latestSwagger 2.02026-08-10422755.5 KB

9e1d4f09d0b2

Widget / Eligibility and Estimates / CGX

CGXInquiry is our combined Eligibility & Estimate endpoint.

Note that only a handful of items are required. This allows very quick and easy coding to get a response. The NPI is hard coded to use the default NPI. The location can use the first/default location. Pricing is based either on payer/location specific pricing or the medicare price. If the former, then the CPT codes need to be imported into pVerify. If the later, then the location needs to have the state/ZIP code set, and the default medicare % needs to be set from Premium (Admin Setup). It is possible when configured to use remit data to power this estimate. The eligibility call is the same as the EligibilitySummary call. Either the practice type can be set from the body or it will use the default practice type set by client.

post/API/CGXInquiry

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

PayerCodestring
PayerNamestring
MemberIdstring
PatientFirstNamestring
PatientLastNamestring
PatientDOBstring
MRNstring
IsActiveSecondryboolean
{"stackTrail":"components:schemas:pVerify.BusinessObjects.CGX.PboCGXRequest:properties:CPTList","oasType":"schema","type":"unknown"}
SelfPayboolean
{"stackTrail":"components:schemas:pVerify.BusinessObjects.CGX.PboCGXRequest:properties:PracticeTypeId","oasType":"schema","type":"unknown"}
Locationstring
AppointmentTypestring

Response

OK

object required