---
title: "Policy Scan"
method: POST
path: "/v1/scan"
---

# Policy Scan

`POST /v1/scan`

Search for a patient’s active policy,         without payer_id. Return member_id and payer_Id if found.

## Request body

- ScanInput
  - `member_dob` string, date, required — Member’s date of birth provided in yyyy-mm-dd format
  - `provider_npi` string, required — Service Provider’s 10-character NPI
  - `next_appointment` string, date — Patient's next appointment date in yyyy-mm-dd format
  - `patient_type` 'PROSPECT' | 'NEW_PATIENT' | 'EXISTING_PATIENT'
  - `patient_id` string — Patient's id
  - `member_first_name` string, required — Member’s first name; as printed on the insurance card
  - `member_last_name` string, required — Member’s last name; as printed on the insurance card
  - `zip` string, required — Zip code
  - `office_id` string — An identifier for the office or location being visited.

## Response `200`

Successful Response

- DiscoverResponse
  - `payer_id` string, required — Payer ID used to verify benefits
  - `payer_name` string — Payer name
  - `plan_status` 'UNKNOWN' | 'INACTIVE' | 'ACTIVE' | 'ACTIVE_AT_RISK'
  - `plan_name` string — The name of the member’s insurance plan
  - `group_name` string — The group name of the member’s insurance plan
  - `group_id` string — The group id of the member's insurance plan
  - `plan_type` 'UNKNOWN' | 'ORIGINAL_MEDICAID' | 'MANAGED_MEDICAID' | 'MEDICARE_ADVANTAGE' | 'ORIGINAL_MEDICARE' | 'DUAL' | 'MARKETPLACE' | 'GOVERNMENT' | 'COMMERCIAL'
  - `insurance_type` 'HMO' | 'PPO' | 'EPO' | 'POS'
  - `plan_begin_date` string, date — The date the member’s plan was activated
  - `plan_end_date` string, date — The date the member’s plan expires
  - `demographics` Demographics
    - `gender` 'M' | 'F'
    - `member_id` string — Member's unique insurance ID, as provided by the insurer
    - `first_name` string — First name, as printed on the insurer card or government ID
    - `last_name` string — Last name, as printed on the insurer card or government ID
    - `dob` string, date — Date of birth, as printed on the insurer card or government ID
    - `address` AddressModel
      - `street_line_1` string, required — Physical address of client: street name and number
      - `street_line_2` string — Physical address of client: apartment or unit number
      - `city` string, required — Physical address of client: city
      - `state` string, required — Physical address of client: state
      - `zip` string, required — Physical address of client: zip
  - `relationship_to_subscriber` string — The member’s relation to the subscriber of the plan (e.g. self, spouse, child, etc.)
  - `subscriber_demographics` Demographics
    - `gender` 'M' | 'F'
    - `member_id` string — Member's unique insurance ID, as provided by the insurer
    - `first_name` string — First name, as printed on the insurer card or government ID
    - `last_name` string — Last name, as printed on the insurer card or government ID
    - `dob` string, date — Date of birth, as printed on the insurer card or government ID
    - `address` AddressModel
      - `street_line_1` string, required — Physical address of client: street name and number
      - `street_line_2` string — Physical address of client: apartment or unit number
      - `city` string, required — Physical address of client: city
      - `state` string, required — Physical address of client: state
      - `zip` string, required — Physical address of client: zip
  - `additional_policy` AdditionalPolicy
    - `type` string
    - `insurer` string
    - `member_id` string
    - `plan_type` 'MEDICAID' | 'UNKNOWN'
  - `bluecard_eligible` boolean — Indicates if the policy belongs to a Bluecard member
  - `network_status` NetworkStatus
    - `is_alert` boolean, nullable
    - `rule` NetworkStatusRule
      - `id` integer, required
      - `network_status` 'IN' | 'OUT', required

## Other responses

- `400` — Bad Request
- `401` — Unauthorized
- `404` — Not Found
- `422` — Unprocessable Entity
- `429` — Too Many Requests
- `500` — Internal Server Error
- `502` — Bad Gateway
- `504` — Gateway Timeout

---

[API](https://skmtc.net/meetnirvana/apis/nirvana-api.md) · [All operations](https://skmtc.net/meetnirvana/apis/nirvana-api/llms.txt) · [OpenAPI document](https://skmtc-service-staging.skmtc.workers.dev/v1/apis/meetnirvana/nirvana-api/versions/80ac8e79aef7/schema)