latestSwagger 2.02026-08-10422755.5 KB

9e1d4f09d0b2

Eligibility

Eligibility summary is our 2nd gen eligibility endpoint designed to cover the vast majority of payers and return simplified objects with key data such as copay for your practice type. For example, when you send as practice type PT, we will return a Physical Therapy object with key PT benefits.

Key benefits are:

Easy and discrete eligibility information, allowing easy coding to obtain pertinent data.

Support for nearly all types of medical practices with key benefits such as surgical benefits, DME benefits, or PT benefits.

Support for nearly all payers, electronic and non electronic. We have tested all payers available to us and over 90% are returning parsed information correctly

post/API/EligibilitySummary

Headers

Authorizationstring required

The authorization token required for the request. Provide the token in the format Bearer { token}, where { token} is your actual authentication token.

Client-Api-Idstring required

Client Id (Accepts valid GUID)

Request body

PayerNamestring
PracticeTypeCodeinteger
{"stackTrail":"components:schemas:pVerify.BusinessObjects.PboBaseEligibilitySummaryRequest:properties:ServiceCodes","oasType":"schema","type":"unknown"}
IncludeTextResponseboolean
PlaceOfServicestring
InternalIdstring
CustomerIdstring
PayerCodestring
{"stackTrail":"components:schemas:pVerify.BusinessObjects.PboBaseEligibilitySummaryRequest:properties:Provider","oasType":"schema","type":"unknown"}
{"stackTrail":"components:schemas:pVerify.BusinessObjects.PboBaseEligibilitySummaryRequest:properties:Subscriber","oasType":"schema","type":"unknown"}
{"stackTrail":"components:schemas:pVerify.BusinessObjects.PboBaseEligibilitySummaryRequest:properties:Dependent","oasType":"schema","type":"unknown"}
IsSubscriberPatientstring
DOS_StartDatestring
DOS_EndDatestring
ReferenceIdstring
Locationstring

Response

OK

object required