> For clean Markdown of any page, append .md to the page URL. > For a complete documentation index, see https://docs.joincandidhealth.com/llms.txt. > For AI client integration (Claude Code, Cursor, etc.), connect to the MCP server at https://docs.joincandidhealth.com/_mcp/server. # Create POST https://pre-api.joincandidhealth.com/coverages/v1/ Content-Type: application/json 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. Reference: https://docs.joincandidhealth.com/api-reference/pre-encounter/coverages/v-1/create ## Authentication - OAuth2 — send the obtained token as `Authorization: Bearer ` ## Servers - `https://pre-api.joincandidhealth.com` (Production, default) - `https://pre-api-staging.joincandidhealth.com` (Staging) - `https://sandbox-pre-api.joincandidhealth.com` (CandidSandbox) - `https://staging-pre-api.joincandidhealth.com` (CandidStaging) - `http://localhost:4000` (Local) ## Request ### Body (application/json) This endpoint expects a MutableCoverage. - `status` (enum, required) — The status indiciating if the coverage is active or not. - Allowed values: `ACTIVE`, `CANCELLED`, `DRAFT`, `ENTERED_IN_ERROR` - `subscriber` (Subscriber, required) — 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. - `relationship` (enum, required) — The relationship of beneficiary (patient) to the subscriber. https://hl7.org/fhir/valueset-relationship.html - Allowed values: `SELF`, `SPOUSE`, `CHILD`, `COMMON_LAW_SPOUSE`, `OTHER` - `patient` (string, required) — The canonical Candid patient UUID corresponding with the patient who benefits from the insurance coverage - `insurance_plan` (InsurancePlan, required) - `verified` (boolean, required) — A boolean indicating if the coverage has been verified by a user. - `eligibility_checks` (list of EligibilityCheckMetadata, optional) — A list of eligibility check metadata that have been initiated on this coverage. - `latest_eligibility_check` (LatestEligibilityCheck, optional) — The latest eligibility check metadata that has been initiated on this coverage. - `benefits` (CoverageBenefits, optional) — The eligibility of the patient for the coverage, manually verified by users. - `orcon` (boolean, optional) — 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_enabled` (boolean, optional) — 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. - `previous_appointment_copays` (map from enum to integer, optional) — A map of UniversalServiceIdentifier (MD_Visit, Treatment, Tests, Activity) to copay values in cents. This is used to track copay values for each service type to handle OOP max resets correctly. ## Response ### 200 - `deactivated` (boolean, required) — True if the object is deactivated. Deactivated objects are not returned in search results but are returned in all other endpoints including scan. - `id` (UUID, required) — The unique identifier for a Coverage in the database - `insurance_plan` (InsurancePlan, required) - `organization_id` (string, required) — The organization that owns this object. - `patient` (string, required) — The canonical Candid patient UUID corresponding with the patient who benefits from the insurance coverage - `relationship` (enum, required) — The relationship of beneficiary (patient) to the subscriber. https://hl7.org/fhir/valueset-relationship.html - Allowed values: `SELF`, `SPOUSE`, `CHILD`, `COMMON_LAW_SPOUSE`, `OTHER` - `status` (enum, required) — The status indiciating if the coverage is active or not. - Allowed values: `ACTIVE`, `CANCELLED`, `DRAFT`, `ENTERED_IN_ERROR` - `subscriber` (Subscriber, required) — 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_at` (datetime, required) - `updating_user_id` (string, required) — The user ID of the user who last updated the object. - `verified` (boolean, required) — A boolean indicating if the coverage has been verified by a user. - `version` (integer, required) — The version of the object. Any update to any property of an object object will create a new version. - `auto_update_enabled` (boolean, optional) — 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. - `benefits` (CoverageBenefits, optional) — The eligibility of the patient for the coverage, manually verified by users. - `eligibility_checks` (list of EligibilityCheckMetadata, optional) — A list of eligibility check metadata that have been initiated on this coverage. - `latest_eligibility_check` (LatestEligibilityCheck, optional) — The latest eligibility check metadata that has been initiated on this coverage. - `orcon` (boolean, optional) — 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. - `previous_appointment_copays` (map from enum to integer, optional) — A map of UniversalServiceIdentifier (MD_Visit, Treatment, Tests, Activity) to copay values in cents. This is used to track copay values for each service type to handle OOP max resets correctly. ## Types ### Subscriber - `name` (HumanName, required) - `biological_sex` (enum, required) - Allowed values: `FEMALE`, `MALE`, `UNKNOWN`, `REFUSED` - `date_of_birth` (date, optional) - `address` (Address, optional) - `employer_name` (string, optional) ### InsurancePlan - `member_id` (string, required) - `payer_id` (string, required) — The unique identifier for a Payer in the database - `payer_name` (string, required) - `additional_payer_information` (AdditionalPayerInformation, optional) - `group_number` (string, optional) - `name` (string, optional) - `plan_type` (enum, optional) - Allowed values: `09`, `11`, `12`, `13`, `14`, `15`, `16`, `17`, `AM`, `BL`, `CH`, `CI`, `DS`, `FI`, `HM`, `LM`, `MA`, `MB`, `MC`, `OF`, `TV`, `VA`, `WC`, `ZZ` - `type` (enum, optional) — Code identifying the type of insurance policy within a specific insurance program (X12 008020 Element 1336) - Allowed values: `01`, `12`, `13`, `14`, `15`, `16`, `17`, `18`, `19`, `41`, `42`, `43`, `47`, `AP`, `C1`, `CO`, `CP`, `D`, `DB`, `E`, `EP`, `FF`, `GP`, `HA`, `HB`, `HD`, `HG`, `HM`, `HN`, `HP`, `HS`, `IN`, `IP`, `LC`, `LD`, `LI`, `LT`, `M`, `MA`, `MB`, `MC`, `MD`, `ME`, `MF`, `MH`, `MI`, `MJ`, `MK`, `ML`, `MM`, `MN`, `MO`, `MP`, `MR`, `MT`, `MV`, `OA`, `OT`, `PE`, `PL`, `PP`, `PR`, `PS`, `QM`, `RP`, `SP`, `TF`, `U`, `WC`, `WU` - `period` (Period, optional) - `insurance_card_image_locator` (string, optional) - `address` (Address, optional) - `payer_plan_group_id` (UUID, optional) — The ID of the Candid configured payer plan group associated with this coverage - `carve_outs` (list of CoverageCarveOut, optional) ### EligibilityCheckMetadata - `check_id` (string, required) - `service_code` (enum, required) — Code identifying the type of service or benefit within a specific insurance policy (X12 008010 Element 1365) - Allowed values: `1`, `2`, `3`, `4`, `5`, `6`, `7`, `8`, `9`, `10`, `11`, `12`, `13`, `14`, `15`, `16`, `17`, `18`, `19`, `20`, `21`, `22`, `23`, `24`, `25`, `26`, `27`, `28`, `30`, `32`, `33`, `34`, `35`, `36`, `37`, `38`, `39`, `40`, `41`, `42`, `43`, `44`, `45`, `46`, `47`, `48`, `49`, `50`, `51`, `52`, `53`, `54`, `55`, `56`, `57`, `58`, `59`, `60`, `61`, `62`, `63`, `64`, `65`, `66`, `67`, `68`, `69`, `70`, `71`, `72`, `73`, `74`, `75`, `76`, `77`, `78`, `79`, `80`, `81`, `82`, `83`, `84`, `85`, `86`, `87`, `88`, `89`, `90`, `91`, `92`, `93`, `94`, `95`, `96`, `97`, `98`, `99`, `A0`, `A1`, `A2`, `A3`, `A4`, `A5`, `A6`, `A7`, `A8`, `A9`, `AA`, `AB`, `AC`, `AD`, `AE`, `AF`, `AG`, `AH`, `AI`, `AJ`, `AK`, `AL`, `AM`, `AN`, `AO`, `AQ`, `AR`, `B1`, `B2`, `B3`, `BA`, `BB`, `BC`, `BD`, `BE`, `BF`, `BG`, `BH`, `BI`, `BJ`, `BK`, `BL`, `BM`, `BN`, `BP`, `BQ`, `BR`, `BS`, `BT`, `BU`, `BV`, `BW`, `BX`, `BY`, `BZ`, `C1`, `CA`, `CB`, `CC`, `CD`, `CE`, `CF`, `CG`, `CH`, `CI`, `CJ`, `CK`, `CL`, `CM`, `CN`, `CO`, `CP`, `CQ`, `DG`, `DM`, `DS`, `GF`, `GN`, `GY`, `IC`, `MH`, `NI`, `ON`, `PT`, `PU`, `RN`, `RT`, `TC`, `TN`, `UC` - `status` (enum, required) — enum to represent the status of an eligibility checks - Allowed values: `COMPLETED`, `FAILED`, `PENDING` - `initiated_by` (string, required) — The unique identifier for a User in the database - `initiated_at` (datetime, required) ### LatestEligibilityCheck A type to represent the latest eligibility check status of a coverage. - `check_id` (string, required) - `status` (enum, required) — enum to represent the status of a patient's coverage - Allowed values: `ACTIVE`, `INACTIVE`, `UNKNOWN` - `initiated_at` (datetime, required) - `errors` (list of EligibilityCheckErrorDetails, optional) - `request_corrections` (list of RequestCorrection, optional) — Fields where the payer's 271 response disagreed with what we sent on the request, surfaced from the check so consumers can detect that the eligibility response contradicted the coverage on file. Empty when the payer echoed everything we sent. - `trading_partner` (string, optional) — The payer's own identifier as returned on the Stedi eligibility response (271) `tradingPartnerServiceId`, surfaced from the latest check's plan metadata so it is readable off the coverage. Can differ from the ID we submitted. ### CoverageBenefits - `plan_coverage` (PlanCoverage, optional) - `service_specific_coverage` (list of ServiceCoverage, optional) - `benefits_related_entities` (list of BenefitsRelatedEntity, optional) - `non_covered_details` (list of NonCoveredDetail, optional) - `notes` (string, optional) - `autoUpdatedEligibilityCheckId` (string, optional) ### HumanName - `family` (string, required) - `given` (list of string, required) - `use` (enum, required) - Allowed values: `USUAL`, `OFFICIAL`, `TEMP`, `NICKNAME`, `ANONYMOUS`, `OLD`, `MAIDEN` - `period` (Period, optional) - `suffix` (string, optional) ### Address - `use` (enum, required) - Allowed values: `HOME`, `WORK`, `TEMP`, `OLD`, `BILLING` - `line` (list of string, required) - `city` (string, required) - `state` (string, required) - `postal_code` (string, required) - `country` (string, required) - `administrative_area` (string, optional) — The top-level administrative subdivision of the country for addresses outside the US — for example a Canadian province, a UK county, or a Japanese prefecture. Only permitted on international addresses: `country` must be present and non-US, and `state` must be "FC" (the X12 foreign-country sentinel). For US addresses use `state` instead. - `county` (string, optional) - `period` (Period, optional) ### AdditionalPayerInformation - `availity_eligibility_id` (string, optional) - `availity_payer_id` (string, optional) - `availity_payer_name` (string, optional) - `availity_remittance_payer_id` (string, optional) ### Period - `start` (date, optional) - `end` (date, optional) ### CoverageCarveOut - `carve_out` (enum, required) - Allowed values: `BEHAVIORAL`, `MEDICAL`, `THERAPY`, `OTHER` - `member_id` (string, required) - `payer_id` (string, required) — The unique identifier for a Payer in the database - `payer_name` (string, required) - `group_number` (string, optional) - `plan_type` (enum, optional) - Allowed values: `09`, `11`, `12`, `13`, `14`, `15`, `16`, `17`, `AM`, `BL`, `CH`, `CI`, `DS`, `FI`, `HM`, `LM`, `MA`, `MB`, `MC`, `OF`, `TV`, `VA`, `WC`, `ZZ` - `type` (enum, optional) — Code identifying the type of insurance policy within a specific insurance program (X12 008020 Element 1336) - Allowed values: `01`, `12`, `13`, `14`, `15`, `16`, `17`, `18`, `19`, `41`, `42`, `43`, `47`, `AP`, `C1`, `CO`, `CP`, `D`, `DB`, `E`, `EP`, `FF`, `GP`, `HA`, `HB`, `HD`, `HG`, `HM`, `HN`, `HP`, `HS`, `IN`, `IP`, `LC`, `LD`, `LI`, `LT`, `M`, `MA`, `MB`, `MC`, `MD`, `ME`, `MF`, `MH`, `MI`, `MJ`, `MK`, `ML`, `MM`, `MN`, `MO`, `MP`, `MR`, `MT`, `MV`, `OA`, `OT`, `PE`, `PL`, `PP`, `PR`, `PS`, `QM`, `RP`, `SP`, `TF`, `U`, `WC`, `WU` - `payer_plan_group_id` (UUID, optional) — The ID of the Candid configured payer plan group associated with this coverage ### EligibilityCheckErrorDetails This object is our fern representation of Stedi's EligbilityCheckError object from their API. - `field?` (string, optional) - `description?` (string, optional) - `location?` (string, optional) - `possibleResolutions?` (string, optional) - `code?` (string, optional) - `followupAction?` (string, optional) ### RequestCorrection - `property` (string, required) - `request_value` (string, required) - `corrected_value` (string, required) ### PlanCoverage - `in_network` (PlanCoverageDetails, optional) - `in_network_flat` (list of CoverageDetails, optional) - `out_of_network` (PlanCoverageDetails, optional) - `out_of_network_flat` (list of CoverageDetails, optional) ### ServiceCoverage - `service_code` (enum, required) — Code identifying the type of service or benefit within a specific insurance policy (X12 008010 Element 1365) - Allowed values: `1`, `2`, `3`, `4`, `5`, `6`, `7`, `8`, `9`, `10`, `11`, `12`, `13`, `14`, `15`, `16`, `17`, `18`, `19`, `20`, `21`, `22`, `23`, `24`, `25`, `26`, `27`, `28`, `30`, `32`, `33`, `34`, `35`, `36`, `37`, `38`, `39`, `40`, `41`, `42`, `43`, `44`, `45`, `46`, `47`, `48`, `49`, `50`, `51`, `52`, `53`, `54`, `55`, `56`, `57`, `58`, `59`, `60`, `61`, `62`, `63`, `64`, `65`, `66`, `67`, `68`, `69`, `70`, `71`, `72`, `73`, `74`, `75`, `76`, `77`, `78`, `79`, `80`, `81`, `82`, `83`, `84`, `85`, `86`, `87`, `88`, `89`, `90`, `91`, `92`, `93`, `94`, `95`, `96`, `97`, `98`, `99`, `A0`, `A1`, `A2`, `A3`, `A4`, `A5`, `A6`, `A7`, `A8`, `A9`, `AA`, `AB`, `AC`, `AD`, `AE`, `AF`, `AG`, `AH`, `AI`, `AJ`, `AK`, `AL`, `AM`, `AN`, `AO`, `AQ`, `AR`, `B1`, `B2`, `B3`, `BA`, `BB`, `BC`, `BD`, `BE`, `BF`, `BG`, `BH`, `BI`, `BJ`, `BK`, `BL`, `BM`, `BN`, `BP`, `BQ`, `BR`, `BS`, `BT`, `BU`, `BV`, `BW`, `BX`, `BY`, `BZ`, `C1`, `CA`, `CB`, `CC`, `CD`, `CE`, `CF`, `CG`, `CH`, `CI`, `CJ`, `CK`, `CL`, `CM`, `CN`, `CO`, `CP`, `CQ`, `DG`, `DM`, `DS`, `GF`, `GN`, `GY`, `IC`, `MH`, `NI`, `ON`, `PT`, `PU`, `RN`, `RT`, `TC`, `TN`, `UC` - `in_network` (ServiceCoverageDetails, optional) - `in_network_flat` (list of CoverageDetails, optional) - `out_of_network` (ServiceCoverageDetails, optional) - `out_of_network_flat` (list of CoverageDetails, optional) ### BenefitsRelatedEntity - `entityIdentifier` (string, optional) - `entityType` (string, optional) - `entityName` (string, optional) - `contactInformation` (list of RelatedEntityContact, optional) - `serviceTypeCodes` (list of enum, optional) - Allowed values: `1`, `2`, `3`, `4`, `5`, `6`, `7`, `8`, `9`, `10`, `11`, `12`, `13`, `14`, `15`, `16`, `17`, `18`, `19`, `20`, `21`, `22`, `23`, `24`, `25`, `26`, `27`, `28`, `30`, `32`, `33`, `34`, `35`, `36`, `37`, `38`, `39`, `40`, `41`, `42`, `43`, `44`, `45`, `46`, `47`, `48`, `49`, `50`, `51`, `52`, `53`, `54`, `55`, `56`, `57`, `58`, `59`, `60`, `61`, `62`, `63`, `64`, `65`, `66`, `67`, `68`, `69`, `70`, `71`, `72`, `73`, `74`, `75`, `76`, `77`, `78`, `79`, `80`, `81`, `82`, `83`, `84`, `85`, `86`, `87`, `88`, `89`, `90`, `91`, `92`, `93`, `94`, `95`, `96`, `97`, `98`, `99`, `A0`, `A1`, `A2`, `A3`, `A4`, `A5`, `A6`, `A7`, `A8`, `A9`, `AA`, `AB`, `AC`, `AD`, `AE`, `AF`, `AG`, `AH`, `AI`, `AJ`, `AK`, `AL`, `AM`, `AN`, `AO`, `AQ`, `AR`, `B1`, `B2`, `B3`, `BA`, `BB`, `BC`, `BD`, `BE`, `BF`, `BG`, `BH`, `BI`, `BJ`, `BK`, `BL`, `BM`, `BN`, `BP`, `BQ`, `BR`, `BS`, `BT`, `BU`, `BV`, `BW`, `BX`, `BY`, `BZ`, `C1`, `CA`, `CB`, `CC`, `CD`, `CE`, `CF`, `CG`, `CH`, `CI`, `CJ`, `CK`, `CL`, `CM`, `CN`, `CO`, `CP`, `CQ`, `DG`, `DM`, `DS`, `GF`, `GN`, `GY`, `IC`, `MH`, `NI`, `ON`, `PT`, `PU`, `RN`, `RT`, `TC`, `TN`, `UC` ### NonCoveredDetail - `type` (enum, required) - Allowed values: `DEDUCTIBLE`, `DEDUCTIBLE_CONTRACT`, `DEDUCTIBLE_REMAINING`, `DEDUCTIBLE_YEAR_TO_DATE`, `OOP_MAX`, `OOP_MAX_CONTRACT`, `OOP_MAX_REMAINING`, `OOP_MAX_YEAR_TO_DATE`, `COPAY`, `COINSURANCE`, `NON_COVERED`, `LIMITATION` - `coverageLevel` (enum, required) - Allowed values: `EMPLOYEE_AND_CHILDREN`, `EMPLOYEE_ONLY`, `EMPLOYEE_AND_SPOUSE`, `FAMILY`, `INDIVIDUAL` - `unit` (enum, required) - Allowed values: `PERCENT`, `CURRENCY`, `COUNT` - `value` (double, required) - `additional_notes` (string, optional) - `service_type_codes` (list of enum, optional) - Allowed values: `1`, `2`, `3`, `4`, `5`, `6`, `7`, `8`, `9`, `10`, `11`, `12`, `13`, `14`, `15`, `16`, `17`, `18`, `19`, `20`, `21`, `22`, `23`, `24`, `25`, `26`, `27`, `28`, `30`, `32`, `33`, `34`, `35`, `36`, `37`, `38`, `39`, `40`, `41`, `42`, `43`, `44`, `45`, `46`, `47`, `48`, `49`, `50`, `51`, `52`, `53`, `54`, `55`, `56`, `57`, `58`, `59`, `60`, `61`, `62`, `63`, `64`, `65`, `66`, `67`, `68`, `69`, `70`, `71`, `72`, `73`, `74`, `75`, `76`, `77`, `78`, `79`, `80`, `81`, `82`, `83`, `84`, `85`, `86`, `87`, `88`, `89`, `90`, `91`, `92`, `93`, `94`, `95`, `96`, `97`, `98`, `99`, `A0`, `A1`, `A2`, `A3`, `A4`, `A5`, `A6`, `A7`, `A8`, `A9`, `AA`, `AB`, `AC`, `AD`, `AE`, `AF`, `AG`, `AH`, `AI`, `AJ`, `AK`, `AL`, `AM`, `AN`, `AO`, `AQ`, `AR`, `B1`, `B2`, `B3`, `BA`, `BB`, `BC`, `BD`, `BE`, `BF`, `BG`, `BH`, `BI`, `BJ`, `BK`, `BL`, `BM`, `BN`, `BP`, `BQ`, `BR`, `BS`, `BT`, `BU`, `BV`, `BW`, `BX`, `BY`, `BZ`, `C1`, `CA`, `CB`, `CC`, `CD`, `CE`, `CF`, `CG`, `CH`, `CI`, `CJ`, `CK`, `CL`, `CM`, `CN`, `CO`, `CP`, `CQ`, `DG`, `DM`, `DS`, `GF`, `GN`, `GY`, `IC`, `MH`, `NI`, `ON`, `PT`, `PU`, `RN`, `RT`, `TC`, `TN`, `UC` ### PlanCoverageDetails - `deductible` (CoverageValue, optional) - `deductible_contract` (CoverageValue, optional) - `deductible_remaining` (CoverageValue, optional) - `deductible_year_to_date` (CoverageValue, optional) - `oop_max` (CoverageValue, optional) - `oop_max_contract` (CoverageValue, optional) - `oop_max_remaining` (CoverageValue, optional) - `oop_max_year_to_date` (CoverageValue, optional) - `additional_notes` (string, optional) ### CoverageDetails - `type` (enum, required) - Allowed values: `DEDUCTIBLE`, `DEDUCTIBLE_CONTRACT`, `DEDUCTIBLE_REMAINING`, `DEDUCTIBLE_YEAR_TO_DATE`, `OOP_MAX`, `OOP_MAX_CONTRACT`, `OOP_MAX_REMAINING`, `OOP_MAX_YEAR_TO_DATE`, `COPAY`, `COINSURANCE`, `NON_COVERED`, `LIMITATION` - `coverageLevel` (enum, required) - Allowed values: `EMPLOYEE_AND_CHILDREN`, `EMPLOYEE_ONLY`, `EMPLOYEE_AND_SPOUSE`, `FAMILY`, `INDIVIDUAL` - `unit` (enum, required) - Allowed values: `PERCENT`, `CURRENCY`, `COUNT` - `value` (double, required) - `additional_notes` (string, optional) ### ServiceCoverageDetails - `copay` (CoverageValue, optional) - `coinsurance` (CoverageValue, optional) - `visits` (CoverageValue, optional) - `visits_remaining` (CoverageValue, optional) - `additional_notes` (string, optional) ### RelatedEntityContact - `mode` (string, optional) - `value` (string, optional) ### CoverageValue - `family` (double, optional) - `individual` (double, optional) - `employeeAndSpouse` (double, optional) - `employeeAndChildren` (double, optional) ## Examples **Request** ```json { "status": "ACTIVE", "subscriber": { "name": { "family": "family", "given": [ "given", "given" ], "use": "USUAL" }, "biological_sex": "FEMALE" }, "relationship": "SELF", "patient": "patient", "insurance_plan": { "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name" }, "verified": true } ``` **Response** ```json { "deactivated": true, "id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32", "insurance_plan": { "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name", "additional_payer_information": { "availity_eligibility_id": "availity_eligibility_id", "availity_payer_id": "availity_payer_id", "availity_payer_name": "availity_payer_name", "availity_remittance_payer_id": "availity_remittance_payer_id" }, "group_number": "group_number", "name": "name", "plan_type": "09", "type": "01", "period": { "start": "2023-01-15", "end": "2023-01-15" }, "insurance_card_image_locator": "insurance_card_image_locator", "address": { "use": "HOME", "line": [ "line", "line" ], "city": "city", "state": "state", "postal_code": "postal_code", "country": "country", "administrative_area": "administrative_area", "county": "county", "period": { "start": "2023-01-15", "end": "2023-01-15" } }, "payer_plan_group_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32", "carve_outs": [ { "carve_out": "BEHAVIORAL", "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name", "group_number": "group_number", "plan_type": "09", "type": "01", "payer_plan_group_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32" }, { "carve_out": "BEHAVIORAL", "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name", "group_number": "group_number", "plan_type": "09", "type": "01", "payer_plan_group_id": "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32" } ] }, "organization_id": "organization_id", "patient": "patient", "relationship": "SELF", "status": "ACTIVE", "subscriber": { "name": { "family": "family", "given": [ "given", "given" ], "use": "USUAL", "period": { "start": "2023-01-15", "end": "2023-01-15" }, "suffix": "suffix" }, "biological_sex": "FEMALE", "date_of_birth": "2023-01-15", "address": { "use": "HOME", "line": [ "line", "line" ], "city": "city", "state": "state", "postal_code": "postal_code", "country": "country", "administrative_area": "administrative_area", "county": "county", "period": { "start": "2023-01-15", "end": "2023-01-15" } }, "employer_name": "employer_name" }, "updated_at": "2024-01-15T09:30:00Z", "updating_user_id": "updating_user_id", "verified": true, "version": 1, "auto_update_enabled": true, "benefits": { "plan_coverage": { "in_network": { "deductible": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "deductible_contract": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "deductible_remaining": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "deductible_year_to_date": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max_contract": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max_remaining": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max_year_to_date": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "additional_notes": "additional_notes" }, "in_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" } ], "out_of_network": { "deductible": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "deductible_contract": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "deductible_remaining": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "deductible_year_to_date": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max_contract": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max_remaining": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "oop_max_year_to_date": { "family": 1.1, "individual": 1.1, "employeeAndSpouse": 1.1, "employeeAndChildren": 1.1 }, "additional_notes": "additional_notes" }, "out_of_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" } ] }, "service_specific_coverage": [ { "service_code": "1", "in_network": { "copay": {}, "coinsurance": {}, "visits": {}, "visits_remaining": {}, "additional_notes": "additional_notes" }, "in_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" } ], "out_of_network": { "copay": {}, "coinsurance": {}, "visits": {}, "visits_remaining": {}, "additional_notes": "additional_notes" }, "out_of_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" } ] }, { "service_code": "1", "in_network": { "copay": {}, "coinsurance": {}, "visits": {}, "visits_remaining": {}, "additional_notes": "additional_notes" }, "in_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" } ], "out_of_network": { "copay": {}, "coinsurance": {}, "visits": {}, "visits_remaining": {}, "additional_notes": "additional_notes" }, "out_of_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes" } ] } ], "benefits_related_entities": [ { "entityIdentifier": "entityIdentifier", "entityType": "entityType", "entityName": "entityName", "contactInformation": [ { "mode": "mode", "value": "value" }, { "mode": "mode", "value": "value" } ], "serviceTypeCodes": [ "1", "1" ] }, { "entityIdentifier": "entityIdentifier", "entityType": "entityType", "entityName": "entityName", "contactInformation": [ { "mode": "mode", "value": "value" }, { "mode": "mode", "value": "value" } ], "serviceTypeCodes": [ "1", "1" ] } ], "non_covered_details": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes", "service_type_codes": [ "1", "1" ] }, { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 1.1, "additional_notes": "additional_notes", "service_type_codes": [ "1", "1" ] } ], "notes": "notes", "autoUpdatedEligibilityCheckId": "autoUpdatedEligibilityCheckId" }, "eligibility_checks": [ { "check_id": "check_id", "service_code": "1", "status": "COMPLETED", "initiated_by": "initiated_by", "initiated_at": "2024-01-15T09:30:00Z" }, { "check_id": "check_id", "service_code": "1", "status": "COMPLETED", "initiated_by": "initiated_by", "initiated_at": "2024-01-15T09:30:00Z" } ], "latest_eligibility_check": { "check_id": "check_id", "status": "ACTIVE", "initiated_at": "2024-01-15T09:30:00Z", "errors": [ { "field?": "field?", "description?": "description?", "location?": "location?", "possibleResolutions?": "possibleResolutions?", "code?": "code?", "followupAction?": "followupAction?" }, { "field?": "field?", "description?": "description?", "location?": "location?", "possibleResolutions?": "possibleResolutions?", "code?": "code?", "followupAction?": "followupAction?" } ], "request_corrections": [ { "property": "property", "request_value": "request_value", "corrected_value": "corrected_value" }, { "property": "property", "request_value": "request_value", "corrected_value": "corrected_value" } ], "trading_partner": "trading_partner" }, "orcon": true, "previous_appointment_copays": { "MD_Visit": 1 } } ``` **SDK Code** ```python import requests url = "https://pre-api.joincandidhealth.com/coverages/v1/" payload = { "status": "ACTIVE", "subscriber": { "name": { "family": "family", "given": ["given", "given"], "use": "USUAL" }, "biological_sex": "FEMALE" }, "relationship": "SELF", "patient": "patient", "insurance_plan": { "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name" }, "verified": True } headers = { "Authorization": ".", "Content-Type": "application/json" } response = requests.post(url, json=payload, headers=headers) print(response.json()) ``` ```javascript const url = 'https://pre-api.joincandidhealth.com/coverages/v1/'; const options = { method: 'POST', headers: {Authorization: '.', 'Content-Type': 'application/json'}, body: '{"status":"ACTIVE","subscriber":{"name":{"family":"family","given":["given","given"],"use":"USUAL"},"biological_sex":"FEMALE"},"relationship":"SELF","patient":"patient","insurance_plan":{"member_id":"member_id","payer_id":"payer_id","payer_name":"payer_name"},"verified":true}' }; try { const response = await fetch(url, options); const data = await response.json(); console.log(data); } catch (error) { console.error(error); } ``` ```go package main import ( "fmt" "strings" "net/http" "io" ) func main() { url := "https://pre-api.joincandidhealth.com/coverages/v1/" payload := strings.NewReader("{\n \"status\": \"ACTIVE\",\n \"subscriber\": {\n \"name\": {\n \"family\": \"family\",\n \"given\": [\n \"given\",\n \"given\"\n ],\n \"use\": \"USUAL\"\n },\n \"biological_sex\": \"FEMALE\"\n },\n \"relationship\": \"SELF\",\n \"patient\": \"patient\",\n \"insurance_plan\": {\n \"member_id\": \"member_id\",\n \"payer_id\": \"payer_id\",\n \"payer_name\": \"payer_name\"\n },\n \"verified\": true\n}") req, _ := http.NewRequest("POST", url, payload) req.Header.Add("Authorization", ".") req.Header.Add("Content-Type", "application/json") res, _ := http.DefaultClient.Do(req) defer res.Body.Close() body, _ := io.ReadAll(res.Body) fmt.Println(res) fmt.Println(string(body)) } ``` ```ruby require 'uri' require 'net/http' url = URI("https://pre-api.joincandidhealth.com/coverages/v1/") http = Net::HTTP.new(url.host, url.port) http.use_ssl = true request = Net::HTTP::Post.new(url) request["Authorization"] = '.' request["Content-Type"] = 'application/json' request.body = "{\n \"status\": \"ACTIVE\",\n \"subscriber\": {\n \"name\": {\n \"family\": \"family\",\n \"given\": [\n \"given\",\n \"given\"\n ],\n \"use\": \"USUAL\"\n },\n \"biological_sex\": \"FEMALE\"\n },\n \"relationship\": \"SELF\",\n \"patient\": \"patient\",\n \"insurance_plan\": {\n \"member_id\": \"member_id\",\n \"payer_id\": \"payer_id\",\n \"payer_name\": \"payer_name\"\n },\n \"verified\": true\n}" response = http.request(request) puts response.read_body ``` ```java import com.mashape.unirest.http.HttpResponse; import com.mashape.unirest.http.Unirest; HttpResponse response = Unirest.post("https://pre-api.joincandidhealth.com/coverages/v1/") .header("Authorization", ".") .header("Content-Type", "application/json") .body("{\n \"status\": \"ACTIVE\",\n \"subscriber\": {\n \"name\": {\n \"family\": \"family\",\n \"given\": [\n \"given\",\n \"given\"\n ],\n \"use\": \"USUAL\"\n },\n \"biological_sex\": \"FEMALE\"\n },\n \"relationship\": \"SELF\",\n \"patient\": \"patient\",\n \"insurance_plan\": {\n \"member_id\": \"member_id\",\n \"payer_id\": \"payer_id\",\n \"payer_name\": \"payer_name\"\n },\n \"verified\": true\n}") .asString(); ``` ```php request('POST', 'https://pre-api.joincandidhealth.com/coverages/v1/', [ 'body' => '{ "status": "ACTIVE", "subscriber": { "name": { "family": "family", "given": [ "given", "given" ], "use": "USUAL" }, "biological_sex": "FEMALE" }, "relationship": "SELF", "patient": "patient", "insurance_plan": { "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name" }, "verified": true }', 'headers' => [ 'Authorization' => '.', 'Content-Type' => 'application/json', ], ]); echo $response->getBody(); ``` ```csharp using RestSharp; var client = new RestClient("https://pre-api.joincandidhealth.com/coverages/v1/"); var request = new RestRequest(Method.POST); request.AddHeader("Authorization", "."); request.AddHeader("Content-Type", "application/json"); request.AddParameter("application/json", "{\n \"status\": \"ACTIVE\",\n \"subscriber\": {\n \"name\": {\n \"family\": \"family\",\n \"given\": [\n \"given\",\n \"given\"\n ],\n \"use\": \"USUAL\"\n },\n \"biological_sex\": \"FEMALE\"\n },\n \"relationship\": \"SELF\",\n \"patient\": \"patient\",\n \"insurance_plan\": {\n \"member_id\": \"member_id\",\n \"payer_id\": \"payer_id\",\n \"payer_name\": \"payer_name\"\n },\n \"verified\": true\n}", ParameterType.RequestBody); IRestResponse response = client.Execute(request); ``` ```swift import Foundation let headers = [ "Authorization": ".", "Content-Type": "application/json" ] let parameters = [ "status": "ACTIVE", "subscriber": [ "name": [ "family": "family", "given": ["given", "given"], "use": "USUAL" ], "biological_sex": "FEMALE" ], "relationship": "SELF", "patient": "patient", "insurance_plan": [ "member_id": "member_id", "payer_id": "payer_id", "payer_name": "payer_name" ], "verified": true ] as [String : Any] let postData = JSONSerialization.data(withJSONObject: parameters, options: []) let request = NSMutableURLRequest(url: NSURL(string: "https://pre-api.joincandidhealth.com/coverages/v1/")! as URL, cachePolicy: .useProtocolCachePolicy, timeoutInterval: 10.0) request.httpMethod = "POST" request.allHTTPHeaderFields = headers request.httpBody = postData as Data let session = URLSession.shared let dataTask = session.dataTask(with: request as URLRequest, completionHandler: { (data, response, error) -> Void in if (error != nil) { print(error as Any) } else { let httpResponse = response as? HTTPURLResponse print(httpResponse) } }) dataTask.resume() ```