compensation_ratio Number 10000 赔付比例之内的（因为剩余赔付金额不足）用户需要付的金额（单位分） └ insured_pay_amount_outside_compensation_ratio Number 10000 赔付比例之外的，用户需要付的金额（单位分） └ total_insured_pay_amount Number 10000 总的自费金额（单位分） └ total_insured_pay_amount_after_discount Number 10000 优惠后自费总金额（单位分） └ compensation_amount Number 10000 赔付金额（单位分） └ left_insurance_amount_after_compensation Number 10000 本次理赔后，剩余保额（单位分） service_items_outside_insurance ServiceItemOutsideInsurance [] 其他服务项目 └ item_name String 洗牙项目名称 └ service_total_price Number 10000 项目金额（单位：分） └ service_price_after_discount Number 9000 优惠后项目金额（单位：分） └ insurance_policy_number String 2022xxxxx 保单号 └ total_compensation_amount Number 60000 总的赔付金额（单位：分） └ total_insured_pay_amount Number 60000 总的保险支付金额（单位：分）（即总的自费金额）
result_code	String	PARAM_ERROR	结果码
result_msg	String	入参错误	结果消息提示

JAVA
.NET
PHP
CURL
Python
C/C++
NodeJS

TaobaoClient client = new DefaultTaobaoClient(url, appkey, secret);
AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest req = new AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest();
AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest.QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest obj1 = new AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest.QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest();
obj1.setBizClaimSettlementReportId("45000");
req.setQueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest(obj1);
AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryResponse rsp = client.execute(req);
System.out.println(rsp.getBody());

ITopClient client = new DefaultTopClient(url, appkey, secret);
AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest req = new AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest();
AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest.QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequestDomain obj1 = new AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest.QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequestDomain();
obj1.BizClaimSettlementReportId = "45000";
req.QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest_ = obj1;
AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryResponse rsp = client.Execute(req);
Console.WriteLine(rsp.Body);

$c = new TopClient;
$c->appkey = $appkey;
$c->secretKey = $secret;
$req = new AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest;
$query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request = new QueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest;
$query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request->biz_claim_settlement_report_id="45000";
$req->setQueryClaimSettlementRecordByBizClaimSettlementReportIdTopRequest(json_encode($query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request));
$resp = $c->execute($req);

curl -X POST 'http://gw.api.taobao.com/router/rest' \
-H 'Content-Type:application/x-www-form-urlencoded;charset=utf-8' \
-d 'app_key=12129701' \
-d 'format=json' \
-d 'method=alibaba.alihealth.medical.insurance.claim.settlement.info.query' \
-d 'partner_id=apidoc' \
-d 'sign=6E2CB105CC3C570B0CFD9A6ED5A984E6' \
-d 'sign_method=hmac' \
-d 'timestamp=2026-04-19+09%3A58%3A47' \
-d 'v=2.0' \
-d 'query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request=null'

# -*- coding: utf-8 -*-
import top.api

req=top.api.AlibabaAlihealthMedicalInsuranceClaimSettlementInfoQueryRequest(url,port)
req.set_app_info(top.appinfo(appkey,secret))

req.query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request="数据结构示例JSON格式"
try:
	resp= req.getResponse()
	print(resp)
except Exception,e:
	print(e)

pTopRequest pRequest = alloc_top_request();
pTopResponse pResponse = NULL;
pTaobaoClient pClient = alloc_taobao_client(url, appkey, appsecret);
set_api_name(pRequest,"alibaba.alihealth.medical.insurance.claim.settlement.info.query");
add_param(pRequest,"query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request","数据结构JSON示例");
pResponse = top_execute(pClient,pRequest,NULL);
printf("ret code:%d\n",pResponse->code);
if(pResponse->code == 0){
	pTopResponseIterator ite = init_response_iterator(pResponse);
	pResultItem pResultItem = alloc_result_item();
	while(parseNext(ite, pResultItem) == 0){
		printf("%s:%s\n",pResultItem->key,pResultItem->value);
	}
	destroy_response_iterator(ite);
	destroy_result_item(pResultItem);
}
destroy_top_request(pRequest);
destroy_top_response(pResponse);
destroy_taobao_client(pClient);

TopClient = require('./topClient').TopClient;
var client = new TopClient({
	'appkey': 'appkey',
	'appsecret': 'secret',
	'url': 'http://gw.api.taobao.com/router/rest'
});

client.execute('alibaba.alihealth.medical.insurance.claim.settlement.info.query', {
	'query_claim_settlement_record_by_biz_claim_settlement_report_id_top_request':'数据结构JSON示例'
}, function(error, response) {
	if (!error) console.log(response);
	else console.log(error);
})

XML示例
JSON示例

<alibaba_alihealth_medical_insurance_claim_settlement_info_query_response>
    <result_status>SUCCESS</result_status>
    <query_claim_settlement_record_top_response>
        <claim_settlement_records>
            <claim_settlement_record_top_model>
                <alihealth_claim_settlement_record_id>1000223312xx123213</alihealth_claim_settlement_record_id>
                <biz_claim_settlement_report_id>439202</biz_claim_settlement_report_id>
                <insured_info>
                    <mobile>*****8578</mobile>
                    <id_no>****2533</id_no>
                </insured_info>
                <status>CLAIMING</status>
                <service_infos>
                    <claim_settlement_service_info>
                        <occurrence_time>2022-11-01 22:00:00</occurrence_time>
                        <department_name>口腔科</department_name>
                        <doctor_name>李三</doctor_name>
                        <store_name>xx牙科医院</store_name>
                    </claim_settlement_service_info>
                </service_infos>
                <claim_settlement_items>
                    <claim_settlement_item_info>
                        <insurer_insurance_item_id>CG00.000</insurer_insurance_item_id>
                        <item_name>种植保健治疗</item_name>
                        <compensation_ratio>90</compensation_ratio>
                        <left_insurance_amount_before_compensation>1000000</left_insurance_amount_before_compensation>
                        <service_total_price>10000</service_total_price>
                        <insured_pay_amount_inside_compensation_ratio>10000</insured_pay_amount_inside_compensation_ratio>
                        <insured_pay_amount_outside_compensation_ratio>10000</insured_pay_amount_outside_compensation_ratio>
                        <total_insured_pay_amount>10000</total_insured_pay_amount>
                        <total_insured_pay_amount_after_discount>10000</total_insured_pay_amount_after_discount>
                        <compensation_amount>10000</compensation_amount>
                        <left_insurance_amount_after_compensation>10000</left_insurance_amount_after_compensation>
                    </claim_settlement_item_info>
                </claim_settlement_items>
                <service_items_outside_insurance>
                    <service_item_outside_insurance>
                        <item_name>洗牙</item_name>
                        <service_total_price>10000</service_total_price>
                        <service_price_after_discount>9000</service_price_after_discount>
                    </service_item_outside_insurance>
                </service_items_outside_insurance>
                <insurance_policy_number>2022xxxxx</insurance_policy_number>
                <total_compensation_amount>60000</total_compensation_amount>
                <total_insured_pay_amount>60000</total_insured_pay_amount>
            </claim_settlement_record_top_model>
        </claim_settlement_records>
    </query_claim_settlement_record_top_response>
    <result_code>PARAM_ERROR</result_code>
    <result_msg>入参错误</result_msg>
</alibaba_alihealth_medical_insurance_claim_settlement_info_query_response>

{
    "alibaba_alihealth_medical_insurance_claim_settlement_info_query_response":{
        "result_status":"SUCCESS",
        "query_claim_settlement_record_top_response":{
            "claim_settlement_records":{
                "claim_settlement_record_top_model":[
                    {
                        "alihealth_claim_settlement_record_id":"1000223312xx123213",
                        "biz_claim_settlement_report_id":"439202",
                        "insured_info":{
                            "mobile":"*****8578",
                            "id_no":"****2533"
                        },
                        "status":"CLAIMING",
                        "service_infos":{
                            "claim_settlement_service_info":[
                                {
                                    "occurrence_time":"2022-11-01 22:00:00",
                                    "department_name":"口腔科",
                                    "doctor_name":"李三",
                                    "store_name":"xx牙科医院"
                                }
                            ]
                        },
                        "claim_settlement_items":{
                            "claim_settlement_item_info":[
                                {
                                    "insurer_insurance_item_id":"CG00.000",
                                    "item_name":"种植保健治疗",
                                    "compensation_ratio":"90",
                                    "left_insurance_amount_before_compensation":1000000,
                                    "service_total_price":10000,
                                    "insured_pay_amount_inside_compensation_ratio":10000,
                                    "insured_pay_amount_outside_compensation_ratio":10000,
                                    "total_insured_pay_amount":10000,
                                    "total_insured_pay_amount_after_discount":10000,
                                    "compensation_amount":10000,
                                    "left_insurance_amount_after_compensation":10000
                                }
                            ]
                        },
                        "service_items_outside_insurance":{
                            "service_item_outside_insurance":[
                                {
                                    "item_name":"洗牙",
                                    "service_total_price":10000,
                                    "service_price_after_discount":9000
                                }
                            ]
                        },
                        "insurance_policy_number":"2022xxxxx",
                        "total_compensation_amount":60000,
                        "total_insured_pay_amount":60000
                    }
                ]
            }
        },
        "result_code":"PARAM_ERROR",
        "result_msg":"入参错误"
    }
}

XML示例
JSON示例

<error_response>
    <code>50</code>
    <msg>Remote service error</msg>
    <sub_code>isv.invalid-parameter</sub_code>
    <sub_msg>非法参数</sub_msg>
</error_response>

{
	"error_response":{
		"msg":"Remote service error",
		"code":50,
		"sub_msg":"非法参数",
		"sub_code":"isv.invalid-parameter"
	}
}

错误码	错误描述	解决方案

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开放平台

阿里健康-消费医疗-保险合作

alibaba.alihealth.medical.insurance.claim.settlement.info.query (查询预约对应的保险理赔信息)

公共参数

请求参数

响应参数

请求示例

响应示例

异常示例

错误码解释

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