Provides real-time access to patient eligibility benefits information, such as deductibles, copays, etc.
Request body
Patient first name
Patient last name
Patient Date of Birth, formatted as MM-DD-YYYY
Member ID of patient's insurance policy
Date to request coverage information. Formatted as MM-DD-YYYY
Payer ID. Can be found under the enrollments page in the platform, or the Fetch Enrollments API
Provider ID. Can be found by copying the enrollment ID in the enrollments page in the platform, or the Fetch Enrollments API
Optional flag to only return mock data
Response
Eligibility check successful
Message of response. Any errors will be displayed here.
Name of the insurance payer
Coverage status
Member ID of the subscriber
Group name from the plan
Group number from the plan
Type of insurance (e.g. PPO, HMO)
Name of the plan
Eligibility begin date (YYYY-MM-DD)