> ## Documentation Index
> Fetch the complete documentation index at: https://docs.usecobalt.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Sync Events
Sync events fire when Cobalt detects changes that occurred directly in your EHR system. These keep you informed about activities your staff performed in the EHR itself — appointments scheduled, patient information updated, and statuses changed.
`appointment.created` and `appointment.updated` also fire as [Operation
Events](/docs/webhooks/operation-events) when triggered by an RPA action
Cobalt performed. The event types are the same; the trigger differs.
## Payload Envelope
Every sync event uses this envelope:
```json theme={null}
{
"id": "508c368e7de13b40f9397eec966d0329",
"access_token_reference_id": "your-reference-id",
"object": "event",
"created": "2025-07-28T08:50:42.491-07:00",
"type": "appointment.updated",
"data": {
// Event-specific payload
}
}
```
| Field | Type | Description |
| --------------------------- | ------ | ---------------------------------------------- |
| `id` | string | Unique identifier for this event |
| `access_token_reference_id` | string | Your reference ID associated with this webhook |
| `object` | string | Always `"event"` |
| `created` | string | ISO 8601 timestamp when the event was created |
| `type` | string | The event type |
| `data` | object | Event-specific data payload |
## Appointment Events
Triggered when EHR staff create an appointment in your EHR (detected by Cobalt's sync).
**Payload Example:**
```json theme={null}
{
"id": "759df7ac-2688-44a9-926c-58d36376b412",
"access_token_reference_id": "clinic_1",
"object": "event",
"created": "2025-07-28T16:05:48.929Z",
"type": "appointment.created",
"data": {
"appointment_id": "c5c0e613fc7d68a1c01ef4160483a0b6",
"mrn": "44235",
"date_time": "2025-07-28T16:00:00.000Z",
"timezone": "America/New_York",
"provider_id": "defe69ae-f363-4797-87bd-1c70acb52b21",
"provider_name": "Dr. Jose Gonzalez",
"secondary_provider_id": null
}
}
```
**Data Fields:**
| Field | Type | Description |
| ----------------------- | -------------- | ---------------------------------------------- |
| `appointment_id` | string | Cobalt's unique identifier for the appointment |
| `mrn` | string | Patient's Medical Record Number |
| `date_time` | string | Appointment date and time (ISO 8601) |
| `timezone` | string | Timezone for the appointment |
| `provider_id` | string | Primary provider's ID |
| `provider_name` | string | Primary provider's name |
| `secondary_provider_id` | string \| null | Secondary provider's ID (if applicable) |
Triggered when EHR staff update an appointment in your EHR (detected by Cobalt's sync).
**Payload Example:**
```json theme={null}
{
"id": "508c368e7de13b40f9397eec966d0329",
"access_token_reference_id": "clinic_1",
"object": "event",
"created": "2025-07-28T08:50:42.491-07:00",
"type": "appointment.updated",
"data": {
"id": "0551c88b2249945151f967525ee3f7b4",
"ehr_appointment_id": "482129",
"patient_mrn": "804",
"patient_name": "John Doe",
"datetime": "2025-07-28T16:00:00.000Z",
"duration": 20,
"location": "2",
"status": "2",
"provider_name": "Dr. Michael Denenberg",
"appointment_type": "FOLLOW-UP",
"appointment_mode": "office",
"updated_fields": {
"status": "2"
}
}
}
```
**Data Fields:**
| Field | Type | Description |
| -------------------- | ------ | ---------------------------------------------- |
| `id` | string | Cobalt's unique identifier for the appointment |
| `ehr_appointment_id` | string | The EHR's native appointment ID |
| `patient_mrn` | string | Patient's Medical Record Number |
| `patient_name` | string | Patient's full name |
| `datetime` | string | Appointment date and time (ISO 8601) |
| `duration` | number | Appointment duration in minutes |
| `location` | string | Appointment location/room |
| `status` | string | Appointment status code |
| `provider_name` | string | Provider's name |
| `appointment_type` | string | Type of appointment |
| `appointment_mode` | string | Mode (e.g., "office", "telehealth") |
| `updated_fields` | object | Fields that changed in this update |
Triggered when an appointment's status changes in your EHR system.
**Payload Example:**
```json theme={null}
{
"id": "508c368e7de13b40f9397eec966d0330",
"access_token_reference_id": "clinic_1",
"object": "event",
"created": "2025-07-28T09:15:22.491-07:00",
"type": "appointment.status_updated",
"data": {
"id": "0551c88b2249945151f967525ee3f7b4",
"ehr_appointment_id": "482129",
"patient_mrn": "804",
"patient_name": "John Doe",
"datetime": "2025-07-28T16:00:00.000Z",
"status": "checked-in",
"previous_status": "scheduled",
"provider_name": "Dr. Michael Denenberg"
}
}
```
**Data Fields:**
| Field | Type | Description |
| -------------------- | ------ | ---------------------------------------------- |
| `id` | string | Cobalt's unique identifier for the appointment |
| `ehr_appointment_id` | string | The EHR's native appointment ID |
| `patient_mrn` | string | Patient's Medical Record Number |
| `patient_name` | string | Patient's full name |
| `datetime` | string | Appointment date and time (ISO 8601) |
| `status` | string | New appointment status |
| `previous_status` | string | Previous appointment status |
| `provider_name` | string | Provider's name |
## Patient Events
Triggered when patient information is updated in your EHR system.
**Payload Example:**
```json theme={null}
{
"id": "508c368e7de13b40f9397eec966d0331",
"access_token_reference_id": "clinic_1",
"object": "event",
"created": "2025-07-28T10:20:15.491-07:00",
"type": "patient.updated",
"data": {
"mrn": "MRN123456",
"patient_name": "Jane Smith",
"updated_fields": {
"phone": "555-9999",
"email": "jane.newemail@example.com"
}
}
}
```
**Data Fields:**
| Field | Type | Description |
| ---------------- | ------ | ---------------------------------- |
| `mrn` | string | Patient's Medical Record Number |
| `patient_name` | string | Patient's full name |
| `updated_fields` | object | Fields that changed in this update |
## Claim Events
Triggered when a new claim is detected in your EHR (detected by Cobalt's sync).
**Payload Example:**
```json theme={null}
{
"id": "759df7ac268844a9926c58d36376b412",
"access_token_reference_id": "clinic_1",
"object": "event",
"created": "2026-07-13T04:12:08.921Z",
"type": "claim.created",
"data": {
"id": "0551c88b2249945151f967525ee3f7b4",
"emr_claim_id": "73001",
"emr_appointment_id": "264453",
"emr_patient_id": "32191",
"patient_name": "Jane Smith",
"provider_name": "Dr. Michael Denenberg",
"service_date": "2026-04-13",
"claim_date": "2026-04-14",
"claim_status": "PEN",
"claim_status_description": "Pending",
"claim_type": "0",
"void_flag": false,
"total_charge": "1233.87",
"total_payment": "0.00",
"net_payment": "0.00",
"balance": "1233.87",
"net_adjustment": "0.00",
"patient_responsibility": "0.00",
"icd_codes": [
{
"code": "Z01.411",
"primary": "1",
"description": "Encounter for gynecological examination with abnormal findings",
"icd_version": "10"
}
]
}
}
```
**Data Fields:**
| Field | Type | Description |
| -------------------------- | -------------- | ------------------------------------------------------- |
| `id` | string | Cobalt's unique identifier for the claim |
| `emr_claim_id` | string | The EHR's native claim ID |
| `emr_appointment_id` | string | The EHR's appointment/encounter ID the claim belongs to |
| `emr_patient_id` | string | The EHR's patient ID |
| `patient_name` | string | Patient's full name |
| `emr_provider_id` | string | The EHR's provider ID |
| `provider_name` | string \| null | Rendering provider's name |
| `service_date` | string | Date of service (YYYY-MM-DD) |
| `claim_date` | string | Claim date (YYYY-MM-DD) |
| `claim_status` | string | EHR claim status code (e.g. `PEN`) |
| `claim_status_description` | string | Human-readable claim status |
| `claim_type` | string | EHR claim type code |
| `void_flag` | boolean | Whether the claim is voided |
| `total_charge` | string | Total billed amount |
| `total_payment` | string | Total payment received |
| `net_payment` | string | Net payment |
| `balance` | string | Outstanding balance |
| `net_adjustment` | string | Net adjustment |
| `patient_responsibility` | string | Patient responsibility amount |
| `icd_codes` | array | ICD-10 diagnosis codes on the claim |
Triggered when a synced claim changes in your EHR. Only fires when a header field actually changed (for example a status, payment, or balance update), so unchanged claims re-seen during a sync do not emit an event.
**Payload Example:**
```json theme={null}
{
"id": "759df7ac268844a9926c58d36376b413",
"access_token_reference_id": "clinic_1",
"object": "event",
"created": "2026-07-13T05:41:22.104Z",
"type": "claim.updated",
"data": {
"id": "0551c88b2249945151f967525ee3f7b4",
"emr_claim_id": "73001",
"emr_appointment_id": "264453",
"emr_patient_id": "32191",
"patient_name": "Jane Smith",
"service_date": "2026-04-13",
"claim_status": "PAID",
"claim_status_description": "Paid",
"total_charge": "1233.87",
"total_payment": "1050.00",
"balance": "0.00",
"updated_fields": {
"claim_status": "PAID",
"total_payment": "1050.00",
"balance": "0.00"
}
}
}
```
**Data Fields:**
The full claim object (same fields as `claim.created`) plus:
| Field | Type | Description |
| ---------------- | ------ | ----------------------------------------------------- |
| `updated_fields` | object | Map of the fields that changed, with their new values |