API Reference Pre Encounter Coverages V1

Get Eligibility

Beta

GET

Gets the eligibility of a patient for a specific coverage if successful.

Path parameters

idUUIDRequired

The unique identifier for a Coverage in the database

check_idstringRequired

Response

This endpoint returns an object.

metadataobject

checkobjectOptional

GET

1 curl https://pre-api.joincandidhealth.com/coverages/v1//d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32/eligibility/:check_id \
2      -H "Authorization: Bearer <token>"

200Retrieved

1 {
2   "metadata": {
3     "check_id": "string",
4     "service_code": "1",
5     "status": "CREATED",
6     "initiated_by": "string",
7     "initiated_at": "2023-01-01T00:00:00Z"
8   },
9   "check": {
10     "raw_json": {},
11     "errors": {},
12     "eligibility_status": "ACTIVE",
13     "plan_metadata": {
14       "insurance_type": "string",
15       "insurance_type_code": "string",
16       "plan_name": "string",
17       "member_id": "string",
18       "group_number": "string",
19       "start_date": "2023-01-01",
20       "end_date": "2023-01-01",
21       "eligibility_status": "ACTIVE"
22     },
23     "benefits": {
24       "plan_coverage": {
25         "in_network": {
26           "deductible": {
27             "family": 1,
28             "individual": 1
29           },
30           "deductible_remaining": {
31             "family": 1,
32             "individual": 1
33           },
34           "oop_max": {
35             "family": 1,
36             "individual": 1
37           },
38           "oop_max_remaining": {
39             "family": 1,
40             "individual": 1
41           },
42           "additional_notes": "string"
43         },
44         "out_of_network": {
45           "deductible": {
46             "family": 1,
47             "individual": 1
48           },
49           "deductible_remaining": {
50             "family": 1,
51             "individual": 1
52           },
53           "oop_max": {
54             "family": 1,
55             "individual": 1
56           },
57           "oop_max_remaining": {
58             "family": 1,
59             "individual": 1
60           },
61           "additional_notes": "string"
62         }
63       },
64       "service_specific_coverage": [
65         {
66           "service_code": "1",
67           "in_network": {
68             "copay": {
69               "family": 1,
70               "individual": 1
71             },
72             "coinsurance": {
73               "family": 1,
74               "individual": 1
75             },
76             "visits": {
77               "family": 1,
78               "individual": 1
79             },
80             "visits_remaining": {
81               "family": 1,
82               "individual": 1
83             },
84             "additional_notes": "string"
85           },
86           "out_of_network": {
87             "copay": {
88               "family": 1,
89               "individual": 1
90             },
91             "coinsurance": {
92               "family": 1,
93               "individual": 1
94             },
95             "visits": {
96               "family": 1,
97               "individual": 1
98             },
99             "visits_remaining": {
100               "family": 1,
101               "individual": 1
102             },
103             "additional_notes": "string"
104           }
105         }
106       ]
107     }
108   }
109 }

Built with

1	curl https://pre-api.joincandidhealth.com/coverages/v1//d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32/eligibility/:check_id \
2	-H "Authorization: Bearer <token>"

1	{
2	"metadata": {
3	"check_id": "string",
4	"service_code": "1",
5	"status": "CREATED",
6	"initiated_by": "string",
7	"initiated_at": "2023-01-01T00:00:00Z"
8	},
9	"check": {
10	"raw_json": {},
11	"errors": {},
12	"eligibility_status": "ACTIVE",
13	"plan_metadata": {
14	"insurance_type": "string",
15	"insurance_type_code": "string",
16	"plan_name": "string",
17	"member_id": "string",
18	"group_number": "string",
19	"start_date": "2023-01-01",
20	"end_date": "2023-01-01",
21	"eligibility_status": "ACTIVE"
22	},
23	"benefits": {
24	"plan_coverage": {
25	"in_network": {
26	"deductible": {
27	"family": 1,
28	"individual": 1
29	},
30	"deductible_remaining": {
31	"family": 1,
32	"individual": 1
33	},
34	"oop_max": {
35	"family": 1,
36	"individual": 1
37	},
38	"oop_max_remaining": {
39	"family": 1,
40	"individual": 1
41	},
42	"additional_notes": "string"
43	},
44	"out_of_network": {
45	"deductible": {
46	"family": 1,
47	"individual": 1
48	},
49	"deductible_remaining": {
50	"family": 1,
51	"individual": 1
52	},
53	"oop_max": {
54	"family": 1,
55	"individual": 1
56	},
57	"oop_max_remaining": {
58	"family": 1,
59	"individual": 1
60	},
61	"additional_notes": "string"
62	}
63	},
64	"service_specific_coverage": [
65	{
66	"service_code": "1",
67	"in_network": {
68	"copay": {
69	"family": 1,
70	"individual": 1
71	},
72	"coinsurance": {
73	"family": 1,
74	"individual": 1
75	},
76	"visits": {
77	"family": 1,
78	"individual": 1
79	},
80	"visits_remaining": {
81	"family": 1,
82	"individual": 1
83	},
84	"additional_notes": "string"
85	},
86	"out_of_network": {
87	"copay": {
88	"family": 1,
89	"individual": 1
90	},
91	"coinsurance": {
92	"family": 1,
93	"individual": 1
94	},
95	"visits": {
96	"family": 1,
97	"individual": 1
98	},
99	"visits_remaining": {
100	"family": 1,
101	"individual": 1
102	},
103	"additional_notes": "string"
104	}
105	}
106	]
107	}
108	}
109	}