latestSwagger 2.02026-08-10422755.5 KB

9e1d4f09d0b2

Eligibility

The EligibilityInquiry endpoint is the main method used get an eligibility report for a specific subscriber / dependent. This requires customers to post a request, via REST to a designated URL address. Once a request is received by the service an immediate response is sent for each request posted. To use this or any other method, you must first generate a token via the Token endpoint (see above Token method).

Payers return many formats for the eligibility report, which we parse to put into a JSON object format. Critical to the successful parsing of this information is the concept of our pVerify exclusive payer and client specific parsing logic, stored in NetworkSections in the response. See below for more information.

post/API/EligibilityInquiry

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

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

Response

OK

object required