Expected Network StatusV1

Compute network status

Beta
POST
Computes the expected network status given the provided information.

Request

This endpoint expects an object.
subscriber_payer_id
stringRequired
subscriber_payer_name
stringRequired
billing_provider_npi
stringRequired
The National Provider Identifier (NPI) of the healthcare provider responsible for billing. A unique 10-digit identification number.
billing_provider_tin
stringRequired
Follow the 9-digit format of the Taxpayer Identification Number (TIN).
rendering_provider_npi
stringRequired
The National Provider Identifier (NPI) of the healthcare provider who delivered the services. A unique 10-digit identification number.
contracted_state
enumRequired
The state in which the healthcare provider has a contractual agreement with the insurance payer.
date_of_service
stringRequired
Date formatted as YYYY-MM-DD; eg: 2019-08-25.
external_patient_id
stringOptional
subscriber_insurance_type
enumOptional
Code identifying the type of insurance policy within a specific insurance program (X12 008020 Element 1336)
subscriber_plan_name
stringOptional
The descriptive name of the insurance plan selected by the subscriber, often indicating coverage specifics or tier.

Response

This endpoint returns an object
expected_network_status
enum
The anticipated classification of a healthcare provider within the insurance plan's network.
Allowed values: in_networkout_of_networkunknown
explanation
string
contract_id
UUIDOptional
POST
1curl -X POST https://api.joincandidhealth.com/api/expected-network-status/v1 \
2     -H "Authorization: Bearer <token>" \
3     -H "Content-Type: application/json" \
4     -d '{
5  "subscriber_payer_id": "string",
6  "subscriber_payer_name": "string",
7  "billing_provider_npi": "string",
8  "billing_provider_tin": "string",
9  "rendering_provider_npi": "string",
10  "contracted_state": "AA",
11  "date_of_service": "string"
12}'
200Successful
1{
2  "expected_network_status": "in_network",
3  "explanation": "string",
4  "contract_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"
5}
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