Expected Network StatusV2

Compute for rendering provider

Beta
POST
https://api.joincandidhealth.com/api/expected-network-status/v2/compute/:rendering_provider_id
Computes the expected network status for a given rendering provider. This endpoint is not available to all customers. Reach out to the Candid sales team to discuss enabling this endpoint if it is not available for your organization.

Path parameters

rendering_provider_id
UUID

Request

This endpoint expects an object.
service_type
enum
For some payers, payer routing depends on whether the rendered service qualifies as a behavioral health visit (e.g. Blue Shield of California routes to Magellan for behavioral health visits). For post appointment payer routing, Candid uses a CPT code list to determine whether the appointment qualifies as a behavioral health visit (see “Inputs: Service Type” in the appendix for list of qualifying CPT codes and behavioral health routing logic). Since CPT codes are not available pre-appointment, the service type input is used to determine whether the appointment is expected to qualify as behavioral health.
place_of_service_code
enum
Expected place of service
subscriber_information
object
Information present on the patient's insurance card
patient_address
object
billing_provider_id
UUID
organization_service_facility_id
UUID
The id of the service facility where the appointment will be rendered
date_of_service
date
Expected date of service

Response

This endpoint return an object.
network_status_check_id
UUID
network_status
union

Errors

POST
/api/expected-network-status/v2/compute/:rendering_provider_id
curl -X POST https://api.joincandidhealth.com/api/expected-network-status/v2/compute/d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32 \
-H "Authorization: Bearer <token>" \
-H "Content-Type: application/json" \
-d '{
"service_type": "new_patient_video_appt",
"place_of_service_code": "01",
"subscriber_information": {
"payer_uuid": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
"member_id": "string",
"insurance_type": {
"line_of_business": "medicare",
"insurance_type_codes": {
"type": "insurance_type_code",
"value": "01"
}
}
},
"patient_address": {
"address1": "string",
"city": "string",
"state": "AA",
"zip_code": "string"
},
"billing_provider_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
"organization_service_facility_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
"date_of_service": "2023-01-01"
}'
Response
{
"network_status_check_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
"network_status": {
"type": "in_network",
"routed_billing_provider_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
"routed_payer_uuid": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"
}
}