Get Eligibility

Beta

GET

/coverages/v1//:id/eligibility/:check_id

GET

/coverages/v1//:id/eligibility/:check_id

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

Try it

200Retrieved

1 {
2   "metadata": {
3     "check_id": "check_id",
4     "service_code": "1",
5     "status": "COMPLETED",
6     "initiated_by": "initiated_by",
7     "initiated_at": "2024-01-15T09:30:00Z"
8   },
9   "check": {
10     "response": {
11       "key": "value"
12     },
13     "batch_id": "batch_id",
14     "errors": [
15       {
16         "source": "CANDID",
17         "errorDetails": {
18           "field?": "field?",
19           "description?": "description?",
20           "location?": "location?",
21           "possibleResolutions?": "possibleResolutions?",
22           "code?": "code?",
23           "followupAction?": "followupAction?"
24         }
25       },
26       {
27         "source": "CANDID",
28         "errorDetails": {
29           "field?": "field?",
30           "description?": "description?",
31           "location?": "location?",
32           "possibleResolutions?": "possibleResolutions?",
33           "code?": "code?",
34           "followupAction?": "followupAction?"
35         }
36       }
37     ],
38     "request": {
39       "payer_id": "payer_id",
40       "provider": {
41         "first_name": "first_name",
42         "last_name": "last_name",
43         "npi": "npi"
44       },
45       "subscriber": {
46         "first_name": "first_name",
47         "last_name": "last_name",
48         "member_id": "member_id",
49         "date_of_birth": "2023-01-15"
50       },
51       "submitter_transaction_identifier": "submitter_transaction_identifier",
52       "dependent": {
53         "first_name": "first_name",
54         "last_name": "last_name",
55         "member_id": "member_id",
56         "date_of_birth": "2023-01-15"
57       },
58       "encounter": {
59         "date_of_service": "2023-01-15",
60         "service_type_codes": [
61           "service_type_codes",
62           "service_type_codes"
63         ]
64       }
65     },
66     "parsed_response": {
67       "eligibility_status": "ACTIVE",
68       "plan_metadata": {
69         "payer_name": "payer_name",
70         "insurance_type": "insurance_type",
71         "insurance_type_code": "insurance_type_code",
72         "plan_name": "plan_name",
73         "member_id": "member_id",
74         "group_number": "group_number",
75         "start_date": "2023-01-15",
76         "end_date": "2023-01-15",
77         "plan_dates": [
78           {
79             "start_date": "2023-01-15",
80             "field_name": "field_name"
81           },
82           {
83             "start_date": "2023-01-15",
84             "field_name": "field_name"
85           }
86         ],
87         "subscriber": {
88           "member_id": "member_id",
89           "group_number": "group_number",
90           "first_name": "first_name",
91           "middle_name": "middle_name",
92           "last_name": "last_name",
93           "date_of_birth": "date_of_birth",
94           "gender": "gender",
95           "address": {}
96         },
97         "dependent": {
98           "member_id": "member_id",
99           "group_number": "group_number",
100           "first_name": "first_name",
101           "middle_name": "middle_name",
102           "last_name": "last_name",
103           "date_of_birth": "date_of_birth",
104           "gender": "gender",
105           "address": {}
106         }
107       },
108       "benefits": {
109         "plan_coverage": {
110           "in_network": {},
111           "in_network_flat": [],
112           "out_of_network": {},
113           "out_of_network_flat": []
114         },
115         "service_specific_coverage": [
116           {
117             "service_code": "1"
118           },
119           {
120             "service_code": "1"
121           }
122         ],
123         "benefits_related_entities": [
124           {},
125           {}
126         ],
127         "notes": "notes"
128       }
129     },
130     "request_corrections": [
131       {
132         "property": "property",
133         "request_value": "request_value",
134         "corrected_value": "corrected_value"
135       },
136       {
137         "property": "property",
138         "request_value": "request_value",
139         "corrected_value": "corrected_value"
140       }
141     ]
142   }
143 }

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

Authentication

AuthorizationBearer

OAuth authentication of the form <token>.

Path parameters

idUUIDRequired

The unique identifier for a Coverage in the database

check_idstringRequired

Response

This endpoint returns an object.

metadataobject

checkobject or null