API ReferencePre EncounterCoveragesV1

Create

Beta

Creates a new Coverage. A Coverage provides the high-level identifiers and descriptors of a specific insurance plan for a specific individual - typically the information you can find on an insurance card. Additionally a coverage will include detailed benefits information covered by the specific plan for the individual.

Authentication

AuthorizationBearer

OAuth authentication of the form <token>.

Request

This endpoint expects an object.
statusenumRequired
The status indiciating if the coverage is active or not.
Allowed values:
subscriberobjectRequired

The party who has signed-up for or ‘owns’ the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.

relationshipenumRequired
The relationship of beneficiary (patient) to the subscriber. https://hl7.org/fhir/valueset-relationship.html
Allowed values:
patientstringRequired
The canonical Candid patient UUID corresponding with the patient who benefits from the insurance coverage
insurance_planobjectRequired
verifiedbooleanRequired
A boolean indicating if the coverage has been verified by a user.
eligibility_checkslist of objectsOptional
A list of eligibility check metadata that have been initiated on this coverage.
latest_eligibility_checkobjectOptional
The latest eligibility check metadata that has been initiated on this coverage.
benefitsobjectOptional
The eligibility of the patient for the coverage, manually verified by users.
orconbooleanOptional

ORCON (Originator Controlled) - When set to true, the Candid system will hide this coverage from downstream integrations. Updates made in the Candid UI will unset this flag. Defaults to false.

auto_update_enabledbooleanOptional
Default to true. When set to true, the Candid system will automatically update this coverage with the latest eligibility check benefits information. Auto update behavior is also set at the eligibilityConfig org level configuration.

Response

This endpoint returns an object.
deactivatedboolean
True if the object is deactivated. Deactivated objects are not returned in search results but are returned in all other endpoints including scan.
idUUID
The unique identifier for a Coverage in the database
insurance_planobject
organization_idstring
The organization that owns this object.
patientstring
The canonical Candid patient UUID corresponding with the patient who benefits from the insurance coverage
relationshipenum
The relationship of beneficiary (patient) to the subscriber. https://hl7.org/fhir/valueset-relationship.html
Allowed values:
statusenum
The status indiciating if the coverage is active or not.
Allowed values:
subscriberobject

The party who has signed-up for or ‘owns’ the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.

updated_atdatetime
updating_user_idstring
The user ID of the user who last updated the object.
verifiedboolean
A boolean indicating if the coverage has been verified by a user.
versioninteger
The version of the object. Any update to any property of an object object will create a new version.
auto_update_enabledboolean or null
Default to true. When set to true, the Candid system will automatically update this coverage with the latest eligibility check benefits information. Auto update behavior is also set at the eligibilityConfig org level configuration.
benefitsobject or null
The eligibility of the patient for the coverage, manually verified by users.
eligibility_checkslist of objects or null
A list of eligibility check metadata that have been initiated on this coverage.
latest_eligibility_checkobject or null
The latest eligibility check metadata that has been initiated on this coverage.
orconboolean or null

ORCON (Originator Controlled) - When set to true, the Candid system will hide this coverage from downstream integrations. Updates made in the Candid UI will unset this flag. Defaults to false.