---
title: "Create Eligibility"
method: POST
path: "/api/2.0/patient_insurances/{id}/eligibility/"
tags: ["Insurance Eligibility"]
---

# Create Eligibility

`POST /api/2.0/patient_insurances/{id}/eligibility/`

Create eligibility information for a patient insurance

## Path parameters

- `id` integer, required

## Request body

- CreateInsuranceEligibility
  - `group_id` integer — ID that matches the group record in Elation system
  - `group_name` string — Name of the group / organization. group_npi field is required if this is populated.
  - `group_npi` string — NPI of the group / organization. group_name field is required if this is populated.

## Response `200`

- InsuranceEligibility
  - `eligibility_check_timestamp` string, date-time — Eligibility check timestamp in ISO format.
  - `eligibility_details` EligibilityDetails
    - `coinsurance` string, decimal — Coinsurance percentage value as a decimal (e.g. 0.25).
    - `coinsurance_ambiguous` boolean
    - `copay` number, double, nullable — copayment amount in dollars.
    - `copay_ambiguous` boolean — If true, the given copay value may not be accurate and the full eligibility report will need to be referenced for better details.
    - `deductible` string, decimal — Deductible amount in dollars.
    - `deductible_ambiguous` boolean
    - `deductible_remaining` string, decimal — Remaining deductible amount in dollars.
    - `deductible_remaining_ambiguous` boolean
    - `errors` object[] — Error messages showing reason for failed eligibility check.
  - `eligibility_status` 'active' | 'inactive' | 'error' — * `active` - active * `inactive` - inactive * `error` - error
  - `patient_id` integer — Patient's id in Elation system.
  - `patient_insurance_id` integer — Patient's insurance id in Elation system.
  - `practice_id` integer — Practice's id in Elation system.

---

[API](https://skmtc.net/elationhealth/apis/api-authentication.md) · [All operations](https://skmtc.net/elationhealth/apis/api-authentication/llms.txt) · [OpenAPI document](https://skmtc-service-staging.skmtc.workers.dev/v1/apis/elationhealth/api-authentication/revisions/c060f89d4de7/schema)