Calculate patient cost for a line item
curl --request POST \
--url https://api.example.com/api/v2/clearinghouse/patient-cost \
--header 'Content-Type: application/json' \
--data '
{
"eligibilityResponses": [
{
"inNetwork": true,
"meta": {
"senderId": "<string>",
"submitterId": "<string>",
"billerId": "<string>",
"traceId": "<string>",
"outboundTraceId": "<string>"
},
"controlNumber": "<string>",
"reassociationKey": "<string>",
"tradingPartnerServiceId": "<string>",
"provider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriber": {
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Insured or Subscriber",
"relationToSubscriber": "Self",
"relationToSubscriberCode": "18",
"insuredIndicator": "Y",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriberTraceNumbers": [
{
"traceTypeCode": "<string>",
"traceType": "<string>",
"referenceIdentification": "<string>",
"originatingCompanyIdentifier": "<string>",
"secondaryReferenceIdentification": "<string>"
}
],
"payer": {
"firstName": "<string>",
"lastName": "<string>",
"name": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"federalTaxpayersIdNumber": "<string>",
"naic": "<string>",
"npi": "<string>",
"centersForMedicareAndMedicaidPlanId": "<string>",
"payorIdentification": "<string>",
"contactInformation": {
"name": "<string>",
"contacts": [
{
"communicationNumber": "<string>"
}
]
},
"etin": "<string>",
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"planInformation": {
"stateLicenseNumber": "<string>",
"medicareProviderNumber": "<string>",
"medicaidProviderNumber": "<string>",
"facilityIdNumber": "<string>",
"personalIdentificationNumber": "<string>",
"planNumber": "<string>",
"planDescription": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"caseNumber": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"classOfContractCode": "<string>",
"coverageListId": "<string>",
"contractNumber": "<string>",
"medicalRecordIdentificationNumber": "<string>",
"electronicDevicePin": "<string>",
"submitterIdentificationNumber": "<string>",
"patientAccountNumber": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"idCardSerialNumber": "<string>",
"idCardNumber": "<string>",
"centersForMedicareAndMedicaidServicesNPI": "<string>",
"issueNumber": "<string>",
"insurancePolicyNumber": "<string>",
"userIdentification": "<string>",
"medicalAssistanceCategory": "<string>",
"eligibilityCategory": "<string>",
"planNetworkIdNumber": "<string>",
"planNetworkIdDescription": "<string>",
"facilityNetworkIdentificationNumber": "<string>",
"medicaidRecipientIdNumber": "<string>",
"priorIdNumber": "<string>",
"socialSecurityNumber": "<string>",
"federalTaxpayersIdentificationNumber": "<string>",
"agencyClaimNumber": "<string>"
},
"planDateInformation": {
"discharge": "<string>",
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"plan": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidToDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admission": "<string>",
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>"
},
"errors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
],
"warnings": [
{
"code": "<string>",
"description": "<string>"
}
],
"status": "<string>",
"transactionSetAcknowledgement": "<string>",
"implementationTransactionSetSyntaxError": "<string>",
"x12": "<string>",
"planStatus": [
{
"statusCode": "<string>",
"status": "<string>",
"planDetails": "<string>",
"serviceTypeCodes": []
}
],
"dependents": [
{
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Dependent",
"insuredIndicator": "N",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
}
],
"benefitsInformation": [
{
"serviceTypeCodes": [],
"serviceTypes": [],
"planCoverage": "<string>",
"benefitAmount": "<string>",
"benefitPercent": "<string>",
"benefitQuantity": "<string>",
"headerLoopIdentifierCode": "<string>",
"trailerLoopIdentifierCode": "<string>",
"compositeMedicalProcedureIdentifier": {
"productOrServiceIdQualifierCode": "<string>",
"productOrServiceIdQualifier": "<string>",
"procedureCode": "<string>",
"procedureModifiers": [
"<string>"
],
"productOrServiceID": "<string>",
"diagnosisCodePointer": [
"<string>"
]
},
"benefitsAdditionalInformation": {
"planNumber": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"coverageListId": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"insurancePolicyNumber": "<string>",
"medicalAssistanceCategory": "<string>",
"planNetworkIdNumber": "<string>",
"medicaidRecepientIdNumber": "<string>"
},
"benefitsServiceDelivery": [
{
"quantity": "<string>",
"sampleSelectionModulus": "<string>",
"numOfPeriods": "<string>"
}
],
"additionalInformation": [
{
"description": "<string>"
}
],
"eligibilityAdditionalInformationList": [
{
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
],
"benefitsRelatedEntities": [
{
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [
{
"communicationNumber": "<string>"
}
]
},
"providerInformation": {
"referenceIdentification": "<string>"
}
}
],
"benefitsDateInformation": {
"discharges": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"plan": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidtoDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admissions": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"discharge": "<string>",
"admission": "<string>"
},
"benefitsRelatedEntity": {
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [
{
"communicationNumber": "<string>"
}
]
},
"providerInformation": {
"referenceIdentification": "<string>"
}
},
"eligibilityAdditionalInformation": {
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
}
]
}
],
"lineItems": [
{
"id": "<string>",
"cptCode": "<string>",
"serviceDate": "<string>",
"serviceAmount": 123
}
]
}
'import requests
url = "https://api.example.com/api/v2/clearinghouse/patient-cost"
payload = {
"eligibilityResponses": [
{
"inNetwork": True,
"meta": {
"senderId": "<string>",
"submitterId": "<string>",
"billerId": "<string>",
"traceId": "<string>",
"outboundTraceId": "<string>"
},
"controlNumber": "<string>",
"reassociationKey": "<string>",
"tradingPartnerServiceId": "<string>",
"provider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriber": {
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Insured or Subscriber",
"relationToSubscriber": "Self",
"relationToSubscriberCode": "18",
"insuredIndicator": "Y",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriberTraceNumbers": [
{
"traceTypeCode": "<string>",
"traceType": "<string>",
"referenceIdentification": "<string>",
"originatingCompanyIdentifier": "<string>",
"secondaryReferenceIdentification": "<string>"
}
],
"payer": {
"firstName": "<string>",
"lastName": "<string>",
"name": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"federalTaxpayersIdNumber": "<string>",
"naic": "<string>",
"npi": "<string>",
"centersForMedicareAndMedicaidPlanId": "<string>",
"payorIdentification": "<string>",
"contactInformation": {
"name": "<string>",
"contacts": [{ "communicationNumber": "<string>" }]
},
"etin": "<string>",
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"planInformation": {
"stateLicenseNumber": "<string>",
"medicareProviderNumber": "<string>",
"medicaidProviderNumber": "<string>",
"facilityIdNumber": "<string>",
"personalIdentificationNumber": "<string>",
"planNumber": "<string>",
"planDescription": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"caseNumber": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"classOfContractCode": "<string>",
"coverageListId": "<string>",
"contractNumber": "<string>",
"medicalRecordIdentificationNumber": "<string>",
"electronicDevicePin": "<string>",
"submitterIdentificationNumber": "<string>",
"patientAccountNumber": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"idCardSerialNumber": "<string>",
"idCardNumber": "<string>",
"centersForMedicareAndMedicaidServicesNPI": "<string>",
"issueNumber": "<string>",
"insurancePolicyNumber": "<string>",
"userIdentification": "<string>",
"medicalAssistanceCategory": "<string>",
"eligibilityCategory": "<string>",
"planNetworkIdNumber": "<string>",
"planNetworkIdDescription": "<string>",
"facilityNetworkIdentificationNumber": "<string>",
"medicaidRecipientIdNumber": "<string>",
"priorIdNumber": "<string>",
"socialSecurityNumber": "<string>",
"federalTaxpayersIdentificationNumber": "<string>",
"agencyClaimNumber": "<string>"
},
"planDateInformation": {
"discharge": "<string>",
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"plan": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidToDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admission": "<string>",
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>"
},
"errors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
],
"warnings": [
{
"code": "<string>",
"description": "<string>"
}
],
"status": "<string>",
"transactionSetAcknowledgement": "<string>",
"implementationTransactionSetSyntaxError": "<string>",
"x12": "<string>",
"planStatus": [
{
"statusCode": "<string>",
"status": "<string>",
"planDetails": "<string>",
"serviceTypeCodes": []
}
],
"dependents": [
{
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Dependent",
"insuredIndicator": "N",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
}
],
"benefitsInformation": [
{
"serviceTypeCodes": [],
"serviceTypes": [],
"planCoverage": "<string>",
"benefitAmount": "<string>",
"benefitPercent": "<string>",
"benefitQuantity": "<string>",
"headerLoopIdentifierCode": "<string>",
"trailerLoopIdentifierCode": "<string>",
"compositeMedicalProcedureIdentifier": {
"productOrServiceIdQualifierCode": "<string>",
"productOrServiceIdQualifier": "<string>",
"procedureCode": "<string>",
"procedureModifiers": ["<string>"],
"productOrServiceID": "<string>",
"diagnosisCodePointer": ["<string>"]
},
"benefitsAdditionalInformation": {
"planNumber": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"coverageListId": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"insurancePolicyNumber": "<string>",
"medicalAssistanceCategory": "<string>",
"planNetworkIdNumber": "<string>",
"medicaidRecepientIdNumber": "<string>"
},
"benefitsServiceDelivery": [
{
"quantity": "<string>",
"sampleSelectionModulus": "<string>",
"numOfPeriods": "<string>"
}
],
"additionalInformation": [{ "description": "<string>" }],
"eligibilityAdditionalInformationList": [
{
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
],
"benefitsRelatedEntities": [
{
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [{ "communicationNumber": "<string>" }]
},
"providerInformation": { "referenceIdentification": "<string>" }
}
],
"benefitsDateInformation": {
"discharges": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"plan": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidtoDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admissions": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"discharge": "<string>",
"admission": "<string>"
},
"benefitsRelatedEntity": {
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [{ "communicationNumber": "<string>" }]
},
"providerInformation": { "referenceIdentification": "<string>" }
},
"eligibilityAdditionalInformation": {
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
}
]
}
],
"lineItems": [
{
"id": "<string>",
"cptCode": "<string>",
"serviceDate": "<string>",
"serviceAmount": 123
}
]
}
headers = {"Content-Type": "application/json"}
response = requests.post(url, json=payload, headers=headers)
print(response.text)const options = {
method: 'POST',
headers: {'Content-Type': 'application/json'},
body: JSON.stringify({
eligibilityResponses: [
{
inNetwork: true,
meta: {
senderId: '<string>',
submitterId: '<string>',
billerId: '<string>',
traceId: '<string>',
outboundTraceId: '<string>'
},
controlNumber: '<string>',
reassociationKey: '<string>',
tradingPartnerServiceId: '<string>',
provider: {
providerName: '<string>',
providerFirstName: '<string>',
providerOrgName: '<string>',
middleName: '<string>',
suffix: '<string>',
npi: '<string>',
referenceIdentification: '<string>',
ssn: '<string>',
federalTaxpayersIdNumber: '<string>',
payorIdentification: '<string>',
pharmacyProcessorNumber: '<string>',
serviceProviderNumber: '<string>',
servicesPlanID: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
subscriber: {
healthCareDiagnosisCodes: [{diagnosisTypeCode: '<string>', diagnosisCode: '<string>'}],
memberId: '<string>',
firstName: '<string>',
lastName: '<string>',
middleName: '<string>',
suffix: '<string>',
uniqueHealthIdentifier: '<string>',
dateOfBirth: '<string>',
description: '<string>',
dateTimePeriod: '<string>',
startDateTimePeriod: '<string>',
endDateTimePeriod: '<string>',
ssn: '<string>',
groupNumber: '<string>',
planNumber: '<string>',
planNetworkIdNumber: '<string>',
groupDescription: '<string>',
planDescription: '<string>',
planNetworkDescription: '<string>',
maintenanceTypeCode: '001',
maintenanceReasonCode: '25',
birthSequenceNumber: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
responseProvider: {
providerName: '<string>',
providerFirstName: '<string>',
providerOrgName: '<string>',
middleName: '<string>',
suffix: '<string>',
npi: '<string>',
referenceIdentification: '<string>',
ssn: '<string>',
federalTaxpayersIdNumber: '<string>',
payorIdentification: '<string>',
pharmacyProcessorNumber: '<string>',
serviceProviderNumber: '<string>',
servicesPlanID: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
entityIdentifier: 'Insured or Subscriber',
relationToSubscriber: 'Self',
relationToSubscriberCode: '18',
insuredIndicator: 'Y',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
subscriberTraceNumbers: [
{
traceTypeCode: '<string>',
traceType: '<string>',
referenceIdentification: '<string>',
originatingCompanyIdentifier: '<string>',
secondaryReferenceIdentification: '<string>'
}
],
payer: {
firstName: '<string>',
lastName: '<string>',
name: '<string>',
middleName: '<string>',
suffix: '<string>',
federalTaxpayersIdNumber: '<string>',
naic: '<string>',
npi: '<string>',
centersForMedicareAndMedicaidPlanId: '<string>',
payorIdentification: '<string>',
contactInformation: {name: '<string>', contacts: [{communicationNumber: '<string>'}]},
etin: '<string>',
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
planInformation: {
stateLicenseNumber: '<string>',
medicareProviderNumber: '<string>',
medicaidProviderNumber: '<string>',
facilityIdNumber: '<string>',
personalIdentificationNumber: '<string>',
planNumber: '<string>',
planDescription: '<string>',
policyNumber: '<string>',
memberId: '<string>',
caseNumber: '<string>',
familyUnitNumber: '<string>',
groupNumber: '<string>',
groupDescription: '<string>',
referralNumber: '<string>',
alternativeListId: '<string>',
classOfContractCode: '<string>',
coverageListId: '<string>',
contractNumber: '<string>',
medicalRecordIdentificationNumber: '<string>',
electronicDevicePin: '<string>',
submitterIdentificationNumber: '<string>',
patientAccountNumber: '<string>',
hicNumber: '<string>',
drugFormularyNumber: '<string>',
priorAuthorizationNumber: '<string>',
idCardSerialNumber: '<string>',
idCardNumber: '<string>',
centersForMedicareAndMedicaidServicesNPI: '<string>',
issueNumber: '<string>',
insurancePolicyNumber: '<string>',
userIdentification: '<string>',
medicalAssistanceCategory: '<string>',
eligibilityCategory: '<string>',
planNetworkIdNumber: '<string>',
planNetworkIdDescription: '<string>',
facilityNetworkIdentificationNumber: '<string>',
medicaidRecipientIdNumber: '<string>',
priorIdNumber: '<string>',
socialSecurityNumber: '<string>',
federalTaxpayersIdentificationNumber: '<string>',
agencyClaimNumber: '<string>'
},
planDateInformation: {
discharge: '<string>',
issue: '<string>',
effectiveDateOfChange: '<string>',
plan: '<string>',
eligibility: '<string>',
added: '<string>',
cobraBegin: '<string>',
cobraEnd: '<string>',
premiumPaidToDateBegin: '<string>',
premiumPaidToDateEnd: '<string>',
planBegin: '<string>',
planEnd: '<string>',
eligibilityBegin: '<string>',
eligibilityEnd: '<string>',
enrollment: '<string>',
admission: '<string>',
dateOfDeath: '<string>',
certification: '<string>',
service: '<string>',
policyEffective: '<string>',
policyExpiration: '<string>',
dateOfLastUpdate: '<string>',
status: '<string>',
periodStart: '<string>',
periodEnd: '<string>',
completion: '<string>',
coordinationOfBenefits: '<string>',
benefit: '<string>',
primaryCareProvider: '<string>',
latestVisitOrConsultation: '<string>',
benefitBegin: '<string>',
benefitEnd: '<string>'
},
errors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
],
warnings: [{code: '<string>', description: '<string>'}],
status: '<string>',
transactionSetAcknowledgement: '<string>',
implementationTransactionSetSyntaxError: '<string>',
x12: '<string>',
planStatus: [
{
statusCode: '<string>',
status: '<string>',
planDetails: '<string>',
serviceTypeCodes: []
}
],
dependents: [
{
healthCareDiagnosisCodes: [{diagnosisTypeCode: '<string>', diagnosisCode: '<string>'}],
memberId: '<string>',
firstName: '<string>',
lastName: '<string>',
middleName: '<string>',
suffix: '<string>',
uniqueHealthIdentifier: '<string>',
dateOfBirth: '<string>',
description: '<string>',
dateTimePeriod: '<string>',
startDateTimePeriod: '<string>',
endDateTimePeriod: '<string>',
ssn: '<string>',
groupNumber: '<string>',
planNumber: '<string>',
planNetworkIdNumber: '<string>',
groupDescription: '<string>',
planDescription: '<string>',
planNetworkDescription: '<string>',
maintenanceTypeCode: '001',
maintenanceReasonCode: '25',
birthSequenceNumber: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
responseProvider: {
providerName: '<string>',
providerFirstName: '<string>',
providerOrgName: '<string>',
middleName: '<string>',
suffix: '<string>',
npi: '<string>',
referenceIdentification: '<string>',
ssn: '<string>',
federalTaxpayersIdNumber: '<string>',
payorIdentification: '<string>',
pharmacyProcessorNumber: '<string>',
serviceProviderNumber: '<string>',
servicesPlanID: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
entityIdentifier: 'Dependent',
insuredIndicator: 'N',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
}
],
benefitsInformation: [
{
serviceTypeCodes: [],
serviceTypes: [],
planCoverage: '<string>',
benefitAmount: '<string>',
benefitPercent: '<string>',
benefitQuantity: '<string>',
headerLoopIdentifierCode: '<string>',
trailerLoopIdentifierCode: '<string>',
compositeMedicalProcedureIdentifier: {
productOrServiceIdQualifierCode: '<string>',
productOrServiceIdQualifier: '<string>',
procedureCode: '<string>',
procedureModifiers: ['<string>'],
productOrServiceID: '<string>',
diagnosisCodePointer: ['<string>']
},
benefitsAdditionalInformation: {
planNumber: '<string>',
policyNumber: '<string>',
memberId: '<string>',
familyUnitNumber: '<string>',
groupNumber: '<string>',
groupDescription: '<string>',
planDescription: '<string>',
planNetworkDescription: '<string>',
referralNumber: '<string>',
alternativeListId: '<string>',
coverageListId: '<string>',
hicNumber: '<string>',
drugFormularyNumber: '<string>',
priorAuthorizationNumber: '<string>',
insurancePolicyNumber: '<string>',
medicalAssistanceCategory: '<string>',
planNetworkIdNumber: '<string>',
medicaidRecepientIdNumber: '<string>'
},
benefitsServiceDelivery: [
{
quantity: '<string>',
sampleSelectionModulus: '<string>',
numOfPeriods: '<string>'
}
],
additionalInformation: [{description: '<string>'}],
eligibilityAdditionalInformationList: [
{
codeListQualifier: '<string>',
industryCode: '<string>',
industry: '<string>',
codeCategory: '44',
injuredBodyPartName: '<string>'
}
],
benefitsRelatedEntities: [
{
entityName: '<string>',
entityFirstname: '<string>',
entityMiddlename: '<string>',
entitySuffix: '<string>',
entityIdentificationValue: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
contactInformation: {name: '<string>', contacts: [{communicationNumber: '<string>'}]},
providerInformation: {referenceIdentification: '<string>'}
}
],
benefitsDateInformation: {
discharges: [{date: '<string>', startDate: '<string>', endDate: '<string>'}],
issue: '<string>',
effectiveDateOfChange: '<string>',
periodStart: '<string>',
periodEnd: '<string>',
completion: '<string>',
coordinationOfBenefits: '<string>',
plan: '<string>',
benefit: '<string>',
primaryCareProvider: '<string>',
latestVisitOrConsultation: '<string>',
eligibility: '<string>',
added: '<string>',
cobraBegin: '<string>',
cobraEnd: '<string>',
premiumPaidtoDateBegin: '<string>',
premiumPaidToDateEnd: '<string>',
planBegin: '<string>',
planEnd: '<string>',
benefitBegin: '<string>',
benefitEnd: '<string>',
eligibilityBegin: '<string>',
eligibilityEnd: '<string>',
enrollment: '<string>',
admissions: [{date: '<string>', startDate: '<string>', endDate: '<string>'}],
dateOfDeath: '<string>',
certification: '<string>',
service: '<string>',
policyEffective: '<string>',
policyExpiration: '<string>',
dateOfLastUpdate: '<string>',
status: '<string>',
discharge: '<string>',
admission: '<string>'
},
benefitsRelatedEntity: {
entityName: '<string>',
entityFirstname: '<string>',
entityMiddlename: '<string>',
entitySuffix: '<string>',
entityIdentificationValue: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
contactInformation: {name: '<string>', contacts: [{communicationNumber: '<string>'}]},
providerInformation: {referenceIdentification: '<string>'}
},
eligibilityAdditionalInformation: {
codeListQualifier: '<string>',
industryCode: '<string>',
industry: '<string>',
codeCategory: '44',
injuredBodyPartName: '<string>'
}
}
]
}
],
lineItems: [
{
id: '<string>',
cptCode: '<string>',
serviceDate: '<string>',
serviceAmount: 123
}
]
})
};
fetch('https://api.example.com/api/v2/clearinghouse/patient-cost', options)
.then(res => res.json())
.then(res => console.log(res))
.catch(err => console.error(err));<?php
$curl = curl_init();
curl_setopt_array($curl, [
CURLOPT_URL => "https://api.example.com/api/v2/clearinghouse/patient-cost",
CURLOPT_RETURNTRANSFER => true,
CURLOPT_ENCODING => "",
CURLOPT_MAXREDIRS => 10,
CURLOPT_TIMEOUT => 30,
CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
CURLOPT_CUSTOMREQUEST => "POST",
CURLOPT_POSTFIELDS => json_encode([
'eligibilityResponses' => [
[
'inNetwork' => true,
'meta' => [
'senderId' => '<string>',
'submitterId' => '<string>',
'billerId' => '<string>',
'traceId' => '<string>',
'outboundTraceId' => '<string>'
],
'controlNumber' => '<string>',
'reassociationKey' => '<string>',
'tradingPartnerServiceId' => '<string>',
'provider' => [
'providerName' => '<string>',
'providerFirstName' => '<string>',
'providerOrgName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'npi' => '<string>',
'referenceIdentification' => '<string>',
'ssn' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'payorIdentification' => '<string>',
'pharmacyProcessorNumber' => '<string>',
'serviceProviderNumber' => '<string>',
'servicesPlanID' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'subscriber' => [
'healthCareDiagnosisCodes' => [
[
'diagnosisTypeCode' => '<string>',
'diagnosisCode' => '<string>'
]
],
'memberId' => '<string>',
'firstName' => '<string>',
'lastName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'uniqueHealthIdentifier' => '<string>',
'dateOfBirth' => '<string>',
'description' => '<string>',
'dateTimePeriod' => '<string>',
'startDateTimePeriod' => '<string>',
'endDateTimePeriod' => '<string>',
'ssn' => '<string>',
'groupNumber' => '<string>',
'planNumber' => '<string>',
'planNetworkIdNumber' => '<string>',
'groupDescription' => '<string>',
'planDescription' => '<string>',
'planNetworkDescription' => '<string>',
'maintenanceTypeCode' => '001',
'maintenanceReasonCode' => '25',
'birthSequenceNumber' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'responseProvider' => [
'providerName' => '<string>',
'providerFirstName' => '<string>',
'providerOrgName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'npi' => '<string>',
'referenceIdentification' => '<string>',
'ssn' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'payorIdentification' => '<string>',
'pharmacyProcessorNumber' => '<string>',
'serviceProviderNumber' => '<string>',
'servicesPlanID' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'entityIdentifier' => 'Insured or Subscriber',
'relationToSubscriber' => 'Self',
'relationToSubscriberCode' => '18',
'insuredIndicator' => 'Y',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'subscriberTraceNumbers' => [
[
'traceTypeCode' => '<string>',
'traceType' => '<string>',
'referenceIdentification' => '<string>',
'originatingCompanyIdentifier' => '<string>',
'secondaryReferenceIdentification' => '<string>'
]
],
'payer' => [
'firstName' => '<string>',
'lastName' => '<string>',
'name' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'naic' => '<string>',
'npi' => '<string>',
'centersForMedicareAndMedicaidPlanId' => '<string>',
'payorIdentification' => '<string>',
'contactInformation' => [
'name' => '<string>',
'contacts' => [
[
'communicationNumber' => '<string>'
]
]
],
'etin' => '<string>',
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'planInformation' => [
'stateLicenseNumber' => '<string>',
'medicareProviderNumber' => '<string>',
'medicaidProviderNumber' => '<string>',
'facilityIdNumber' => '<string>',
'personalIdentificationNumber' => '<string>',
'planNumber' => '<string>',
'planDescription' => '<string>',
'policyNumber' => '<string>',
'memberId' => '<string>',
'caseNumber' => '<string>',
'familyUnitNumber' => '<string>',
'groupNumber' => '<string>',
'groupDescription' => '<string>',
'referralNumber' => '<string>',
'alternativeListId' => '<string>',
'classOfContractCode' => '<string>',
'coverageListId' => '<string>',
'contractNumber' => '<string>',
'medicalRecordIdentificationNumber' => '<string>',
'electronicDevicePin' => '<string>',
'submitterIdentificationNumber' => '<string>',
'patientAccountNumber' => '<string>',
'hicNumber' => '<string>',
'drugFormularyNumber' => '<string>',
'priorAuthorizationNumber' => '<string>',
'idCardSerialNumber' => '<string>',
'idCardNumber' => '<string>',
'centersForMedicareAndMedicaidServicesNPI' => '<string>',
'issueNumber' => '<string>',
'insurancePolicyNumber' => '<string>',
'userIdentification' => '<string>',
'medicalAssistanceCategory' => '<string>',
'eligibilityCategory' => '<string>',
'planNetworkIdNumber' => '<string>',
'planNetworkIdDescription' => '<string>',
'facilityNetworkIdentificationNumber' => '<string>',
'medicaidRecipientIdNumber' => '<string>',
'priorIdNumber' => '<string>',
'socialSecurityNumber' => '<string>',
'federalTaxpayersIdentificationNumber' => '<string>',
'agencyClaimNumber' => '<string>'
],
'planDateInformation' => [
'discharge' => '<string>',
'issue' => '<string>',
'effectiveDateOfChange' => '<string>',
'plan' => '<string>',
'eligibility' => '<string>',
'added' => '<string>',
'cobraBegin' => '<string>',
'cobraEnd' => '<string>',
'premiumPaidToDateBegin' => '<string>',
'premiumPaidToDateEnd' => '<string>',
'planBegin' => '<string>',
'planEnd' => '<string>',
'eligibilityBegin' => '<string>',
'eligibilityEnd' => '<string>',
'enrollment' => '<string>',
'admission' => '<string>',
'dateOfDeath' => '<string>',
'certification' => '<string>',
'service' => '<string>',
'policyEffective' => '<string>',
'policyExpiration' => '<string>',
'dateOfLastUpdate' => '<string>',
'status' => '<string>',
'periodStart' => '<string>',
'periodEnd' => '<string>',
'completion' => '<string>',
'coordinationOfBenefits' => '<string>',
'benefit' => '<string>',
'primaryCareProvider' => '<string>',
'latestVisitOrConsultation' => '<string>',
'benefitBegin' => '<string>',
'benefitEnd' => '<string>'
],
'errors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
],
'warnings' => [
[
'code' => '<string>',
'description' => '<string>'
]
],
'status' => '<string>',
'transactionSetAcknowledgement' => '<string>',
'implementationTransactionSetSyntaxError' => '<string>',
'x12' => '<string>',
'planStatus' => [
[
'statusCode' => '<string>',
'status' => '<string>',
'planDetails' => '<string>',
'serviceTypeCodes' => [
]
]
],
'dependents' => [
[
'healthCareDiagnosisCodes' => [
[
'diagnosisTypeCode' => '<string>',
'diagnosisCode' => '<string>'
]
],
'memberId' => '<string>',
'firstName' => '<string>',
'lastName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'uniqueHealthIdentifier' => '<string>',
'dateOfBirth' => '<string>',
'description' => '<string>',
'dateTimePeriod' => '<string>',
'startDateTimePeriod' => '<string>',
'endDateTimePeriod' => '<string>',
'ssn' => '<string>',
'groupNumber' => '<string>',
'planNumber' => '<string>',
'planNetworkIdNumber' => '<string>',
'groupDescription' => '<string>',
'planDescription' => '<string>',
'planNetworkDescription' => '<string>',
'maintenanceTypeCode' => '001',
'maintenanceReasonCode' => '25',
'birthSequenceNumber' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'responseProvider' => [
'providerName' => '<string>',
'providerFirstName' => '<string>',
'providerOrgName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'npi' => '<string>',
'referenceIdentification' => '<string>',
'ssn' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'payorIdentification' => '<string>',
'pharmacyProcessorNumber' => '<string>',
'serviceProviderNumber' => '<string>',
'servicesPlanID' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'entityIdentifier' => 'Dependent',
'insuredIndicator' => 'N',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
]
],
'benefitsInformation' => [
[
'serviceTypeCodes' => [
],
'serviceTypes' => [
],
'planCoverage' => '<string>',
'benefitAmount' => '<string>',
'benefitPercent' => '<string>',
'benefitQuantity' => '<string>',
'headerLoopIdentifierCode' => '<string>',
'trailerLoopIdentifierCode' => '<string>',
'compositeMedicalProcedureIdentifier' => [
'productOrServiceIdQualifierCode' => '<string>',
'productOrServiceIdQualifier' => '<string>',
'procedureCode' => '<string>',
'procedureModifiers' => [
'<string>'
],
'productOrServiceID' => '<string>',
'diagnosisCodePointer' => [
'<string>'
]
],
'benefitsAdditionalInformation' => [
'planNumber' => '<string>',
'policyNumber' => '<string>',
'memberId' => '<string>',
'familyUnitNumber' => '<string>',
'groupNumber' => '<string>',
'groupDescription' => '<string>',
'planDescription' => '<string>',
'planNetworkDescription' => '<string>',
'referralNumber' => '<string>',
'alternativeListId' => '<string>',
'coverageListId' => '<string>',
'hicNumber' => '<string>',
'drugFormularyNumber' => '<string>',
'priorAuthorizationNumber' => '<string>',
'insurancePolicyNumber' => '<string>',
'medicalAssistanceCategory' => '<string>',
'planNetworkIdNumber' => '<string>',
'medicaidRecepientIdNumber' => '<string>'
],
'benefitsServiceDelivery' => [
[
'quantity' => '<string>',
'sampleSelectionModulus' => '<string>',
'numOfPeriods' => '<string>'
]
],
'additionalInformation' => [
[
'description' => '<string>'
]
],
'eligibilityAdditionalInformationList' => [
[
'codeListQualifier' => '<string>',
'industryCode' => '<string>',
'industry' => '<string>',
'codeCategory' => '44',
'injuredBodyPartName' => '<string>'
]
],
'benefitsRelatedEntities' => [
[
'entityName' => '<string>',
'entityFirstname' => '<string>',
'entityMiddlename' => '<string>',
'entitySuffix' => '<string>',
'entityIdentificationValue' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'contactInformation' => [
'name' => '<string>',
'contacts' => [
[
'communicationNumber' => '<string>'
]
]
],
'providerInformation' => [
'referenceIdentification' => '<string>'
]
]
],
'benefitsDateInformation' => [
'discharges' => [
[
'date' => '<string>',
'startDate' => '<string>',
'endDate' => '<string>'
]
],
'issue' => '<string>',
'effectiveDateOfChange' => '<string>',
'periodStart' => '<string>',
'periodEnd' => '<string>',
'completion' => '<string>',
'coordinationOfBenefits' => '<string>',
'plan' => '<string>',
'benefit' => '<string>',
'primaryCareProvider' => '<string>',
'latestVisitOrConsultation' => '<string>',
'eligibility' => '<string>',
'added' => '<string>',
'cobraBegin' => '<string>',
'cobraEnd' => '<string>',
'premiumPaidtoDateBegin' => '<string>',
'premiumPaidToDateEnd' => '<string>',
'planBegin' => '<string>',
'planEnd' => '<string>',
'benefitBegin' => '<string>',
'benefitEnd' => '<string>',
'eligibilityBegin' => '<string>',
'eligibilityEnd' => '<string>',
'enrollment' => '<string>',
'admissions' => [
[
'date' => '<string>',
'startDate' => '<string>',
'endDate' => '<string>'
]
],
'dateOfDeath' => '<string>',
'certification' => '<string>',
'service' => '<string>',
'policyEffective' => '<string>',
'policyExpiration' => '<string>',
'dateOfLastUpdate' => '<string>',
'status' => '<string>',
'discharge' => '<string>',
'admission' => '<string>'
],
'benefitsRelatedEntity' => [
'entityName' => '<string>',
'entityFirstname' => '<string>',
'entityMiddlename' => '<string>',
'entitySuffix' => '<string>',
'entityIdentificationValue' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'contactInformation' => [
'name' => '<string>',
'contacts' => [
[
'communicationNumber' => '<string>'
]
]
],
'providerInformation' => [
'referenceIdentification' => '<string>'
]
],
'eligibilityAdditionalInformation' => [
'codeListQualifier' => '<string>',
'industryCode' => '<string>',
'industry' => '<string>',
'codeCategory' => '44',
'injuredBodyPartName' => '<string>'
]
]
]
]
],
'lineItems' => [
[
'id' => '<string>',
'cptCode' => '<string>',
'serviceDate' => '<string>',
'serviceAmount' => 123
]
]
]),
CURLOPT_HTTPHEADER => [
"Content-Type: application/json"
],
]);
$response = curl_exec($curl);
$err = curl_error($curl);
curl_close($curl);
if ($err) {
echo "cURL Error #:" . $err;
} else {
echo $response;
}package main
import (
"fmt"
"strings"
"net/http"
"io"
)
func main() {
url := "https://api.example.com/api/v2/clearinghouse/patient-cost"
payload := strings.NewReader("{\n \"eligibilityResponses\": [\n {\n \"inNetwork\": true,\n \"meta\": {\n \"senderId\": \"<string>\",\n \"submitterId\": \"<string>\",\n \"billerId\": \"<string>\",\n \"traceId\": \"<string>\",\n \"outboundTraceId\": \"<string>\"\n },\n \"controlNumber\": \"<string>\",\n \"reassociationKey\": \"<string>\",\n \"tradingPartnerServiceId\": \"<string>\",\n \"provider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriber\": {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Insured or Subscriber\",\n \"relationToSubscriber\": \"Self\",\n \"relationToSubscriberCode\": \"18\",\n \"insuredIndicator\": \"Y\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriberTraceNumbers\": [\n {\n \"traceTypeCode\": \"<string>\",\n \"traceType\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"originatingCompanyIdentifier\": \"<string>\",\n \"secondaryReferenceIdentification\": \"<string>\"\n }\n ],\n \"payer\": {\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"name\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"naic\": \"<string>\",\n \"npi\": \"<string>\",\n \"centersForMedicareAndMedicaidPlanId\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"etin\": \"<string>\",\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"planInformation\": {\n \"stateLicenseNumber\": \"<string>\",\n \"medicareProviderNumber\": \"<string>\",\n \"medicaidProviderNumber\": \"<string>\",\n \"facilityIdNumber\": \"<string>\",\n \"personalIdentificationNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"caseNumber\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"classOfContractCode\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"contractNumber\": \"<string>\",\n \"medicalRecordIdentificationNumber\": \"<string>\",\n \"electronicDevicePin\": \"<string>\",\n \"submitterIdentificationNumber\": \"<string>\",\n \"patientAccountNumber\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"idCardSerialNumber\": \"<string>\",\n \"idCardNumber\": \"<string>\",\n \"centersForMedicareAndMedicaidServicesNPI\": \"<string>\",\n \"issueNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"userIdentification\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"eligibilityCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"planNetworkIdDescription\": \"<string>\",\n \"facilityNetworkIdentificationNumber\": \"<string>\",\n \"medicaidRecipientIdNumber\": \"<string>\",\n \"priorIdNumber\": \"<string>\",\n \"socialSecurityNumber\": \"<string>\",\n \"federalTaxpayersIdentificationNumber\": \"<string>\",\n \"agencyClaimNumber\": \"<string>\"\n },\n \"planDateInformation\": {\n \"discharge\": \"<string>\",\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"plan\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidToDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admission\": \"<string>\",\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\"\n },\n \"errors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ],\n \"warnings\": [\n {\n \"code\": \"<string>\",\n \"description\": \"<string>\"\n }\n ],\n \"status\": \"<string>\",\n \"transactionSetAcknowledgement\": \"<string>\",\n \"implementationTransactionSetSyntaxError\": \"<string>\",\n \"x12\": \"<string>\",\n \"planStatus\": [\n {\n \"statusCode\": \"<string>\",\n \"status\": \"<string>\",\n \"planDetails\": \"<string>\",\n \"serviceTypeCodes\": []\n }\n ],\n \"dependents\": [\n {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Dependent\",\n \"insuredIndicator\": \"N\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n }\n ],\n \"benefitsInformation\": [\n {\n \"serviceTypeCodes\": [],\n \"serviceTypes\": [],\n \"planCoverage\": \"<string>\",\n \"benefitAmount\": \"<string>\",\n \"benefitPercent\": \"<string>\",\n \"benefitQuantity\": \"<string>\",\n \"headerLoopIdentifierCode\": \"<string>\",\n \"trailerLoopIdentifierCode\": \"<string>\",\n \"compositeMedicalProcedureIdentifier\": {\n \"productOrServiceIdQualifierCode\": \"<string>\",\n \"productOrServiceIdQualifier\": \"<string>\",\n \"procedureCode\": \"<string>\",\n \"procedureModifiers\": [\n \"<string>\"\n ],\n \"productOrServiceID\": \"<string>\",\n \"diagnosisCodePointer\": [\n \"<string>\"\n ]\n },\n \"benefitsAdditionalInformation\": {\n \"planNumber\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"medicaidRecepientIdNumber\": \"<string>\"\n },\n \"benefitsServiceDelivery\": [\n {\n \"quantity\": \"<string>\",\n \"sampleSelectionModulus\": \"<string>\",\n \"numOfPeriods\": \"<string>\"\n }\n ],\n \"additionalInformation\": [\n {\n \"description\": \"<string>\"\n }\n ],\n \"eligibilityAdditionalInformationList\": [\n {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n ],\n \"benefitsRelatedEntities\": [\n {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n }\n ],\n \"benefitsDateInformation\": {\n \"discharges\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"plan\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidtoDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admissions\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"discharge\": \"<string>\",\n \"admission\": \"<string>\"\n },\n \"benefitsRelatedEntity\": {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n },\n \"eligibilityAdditionalInformation\": {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n }\n ]\n }\n ],\n \"lineItems\": [\n {\n \"id\": \"<string>\",\n \"cptCode\": \"<string>\",\n \"serviceDate\": \"<string>\",\n \"serviceAmount\": 123\n }\n ]\n}")
req, _ := http.NewRequest("POST", url, payload)
req.Header.Add("Content-Type", "application/json")
res, _ := http.DefaultClient.Do(req)
defer res.Body.Close()
body, _ := io.ReadAll(res.Body)
fmt.Println(string(body))
}HttpResponse<String> response = Unirest.post("https://api.example.com/api/v2/clearinghouse/patient-cost")
.header("Content-Type", "application/json")
.body("{\n \"eligibilityResponses\": [\n {\n \"inNetwork\": true,\n \"meta\": {\n \"senderId\": \"<string>\",\n \"submitterId\": \"<string>\",\n \"billerId\": \"<string>\",\n \"traceId\": \"<string>\",\n \"outboundTraceId\": \"<string>\"\n },\n \"controlNumber\": \"<string>\",\n \"reassociationKey\": \"<string>\",\n \"tradingPartnerServiceId\": \"<string>\",\n \"provider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriber\": {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Insured or Subscriber\",\n \"relationToSubscriber\": \"Self\",\n \"relationToSubscriberCode\": \"18\",\n \"insuredIndicator\": \"Y\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriberTraceNumbers\": [\n {\n \"traceTypeCode\": \"<string>\",\n \"traceType\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"originatingCompanyIdentifier\": \"<string>\",\n \"secondaryReferenceIdentification\": \"<string>\"\n }\n ],\n \"payer\": {\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"name\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"naic\": \"<string>\",\n \"npi\": \"<string>\",\n \"centersForMedicareAndMedicaidPlanId\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"etin\": \"<string>\",\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"planInformation\": {\n \"stateLicenseNumber\": \"<string>\",\n \"medicareProviderNumber\": \"<string>\",\n \"medicaidProviderNumber\": \"<string>\",\n \"facilityIdNumber\": \"<string>\",\n \"personalIdentificationNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"caseNumber\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"classOfContractCode\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"contractNumber\": \"<string>\",\n \"medicalRecordIdentificationNumber\": \"<string>\",\n \"electronicDevicePin\": \"<string>\",\n \"submitterIdentificationNumber\": \"<string>\",\n \"patientAccountNumber\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"idCardSerialNumber\": \"<string>\",\n \"idCardNumber\": \"<string>\",\n \"centersForMedicareAndMedicaidServicesNPI\": \"<string>\",\n \"issueNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"userIdentification\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"eligibilityCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"planNetworkIdDescription\": \"<string>\",\n \"facilityNetworkIdentificationNumber\": \"<string>\",\n \"medicaidRecipientIdNumber\": \"<string>\",\n \"priorIdNumber\": \"<string>\",\n \"socialSecurityNumber\": \"<string>\",\n \"federalTaxpayersIdentificationNumber\": \"<string>\",\n \"agencyClaimNumber\": \"<string>\"\n },\n \"planDateInformation\": {\n \"discharge\": \"<string>\",\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"plan\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidToDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admission\": \"<string>\",\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\"\n },\n \"errors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ],\n \"warnings\": [\n {\n \"code\": \"<string>\",\n \"description\": \"<string>\"\n }\n ],\n \"status\": \"<string>\",\n \"transactionSetAcknowledgement\": \"<string>\",\n \"implementationTransactionSetSyntaxError\": \"<string>\",\n \"x12\": \"<string>\",\n \"planStatus\": [\n {\n \"statusCode\": \"<string>\",\n \"status\": \"<string>\",\n \"planDetails\": \"<string>\",\n \"serviceTypeCodes\": []\n }\n ],\n \"dependents\": [\n {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Dependent\",\n \"insuredIndicator\": \"N\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n }\n ],\n \"benefitsInformation\": [\n {\n \"serviceTypeCodes\": [],\n \"serviceTypes\": [],\n \"planCoverage\": \"<string>\",\n \"benefitAmount\": \"<string>\",\n \"benefitPercent\": \"<string>\",\n \"benefitQuantity\": \"<string>\",\n \"headerLoopIdentifierCode\": \"<string>\",\n \"trailerLoopIdentifierCode\": \"<string>\",\n \"compositeMedicalProcedureIdentifier\": {\n \"productOrServiceIdQualifierCode\": \"<string>\",\n \"productOrServiceIdQualifier\": \"<string>\",\n \"procedureCode\": \"<string>\",\n \"procedureModifiers\": [\n \"<string>\"\n ],\n \"productOrServiceID\": \"<string>\",\n \"diagnosisCodePointer\": [\n \"<string>\"\n ]\n },\n \"benefitsAdditionalInformation\": {\n \"planNumber\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"medicaidRecepientIdNumber\": \"<string>\"\n },\n \"benefitsServiceDelivery\": [\n {\n \"quantity\": \"<string>\",\n \"sampleSelectionModulus\": \"<string>\",\n \"numOfPeriods\": \"<string>\"\n }\n ],\n \"additionalInformation\": [\n {\n \"description\": \"<string>\"\n }\n ],\n \"eligibilityAdditionalInformationList\": [\n {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n ],\n \"benefitsRelatedEntities\": [\n {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n }\n ],\n \"benefitsDateInformation\": {\n \"discharges\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"plan\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidtoDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admissions\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"discharge\": \"<string>\",\n \"admission\": \"<string>\"\n },\n \"benefitsRelatedEntity\": {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n },\n \"eligibilityAdditionalInformation\": {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n }\n ]\n }\n ],\n \"lineItems\": [\n {\n \"id\": \"<string>\",\n \"cptCode\": \"<string>\",\n \"serviceDate\": \"<string>\",\n \"serviceAmount\": 123\n }\n ]\n}")
.asString();require 'uri'
require 'net/http'
url = URI("https://api.example.com/api/v2/clearinghouse/patient-cost")
http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true
request = Net::HTTP::Post.new(url)
request["Content-Type"] = 'application/json'
request.body = "{\n \"eligibilityResponses\": [\n {\n \"inNetwork\": true,\n \"meta\": {\n \"senderId\": \"<string>\",\n \"submitterId\": \"<string>\",\n \"billerId\": \"<string>\",\n \"traceId\": \"<string>\",\n \"outboundTraceId\": \"<string>\"\n },\n \"controlNumber\": \"<string>\",\n \"reassociationKey\": \"<string>\",\n \"tradingPartnerServiceId\": \"<string>\",\n \"provider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriber\": {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Insured or Subscriber\",\n \"relationToSubscriber\": \"Self\",\n \"relationToSubscriberCode\": \"18\",\n \"insuredIndicator\": \"Y\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriberTraceNumbers\": [\n {\n \"traceTypeCode\": \"<string>\",\n \"traceType\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"originatingCompanyIdentifier\": \"<string>\",\n \"secondaryReferenceIdentification\": \"<string>\"\n }\n ],\n \"payer\": {\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"name\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"naic\": \"<string>\",\n \"npi\": \"<string>\",\n \"centersForMedicareAndMedicaidPlanId\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"etin\": \"<string>\",\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"planInformation\": {\n \"stateLicenseNumber\": \"<string>\",\n \"medicareProviderNumber\": \"<string>\",\n \"medicaidProviderNumber\": \"<string>\",\n \"facilityIdNumber\": \"<string>\",\n \"personalIdentificationNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"caseNumber\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"classOfContractCode\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"contractNumber\": \"<string>\",\n \"medicalRecordIdentificationNumber\": \"<string>\",\n \"electronicDevicePin\": \"<string>\",\n \"submitterIdentificationNumber\": \"<string>\",\n \"patientAccountNumber\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"idCardSerialNumber\": \"<string>\",\n \"idCardNumber\": \"<string>\",\n \"centersForMedicareAndMedicaidServicesNPI\": \"<string>\",\n \"issueNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"userIdentification\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"eligibilityCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"planNetworkIdDescription\": \"<string>\",\n \"facilityNetworkIdentificationNumber\": \"<string>\",\n \"medicaidRecipientIdNumber\": \"<string>\",\n \"priorIdNumber\": \"<string>\",\n \"socialSecurityNumber\": \"<string>\",\n \"federalTaxpayersIdentificationNumber\": \"<string>\",\n \"agencyClaimNumber\": \"<string>\"\n },\n \"planDateInformation\": {\n \"discharge\": \"<string>\",\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"plan\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidToDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admission\": \"<string>\",\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\"\n },\n \"errors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ],\n \"warnings\": [\n {\n \"code\": \"<string>\",\n \"description\": \"<string>\"\n }\n ],\n \"status\": \"<string>\",\n \"transactionSetAcknowledgement\": \"<string>\",\n \"implementationTransactionSetSyntaxError\": \"<string>\",\n \"x12\": \"<string>\",\n \"planStatus\": [\n {\n \"statusCode\": \"<string>\",\n \"status\": \"<string>\",\n \"planDetails\": \"<string>\",\n \"serviceTypeCodes\": []\n }\n ],\n \"dependents\": [\n {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Dependent\",\n \"insuredIndicator\": \"N\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n }\n ],\n \"benefitsInformation\": [\n {\n \"serviceTypeCodes\": [],\n \"serviceTypes\": [],\n \"planCoverage\": \"<string>\",\n \"benefitAmount\": \"<string>\",\n \"benefitPercent\": \"<string>\",\n \"benefitQuantity\": \"<string>\",\n \"headerLoopIdentifierCode\": \"<string>\",\n \"trailerLoopIdentifierCode\": \"<string>\",\n \"compositeMedicalProcedureIdentifier\": {\n \"productOrServiceIdQualifierCode\": \"<string>\",\n \"productOrServiceIdQualifier\": \"<string>\",\n \"procedureCode\": \"<string>\",\n \"procedureModifiers\": [\n \"<string>\"\n ],\n \"productOrServiceID\": \"<string>\",\n \"diagnosisCodePointer\": [\n \"<string>\"\n ]\n },\n \"benefitsAdditionalInformation\": {\n \"planNumber\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"medicaidRecepientIdNumber\": \"<string>\"\n },\n \"benefitsServiceDelivery\": [\n {\n \"quantity\": \"<string>\",\n \"sampleSelectionModulus\": \"<string>\",\n \"numOfPeriods\": \"<string>\"\n }\n ],\n \"additionalInformation\": [\n {\n \"description\": \"<string>\"\n }\n ],\n \"eligibilityAdditionalInformationList\": [\n {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n ],\n \"benefitsRelatedEntities\": [\n {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n }\n ],\n \"benefitsDateInformation\": {\n \"discharges\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"plan\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidtoDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admissions\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"discharge\": \"<string>\",\n \"admission\": \"<string>\"\n },\n \"benefitsRelatedEntity\": {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n },\n \"eligibilityAdditionalInformation\": {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n }\n ]\n }\n ],\n \"lineItems\": [\n {\n \"id\": \"<string>\",\n \"cptCode\": \"<string>\",\n \"serviceDate\": \"<string>\",\n \"serviceAmount\": 123\n }\n ]\n}"
response = http.request(request)
puts response.read_bodyClearinghouse
Calculate patient cost for a line item
Calculates the cost of a patient’s services based on the provided information.
POST
/
api
/
v2
/
clearinghouse
/
patient-cost
Calculate patient cost for a line item
curl --request POST \
--url https://api.example.com/api/v2/clearinghouse/patient-cost \
--header 'Content-Type: application/json' \
--data '
{
"eligibilityResponses": [
{
"inNetwork": true,
"meta": {
"senderId": "<string>",
"submitterId": "<string>",
"billerId": "<string>",
"traceId": "<string>",
"outboundTraceId": "<string>"
},
"controlNumber": "<string>",
"reassociationKey": "<string>",
"tradingPartnerServiceId": "<string>",
"provider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriber": {
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Insured or Subscriber",
"relationToSubscriber": "Self",
"relationToSubscriberCode": "18",
"insuredIndicator": "Y",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriberTraceNumbers": [
{
"traceTypeCode": "<string>",
"traceType": "<string>",
"referenceIdentification": "<string>",
"originatingCompanyIdentifier": "<string>",
"secondaryReferenceIdentification": "<string>"
}
],
"payer": {
"firstName": "<string>",
"lastName": "<string>",
"name": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"federalTaxpayersIdNumber": "<string>",
"naic": "<string>",
"npi": "<string>",
"centersForMedicareAndMedicaidPlanId": "<string>",
"payorIdentification": "<string>",
"contactInformation": {
"name": "<string>",
"contacts": [
{
"communicationNumber": "<string>"
}
]
},
"etin": "<string>",
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"planInformation": {
"stateLicenseNumber": "<string>",
"medicareProviderNumber": "<string>",
"medicaidProviderNumber": "<string>",
"facilityIdNumber": "<string>",
"personalIdentificationNumber": "<string>",
"planNumber": "<string>",
"planDescription": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"caseNumber": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"classOfContractCode": "<string>",
"coverageListId": "<string>",
"contractNumber": "<string>",
"medicalRecordIdentificationNumber": "<string>",
"electronicDevicePin": "<string>",
"submitterIdentificationNumber": "<string>",
"patientAccountNumber": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"idCardSerialNumber": "<string>",
"idCardNumber": "<string>",
"centersForMedicareAndMedicaidServicesNPI": "<string>",
"issueNumber": "<string>",
"insurancePolicyNumber": "<string>",
"userIdentification": "<string>",
"medicalAssistanceCategory": "<string>",
"eligibilityCategory": "<string>",
"planNetworkIdNumber": "<string>",
"planNetworkIdDescription": "<string>",
"facilityNetworkIdentificationNumber": "<string>",
"medicaidRecipientIdNumber": "<string>",
"priorIdNumber": "<string>",
"socialSecurityNumber": "<string>",
"federalTaxpayersIdentificationNumber": "<string>",
"agencyClaimNumber": "<string>"
},
"planDateInformation": {
"discharge": "<string>",
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"plan": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidToDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admission": "<string>",
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>"
},
"errors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
],
"warnings": [
{
"code": "<string>",
"description": "<string>"
}
],
"status": "<string>",
"transactionSetAcknowledgement": "<string>",
"implementationTransactionSetSyntaxError": "<string>",
"x12": "<string>",
"planStatus": [
{
"statusCode": "<string>",
"status": "<string>",
"planDetails": "<string>",
"serviceTypeCodes": []
}
],
"dependents": [
{
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Dependent",
"insuredIndicator": "N",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
}
],
"benefitsInformation": [
{
"serviceTypeCodes": [],
"serviceTypes": [],
"planCoverage": "<string>",
"benefitAmount": "<string>",
"benefitPercent": "<string>",
"benefitQuantity": "<string>",
"headerLoopIdentifierCode": "<string>",
"trailerLoopIdentifierCode": "<string>",
"compositeMedicalProcedureIdentifier": {
"productOrServiceIdQualifierCode": "<string>",
"productOrServiceIdQualifier": "<string>",
"procedureCode": "<string>",
"procedureModifiers": [
"<string>"
],
"productOrServiceID": "<string>",
"diagnosisCodePointer": [
"<string>"
]
},
"benefitsAdditionalInformation": {
"planNumber": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"coverageListId": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"insurancePolicyNumber": "<string>",
"medicalAssistanceCategory": "<string>",
"planNetworkIdNumber": "<string>",
"medicaidRecepientIdNumber": "<string>"
},
"benefitsServiceDelivery": [
{
"quantity": "<string>",
"sampleSelectionModulus": "<string>",
"numOfPeriods": "<string>"
}
],
"additionalInformation": [
{
"description": "<string>"
}
],
"eligibilityAdditionalInformationList": [
{
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
],
"benefitsRelatedEntities": [
{
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [
{
"communicationNumber": "<string>"
}
]
},
"providerInformation": {
"referenceIdentification": "<string>"
}
}
],
"benefitsDateInformation": {
"discharges": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"plan": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidtoDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admissions": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"discharge": "<string>",
"admission": "<string>"
},
"benefitsRelatedEntity": {
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [
{
"communicationNumber": "<string>"
}
]
},
"providerInformation": {
"referenceIdentification": "<string>"
}
},
"eligibilityAdditionalInformation": {
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
}
]
}
],
"lineItems": [
{
"id": "<string>",
"cptCode": "<string>",
"serviceDate": "<string>",
"serviceAmount": 123
}
]
}
'import requests
url = "https://api.example.com/api/v2/clearinghouse/patient-cost"
payload = {
"eligibilityResponses": [
{
"inNetwork": True,
"meta": {
"senderId": "<string>",
"submitterId": "<string>",
"billerId": "<string>",
"traceId": "<string>",
"outboundTraceId": "<string>"
},
"controlNumber": "<string>",
"reassociationKey": "<string>",
"tradingPartnerServiceId": "<string>",
"provider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriber": {
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Insured or Subscriber",
"relationToSubscriber": "Self",
"relationToSubscriberCode": "18",
"insuredIndicator": "Y",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"subscriberTraceNumbers": [
{
"traceTypeCode": "<string>",
"traceType": "<string>",
"referenceIdentification": "<string>",
"originatingCompanyIdentifier": "<string>",
"secondaryReferenceIdentification": "<string>"
}
],
"payer": {
"firstName": "<string>",
"lastName": "<string>",
"name": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"federalTaxpayersIdNumber": "<string>",
"naic": "<string>",
"npi": "<string>",
"centersForMedicareAndMedicaidPlanId": "<string>",
"payorIdentification": "<string>",
"contactInformation": {
"name": "<string>",
"contacts": [{ "communicationNumber": "<string>" }]
},
"etin": "<string>",
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"planInformation": {
"stateLicenseNumber": "<string>",
"medicareProviderNumber": "<string>",
"medicaidProviderNumber": "<string>",
"facilityIdNumber": "<string>",
"personalIdentificationNumber": "<string>",
"planNumber": "<string>",
"planDescription": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"caseNumber": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"classOfContractCode": "<string>",
"coverageListId": "<string>",
"contractNumber": "<string>",
"medicalRecordIdentificationNumber": "<string>",
"electronicDevicePin": "<string>",
"submitterIdentificationNumber": "<string>",
"patientAccountNumber": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"idCardSerialNumber": "<string>",
"idCardNumber": "<string>",
"centersForMedicareAndMedicaidServicesNPI": "<string>",
"issueNumber": "<string>",
"insurancePolicyNumber": "<string>",
"userIdentification": "<string>",
"medicalAssistanceCategory": "<string>",
"eligibilityCategory": "<string>",
"planNetworkIdNumber": "<string>",
"planNetworkIdDescription": "<string>",
"facilityNetworkIdentificationNumber": "<string>",
"medicaidRecipientIdNumber": "<string>",
"priorIdNumber": "<string>",
"socialSecurityNumber": "<string>",
"federalTaxpayersIdentificationNumber": "<string>",
"agencyClaimNumber": "<string>"
},
"planDateInformation": {
"discharge": "<string>",
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"plan": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidToDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admission": "<string>",
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>"
},
"errors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
],
"warnings": [
{
"code": "<string>",
"description": "<string>"
}
],
"status": "<string>",
"transactionSetAcknowledgement": "<string>",
"implementationTransactionSetSyntaxError": "<string>",
"x12": "<string>",
"planStatus": [
{
"statusCode": "<string>",
"status": "<string>",
"planDetails": "<string>",
"serviceTypeCodes": []
}
],
"dependents": [
{
"healthCareDiagnosisCodes": [
{
"diagnosisTypeCode": "<string>",
"diagnosisCode": "<string>"
}
],
"memberId": "<string>",
"firstName": "<string>",
"lastName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"uniqueHealthIdentifier": "<string>",
"dateOfBirth": "<string>",
"description": "<string>",
"dateTimePeriod": "<string>",
"startDateTimePeriod": "<string>",
"endDateTimePeriod": "<string>",
"ssn": "<string>",
"groupNumber": "<string>",
"planNumber": "<string>",
"planNetworkIdNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"maintenanceTypeCode": "001",
"maintenanceReasonCode": "25",
"birthSequenceNumber": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"responseProvider": {
"providerName": "<string>",
"providerFirstName": "<string>",
"providerOrgName": "<string>",
"middleName": "<string>",
"suffix": "<string>",
"npi": "<string>",
"referenceIdentification": "<string>",
"ssn": "<string>",
"federalTaxpayersIdNumber": "<string>",
"payorIdentification": "<string>",
"pharmacyProcessorNumber": "<string>",
"serviceProviderNumber": "<string>",
"servicesPlanID": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"employersId": "<string>",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
},
"entityIdentifier": "Dependent",
"insuredIndicator": "N",
"aaaErrors": [
{
"field": "<string>",
"description": "<string>",
"location": "<string>",
"possibleResolutions": "<string>"
}
]
}
],
"benefitsInformation": [
{
"serviceTypeCodes": [],
"serviceTypes": [],
"planCoverage": "<string>",
"benefitAmount": "<string>",
"benefitPercent": "<string>",
"benefitQuantity": "<string>",
"headerLoopIdentifierCode": "<string>",
"trailerLoopIdentifierCode": "<string>",
"compositeMedicalProcedureIdentifier": {
"productOrServiceIdQualifierCode": "<string>",
"productOrServiceIdQualifier": "<string>",
"procedureCode": "<string>",
"procedureModifiers": ["<string>"],
"productOrServiceID": "<string>",
"diagnosisCodePointer": ["<string>"]
},
"benefitsAdditionalInformation": {
"planNumber": "<string>",
"policyNumber": "<string>",
"memberId": "<string>",
"familyUnitNumber": "<string>",
"groupNumber": "<string>",
"groupDescription": "<string>",
"planDescription": "<string>",
"planNetworkDescription": "<string>",
"referralNumber": "<string>",
"alternativeListId": "<string>",
"coverageListId": "<string>",
"hicNumber": "<string>",
"drugFormularyNumber": "<string>",
"priorAuthorizationNumber": "<string>",
"insurancePolicyNumber": "<string>",
"medicalAssistanceCategory": "<string>",
"planNetworkIdNumber": "<string>",
"medicaidRecepientIdNumber": "<string>"
},
"benefitsServiceDelivery": [
{
"quantity": "<string>",
"sampleSelectionModulus": "<string>",
"numOfPeriods": "<string>"
}
],
"additionalInformation": [{ "description": "<string>" }],
"eligibilityAdditionalInformationList": [
{
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
],
"benefitsRelatedEntities": [
{
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [{ "communicationNumber": "<string>" }]
},
"providerInformation": { "referenceIdentification": "<string>" }
}
],
"benefitsDateInformation": {
"discharges": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"issue": "<string>",
"effectiveDateOfChange": "<string>",
"periodStart": "<string>",
"periodEnd": "<string>",
"completion": "<string>",
"coordinationOfBenefits": "<string>",
"plan": "<string>",
"benefit": "<string>",
"primaryCareProvider": "<string>",
"latestVisitOrConsultation": "<string>",
"eligibility": "<string>",
"added": "<string>",
"cobraBegin": "<string>",
"cobraEnd": "<string>",
"premiumPaidtoDateBegin": "<string>",
"premiumPaidToDateEnd": "<string>",
"planBegin": "<string>",
"planEnd": "<string>",
"benefitBegin": "<string>",
"benefitEnd": "<string>",
"eligibilityBegin": "<string>",
"eligibilityEnd": "<string>",
"enrollment": "<string>",
"admissions": [
{
"date": "<string>",
"startDate": "<string>",
"endDate": "<string>"
}
],
"dateOfDeath": "<string>",
"certification": "<string>",
"service": "<string>",
"policyEffective": "<string>",
"policyExpiration": "<string>",
"dateOfLastUpdate": "<string>",
"status": "<string>",
"discharge": "<string>",
"admission": "<string>"
},
"benefitsRelatedEntity": {
"entityName": "<string>",
"entityFirstname": "<string>",
"entityMiddlename": "<string>",
"entitySuffix": "<string>",
"entityIdentificationValue": "<string>",
"address": {
"address1": "<string>",
"address2": "<string>",
"city": "<string>",
"postalCode": "<string>",
"countryCode": "<string>",
"countrySubDivisionCode": "<string>"
},
"contactInformation": {
"name": "<string>",
"contacts": [{ "communicationNumber": "<string>" }]
},
"providerInformation": { "referenceIdentification": "<string>" }
},
"eligibilityAdditionalInformation": {
"codeListQualifier": "<string>",
"industryCode": "<string>",
"industry": "<string>",
"codeCategory": "44",
"injuredBodyPartName": "<string>"
}
}
]
}
],
"lineItems": [
{
"id": "<string>",
"cptCode": "<string>",
"serviceDate": "<string>",
"serviceAmount": 123
}
]
}
headers = {"Content-Type": "application/json"}
response = requests.post(url, json=payload, headers=headers)
print(response.text)const options = {
method: 'POST',
headers: {'Content-Type': 'application/json'},
body: JSON.stringify({
eligibilityResponses: [
{
inNetwork: true,
meta: {
senderId: '<string>',
submitterId: '<string>',
billerId: '<string>',
traceId: '<string>',
outboundTraceId: '<string>'
},
controlNumber: '<string>',
reassociationKey: '<string>',
tradingPartnerServiceId: '<string>',
provider: {
providerName: '<string>',
providerFirstName: '<string>',
providerOrgName: '<string>',
middleName: '<string>',
suffix: '<string>',
npi: '<string>',
referenceIdentification: '<string>',
ssn: '<string>',
federalTaxpayersIdNumber: '<string>',
payorIdentification: '<string>',
pharmacyProcessorNumber: '<string>',
serviceProviderNumber: '<string>',
servicesPlanID: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
subscriber: {
healthCareDiagnosisCodes: [{diagnosisTypeCode: '<string>', diagnosisCode: '<string>'}],
memberId: '<string>',
firstName: '<string>',
lastName: '<string>',
middleName: '<string>',
suffix: '<string>',
uniqueHealthIdentifier: '<string>',
dateOfBirth: '<string>',
description: '<string>',
dateTimePeriod: '<string>',
startDateTimePeriod: '<string>',
endDateTimePeriod: '<string>',
ssn: '<string>',
groupNumber: '<string>',
planNumber: '<string>',
planNetworkIdNumber: '<string>',
groupDescription: '<string>',
planDescription: '<string>',
planNetworkDescription: '<string>',
maintenanceTypeCode: '001',
maintenanceReasonCode: '25',
birthSequenceNumber: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
responseProvider: {
providerName: '<string>',
providerFirstName: '<string>',
providerOrgName: '<string>',
middleName: '<string>',
suffix: '<string>',
npi: '<string>',
referenceIdentification: '<string>',
ssn: '<string>',
federalTaxpayersIdNumber: '<string>',
payorIdentification: '<string>',
pharmacyProcessorNumber: '<string>',
serviceProviderNumber: '<string>',
servicesPlanID: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
entityIdentifier: 'Insured or Subscriber',
relationToSubscriber: 'Self',
relationToSubscriberCode: '18',
insuredIndicator: 'Y',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
subscriberTraceNumbers: [
{
traceTypeCode: '<string>',
traceType: '<string>',
referenceIdentification: '<string>',
originatingCompanyIdentifier: '<string>',
secondaryReferenceIdentification: '<string>'
}
],
payer: {
firstName: '<string>',
lastName: '<string>',
name: '<string>',
middleName: '<string>',
suffix: '<string>',
federalTaxpayersIdNumber: '<string>',
naic: '<string>',
npi: '<string>',
centersForMedicareAndMedicaidPlanId: '<string>',
payorIdentification: '<string>',
contactInformation: {name: '<string>', contacts: [{communicationNumber: '<string>'}]},
etin: '<string>',
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
planInformation: {
stateLicenseNumber: '<string>',
medicareProviderNumber: '<string>',
medicaidProviderNumber: '<string>',
facilityIdNumber: '<string>',
personalIdentificationNumber: '<string>',
planNumber: '<string>',
planDescription: '<string>',
policyNumber: '<string>',
memberId: '<string>',
caseNumber: '<string>',
familyUnitNumber: '<string>',
groupNumber: '<string>',
groupDescription: '<string>',
referralNumber: '<string>',
alternativeListId: '<string>',
classOfContractCode: '<string>',
coverageListId: '<string>',
contractNumber: '<string>',
medicalRecordIdentificationNumber: '<string>',
electronicDevicePin: '<string>',
submitterIdentificationNumber: '<string>',
patientAccountNumber: '<string>',
hicNumber: '<string>',
drugFormularyNumber: '<string>',
priorAuthorizationNumber: '<string>',
idCardSerialNumber: '<string>',
idCardNumber: '<string>',
centersForMedicareAndMedicaidServicesNPI: '<string>',
issueNumber: '<string>',
insurancePolicyNumber: '<string>',
userIdentification: '<string>',
medicalAssistanceCategory: '<string>',
eligibilityCategory: '<string>',
planNetworkIdNumber: '<string>',
planNetworkIdDescription: '<string>',
facilityNetworkIdentificationNumber: '<string>',
medicaidRecipientIdNumber: '<string>',
priorIdNumber: '<string>',
socialSecurityNumber: '<string>',
federalTaxpayersIdentificationNumber: '<string>',
agencyClaimNumber: '<string>'
},
planDateInformation: {
discharge: '<string>',
issue: '<string>',
effectiveDateOfChange: '<string>',
plan: '<string>',
eligibility: '<string>',
added: '<string>',
cobraBegin: '<string>',
cobraEnd: '<string>',
premiumPaidToDateBegin: '<string>',
premiumPaidToDateEnd: '<string>',
planBegin: '<string>',
planEnd: '<string>',
eligibilityBegin: '<string>',
eligibilityEnd: '<string>',
enrollment: '<string>',
admission: '<string>',
dateOfDeath: '<string>',
certification: '<string>',
service: '<string>',
policyEffective: '<string>',
policyExpiration: '<string>',
dateOfLastUpdate: '<string>',
status: '<string>',
periodStart: '<string>',
periodEnd: '<string>',
completion: '<string>',
coordinationOfBenefits: '<string>',
benefit: '<string>',
primaryCareProvider: '<string>',
latestVisitOrConsultation: '<string>',
benefitBegin: '<string>',
benefitEnd: '<string>'
},
errors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
],
warnings: [{code: '<string>', description: '<string>'}],
status: '<string>',
transactionSetAcknowledgement: '<string>',
implementationTransactionSetSyntaxError: '<string>',
x12: '<string>',
planStatus: [
{
statusCode: '<string>',
status: '<string>',
planDetails: '<string>',
serviceTypeCodes: []
}
],
dependents: [
{
healthCareDiagnosisCodes: [{diagnosisTypeCode: '<string>', diagnosisCode: '<string>'}],
memberId: '<string>',
firstName: '<string>',
lastName: '<string>',
middleName: '<string>',
suffix: '<string>',
uniqueHealthIdentifier: '<string>',
dateOfBirth: '<string>',
description: '<string>',
dateTimePeriod: '<string>',
startDateTimePeriod: '<string>',
endDateTimePeriod: '<string>',
ssn: '<string>',
groupNumber: '<string>',
planNumber: '<string>',
planNetworkIdNumber: '<string>',
groupDescription: '<string>',
planDescription: '<string>',
planNetworkDescription: '<string>',
maintenanceTypeCode: '001',
maintenanceReasonCode: '25',
birthSequenceNumber: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
responseProvider: {
providerName: '<string>',
providerFirstName: '<string>',
providerOrgName: '<string>',
middleName: '<string>',
suffix: '<string>',
npi: '<string>',
referenceIdentification: '<string>',
ssn: '<string>',
federalTaxpayersIdNumber: '<string>',
payorIdentification: '<string>',
pharmacyProcessorNumber: '<string>',
serviceProviderNumber: '<string>',
servicesPlanID: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
employersId: '<string>',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
},
entityIdentifier: 'Dependent',
insuredIndicator: 'N',
aaaErrors: [
{
field: '<string>',
description: '<string>',
location: '<string>',
possibleResolutions: '<string>'
}
]
}
],
benefitsInformation: [
{
serviceTypeCodes: [],
serviceTypes: [],
planCoverage: '<string>',
benefitAmount: '<string>',
benefitPercent: '<string>',
benefitQuantity: '<string>',
headerLoopIdentifierCode: '<string>',
trailerLoopIdentifierCode: '<string>',
compositeMedicalProcedureIdentifier: {
productOrServiceIdQualifierCode: '<string>',
productOrServiceIdQualifier: '<string>',
procedureCode: '<string>',
procedureModifiers: ['<string>'],
productOrServiceID: '<string>',
diagnosisCodePointer: ['<string>']
},
benefitsAdditionalInformation: {
planNumber: '<string>',
policyNumber: '<string>',
memberId: '<string>',
familyUnitNumber: '<string>',
groupNumber: '<string>',
groupDescription: '<string>',
planDescription: '<string>',
planNetworkDescription: '<string>',
referralNumber: '<string>',
alternativeListId: '<string>',
coverageListId: '<string>',
hicNumber: '<string>',
drugFormularyNumber: '<string>',
priorAuthorizationNumber: '<string>',
insurancePolicyNumber: '<string>',
medicalAssistanceCategory: '<string>',
planNetworkIdNumber: '<string>',
medicaidRecepientIdNumber: '<string>'
},
benefitsServiceDelivery: [
{
quantity: '<string>',
sampleSelectionModulus: '<string>',
numOfPeriods: '<string>'
}
],
additionalInformation: [{description: '<string>'}],
eligibilityAdditionalInformationList: [
{
codeListQualifier: '<string>',
industryCode: '<string>',
industry: '<string>',
codeCategory: '44',
injuredBodyPartName: '<string>'
}
],
benefitsRelatedEntities: [
{
entityName: '<string>',
entityFirstname: '<string>',
entityMiddlename: '<string>',
entitySuffix: '<string>',
entityIdentificationValue: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
contactInformation: {name: '<string>', contacts: [{communicationNumber: '<string>'}]},
providerInformation: {referenceIdentification: '<string>'}
}
],
benefitsDateInformation: {
discharges: [{date: '<string>', startDate: '<string>', endDate: '<string>'}],
issue: '<string>',
effectiveDateOfChange: '<string>',
periodStart: '<string>',
periodEnd: '<string>',
completion: '<string>',
coordinationOfBenefits: '<string>',
plan: '<string>',
benefit: '<string>',
primaryCareProvider: '<string>',
latestVisitOrConsultation: '<string>',
eligibility: '<string>',
added: '<string>',
cobraBegin: '<string>',
cobraEnd: '<string>',
premiumPaidtoDateBegin: '<string>',
premiumPaidToDateEnd: '<string>',
planBegin: '<string>',
planEnd: '<string>',
benefitBegin: '<string>',
benefitEnd: '<string>',
eligibilityBegin: '<string>',
eligibilityEnd: '<string>',
enrollment: '<string>',
admissions: [{date: '<string>', startDate: '<string>', endDate: '<string>'}],
dateOfDeath: '<string>',
certification: '<string>',
service: '<string>',
policyEffective: '<string>',
policyExpiration: '<string>',
dateOfLastUpdate: '<string>',
status: '<string>',
discharge: '<string>',
admission: '<string>'
},
benefitsRelatedEntity: {
entityName: '<string>',
entityFirstname: '<string>',
entityMiddlename: '<string>',
entitySuffix: '<string>',
entityIdentificationValue: '<string>',
address: {
address1: '<string>',
address2: '<string>',
city: '<string>',
postalCode: '<string>',
countryCode: '<string>',
countrySubDivisionCode: '<string>'
},
contactInformation: {name: '<string>', contacts: [{communicationNumber: '<string>'}]},
providerInformation: {referenceIdentification: '<string>'}
},
eligibilityAdditionalInformation: {
codeListQualifier: '<string>',
industryCode: '<string>',
industry: '<string>',
codeCategory: '44',
injuredBodyPartName: '<string>'
}
}
]
}
],
lineItems: [
{
id: '<string>',
cptCode: '<string>',
serviceDate: '<string>',
serviceAmount: 123
}
]
})
};
fetch('https://api.example.com/api/v2/clearinghouse/patient-cost', options)
.then(res => res.json())
.then(res => console.log(res))
.catch(err => console.error(err));<?php
$curl = curl_init();
curl_setopt_array($curl, [
CURLOPT_URL => "https://api.example.com/api/v2/clearinghouse/patient-cost",
CURLOPT_RETURNTRANSFER => true,
CURLOPT_ENCODING => "",
CURLOPT_MAXREDIRS => 10,
CURLOPT_TIMEOUT => 30,
CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
CURLOPT_CUSTOMREQUEST => "POST",
CURLOPT_POSTFIELDS => json_encode([
'eligibilityResponses' => [
[
'inNetwork' => true,
'meta' => [
'senderId' => '<string>',
'submitterId' => '<string>',
'billerId' => '<string>',
'traceId' => '<string>',
'outboundTraceId' => '<string>'
],
'controlNumber' => '<string>',
'reassociationKey' => '<string>',
'tradingPartnerServiceId' => '<string>',
'provider' => [
'providerName' => '<string>',
'providerFirstName' => '<string>',
'providerOrgName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'npi' => '<string>',
'referenceIdentification' => '<string>',
'ssn' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'payorIdentification' => '<string>',
'pharmacyProcessorNumber' => '<string>',
'serviceProviderNumber' => '<string>',
'servicesPlanID' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'subscriber' => [
'healthCareDiagnosisCodes' => [
[
'diagnosisTypeCode' => '<string>',
'diagnosisCode' => '<string>'
]
],
'memberId' => '<string>',
'firstName' => '<string>',
'lastName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'uniqueHealthIdentifier' => '<string>',
'dateOfBirth' => '<string>',
'description' => '<string>',
'dateTimePeriod' => '<string>',
'startDateTimePeriod' => '<string>',
'endDateTimePeriod' => '<string>',
'ssn' => '<string>',
'groupNumber' => '<string>',
'planNumber' => '<string>',
'planNetworkIdNumber' => '<string>',
'groupDescription' => '<string>',
'planDescription' => '<string>',
'planNetworkDescription' => '<string>',
'maintenanceTypeCode' => '001',
'maintenanceReasonCode' => '25',
'birthSequenceNumber' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'responseProvider' => [
'providerName' => '<string>',
'providerFirstName' => '<string>',
'providerOrgName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'npi' => '<string>',
'referenceIdentification' => '<string>',
'ssn' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'payorIdentification' => '<string>',
'pharmacyProcessorNumber' => '<string>',
'serviceProviderNumber' => '<string>',
'servicesPlanID' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'entityIdentifier' => 'Insured or Subscriber',
'relationToSubscriber' => 'Self',
'relationToSubscriberCode' => '18',
'insuredIndicator' => 'Y',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'subscriberTraceNumbers' => [
[
'traceTypeCode' => '<string>',
'traceType' => '<string>',
'referenceIdentification' => '<string>',
'originatingCompanyIdentifier' => '<string>',
'secondaryReferenceIdentification' => '<string>'
]
],
'payer' => [
'firstName' => '<string>',
'lastName' => '<string>',
'name' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'naic' => '<string>',
'npi' => '<string>',
'centersForMedicareAndMedicaidPlanId' => '<string>',
'payorIdentification' => '<string>',
'contactInformation' => [
'name' => '<string>',
'contacts' => [
[
'communicationNumber' => '<string>'
]
]
],
'etin' => '<string>',
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'planInformation' => [
'stateLicenseNumber' => '<string>',
'medicareProviderNumber' => '<string>',
'medicaidProviderNumber' => '<string>',
'facilityIdNumber' => '<string>',
'personalIdentificationNumber' => '<string>',
'planNumber' => '<string>',
'planDescription' => '<string>',
'policyNumber' => '<string>',
'memberId' => '<string>',
'caseNumber' => '<string>',
'familyUnitNumber' => '<string>',
'groupNumber' => '<string>',
'groupDescription' => '<string>',
'referralNumber' => '<string>',
'alternativeListId' => '<string>',
'classOfContractCode' => '<string>',
'coverageListId' => '<string>',
'contractNumber' => '<string>',
'medicalRecordIdentificationNumber' => '<string>',
'electronicDevicePin' => '<string>',
'submitterIdentificationNumber' => '<string>',
'patientAccountNumber' => '<string>',
'hicNumber' => '<string>',
'drugFormularyNumber' => '<string>',
'priorAuthorizationNumber' => '<string>',
'idCardSerialNumber' => '<string>',
'idCardNumber' => '<string>',
'centersForMedicareAndMedicaidServicesNPI' => '<string>',
'issueNumber' => '<string>',
'insurancePolicyNumber' => '<string>',
'userIdentification' => '<string>',
'medicalAssistanceCategory' => '<string>',
'eligibilityCategory' => '<string>',
'planNetworkIdNumber' => '<string>',
'planNetworkIdDescription' => '<string>',
'facilityNetworkIdentificationNumber' => '<string>',
'medicaidRecipientIdNumber' => '<string>',
'priorIdNumber' => '<string>',
'socialSecurityNumber' => '<string>',
'federalTaxpayersIdentificationNumber' => '<string>',
'agencyClaimNumber' => '<string>'
],
'planDateInformation' => [
'discharge' => '<string>',
'issue' => '<string>',
'effectiveDateOfChange' => '<string>',
'plan' => '<string>',
'eligibility' => '<string>',
'added' => '<string>',
'cobraBegin' => '<string>',
'cobraEnd' => '<string>',
'premiumPaidToDateBegin' => '<string>',
'premiumPaidToDateEnd' => '<string>',
'planBegin' => '<string>',
'planEnd' => '<string>',
'eligibilityBegin' => '<string>',
'eligibilityEnd' => '<string>',
'enrollment' => '<string>',
'admission' => '<string>',
'dateOfDeath' => '<string>',
'certification' => '<string>',
'service' => '<string>',
'policyEffective' => '<string>',
'policyExpiration' => '<string>',
'dateOfLastUpdate' => '<string>',
'status' => '<string>',
'periodStart' => '<string>',
'periodEnd' => '<string>',
'completion' => '<string>',
'coordinationOfBenefits' => '<string>',
'benefit' => '<string>',
'primaryCareProvider' => '<string>',
'latestVisitOrConsultation' => '<string>',
'benefitBegin' => '<string>',
'benefitEnd' => '<string>'
],
'errors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
],
'warnings' => [
[
'code' => '<string>',
'description' => '<string>'
]
],
'status' => '<string>',
'transactionSetAcknowledgement' => '<string>',
'implementationTransactionSetSyntaxError' => '<string>',
'x12' => '<string>',
'planStatus' => [
[
'statusCode' => '<string>',
'status' => '<string>',
'planDetails' => '<string>',
'serviceTypeCodes' => [
]
]
],
'dependents' => [
[
'healthCareDiagnosisCodes' => [
[
'diagnosisTypeCode' => '<string>',
'diagnosisCode' => '<string>'
]
],
'memberId' => '<string>',
'firstName' => '<string>',
'lastName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'uniqueHealthIdentifier' => '<string>',
'dateOfBirth' => '<string>',
'description' => '<string>',
'dateTimePeriod' => '<string>',
'startDateTimePeriod' => '<string>',
'endDateTimePeriod' => '<string>',
'ssn' => '<string>',
'groupNumber' => '<string>',
'planNumber' => '<string>',
'planNetworkIdNumber' => '<string>',
'groupDescription' => '<string>',
'planDescription' => '<string>',
'planNetworkDescription' => '<string>',
'maintenanceTypeCode' => '001',
'maintenanceReasonCode' => '25',
'birthSequenceNumber' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'responseProvider' => [
'providerName' => '<string>',
'providerFirstName' => '<string>',
'providerOrgName' => '<string>',
'middleName' => '<string>',
'suffix' => '<string>',
'npi' => '<string>',
'referenceIdentification' => '<string>',
'ssn' => '<string>',
'federalTaxpayersIdNumber' => '<string>',
'payorIdentification' => '<string>',
'pharmacyProcessorNumber' => '<string>',
'serviceProviderNumber' => '<string>',
'servicesPlanID' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'employersId' => '<string>',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
],
'entityIdentifier' => 'Dependent',
'insuredIndicator' => 'N',
'aaaErrors' => [
[
'field' => '<string>',
'description' => '<string>',
'location' => '<string>',
'possibleResolutions' => '<string>'
]
]
]
],
'benefitsInformation' => [
[
'serviceTypeCodes' => [
],
'serviceTypes' => [
],
'planCoverage' => '<string>',
'benefitAmount' => '<string>',
'benefitPercent' => '<string>',
'benefitQuantity' => '<string>',
'headerLoopIdentifierCode' => '<string>',
'trailerLoopIdentifierCode' => '<string>',
'compositeMedicalProcedureIdentifier' => [
'productOrServiceIdQualifierCode' => '<string>',
'productOrServiceIdQualifier' => '<string>',
'procedureCode' => '<string>',
'procedureModifiers' => [
'<string>'
],
'productOrServiceID' => '<string>',
'diagnosisCodePointer' => [
'<string>'
]
],
'benefitsAdditionalInformation' => [
'planNumber' => '<string>',
'policyNumber' => '<string>',
'memberId' => '<string>',
'familyUnitNumber' => '<string>',
'groupNumber' => '<string>',
'groupDescription' => '<string>',
'planDescription' => '<string>',
'planNetworkDescription' => '<string>',
'referralNumber' => '<string>',
'alternativeListId' => '<string>',
'coverageListId' => '<string>',
'hicNumber' => '<string>',
'drugFormularyNumber' => '<string>',
'priorAuthorizationNumber' => '<string>',
'insurancePolicyNumber' => '<string>',
'medicalAssistanceCategory' => '<string>',
'planNetworkIdNumber' => '<string>',
'medicaidRecepientIdNumber' => '<string>'
],
'benefitsServiceDelivery' => [
[
'quantity' => '<string>',
'sampleSelectionModulus' => '<string>',
'numOfPeriods' => '<string>'
]
],
'additionalInformation' => [
[
'description' => '<string>'
]
],
'eligibilityAdditionalInformationList' => [
[
'codeListQualifier' => '<string>',
'industryCode' => '<string>',
'industry' => '<string>',
'codeCategory' => '44',
'injuredBodyPartName' => '<string>'
]
],
'benefitsRelatedEntities' => [
[
'entityName' => '<string>',
'entityFirstname' => '<string>',
'entityMiddlename' => '<string>',
'entitySuffix' => '<string>',
'entityIdentificationValue' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'contactInformation' => [
'name' => '<string>',
'contacts' => [
[
'communicationNumber' => '<string>'
]
]
],
'providerInformation' => [
'referenceIdentification' => '<string>'
]
]
],
'benefitsDateInformation' => [
'discharges' => [
[
'date' => '<string>',
'startDate' => '<string>',
'endDate' => '<string>'
]
],
'issue' => '<string>',
'effectiveDateOfChange' => '<string>',
'periodStart' => '<string>',
'periodEnd' => '<string>',
'completion' => '<string>',
'coordinationOfBenefits' => '<string>',
'plan' => '<string>',
'benefit' => '<string>',
'primaryCareProvider' => '<string>',
'latestVisitOrConsultation' => '<string>',
'eligibility' => '<string>',
'added' => '<string>',
'cobraBegin' => '<string>',
'cobraEnd' => '<string>',
'premiumPaidtoDateBegin' => '<string>',
'premiumPaidToDateEnd' => '<string>',
'planBegin' => '<string>',
'planEnd' => '<string>',
'benefitBegin' => '<string>',
'benefitEnd' => '<string>',
'eligibilityBegin' => '<string>',
'eligibilityEnd' => '<string>',
'enrollment' => '<string>',
'admissions' => [
[
'date' => '<string>',
'startDate' => '<string>',
'endDate' => '<string>'
]
],
'dateOfDeath' => '<string>',
'certification' => '<string>',
'service' => '<string>',
'policyEffective' => '<string>',
'policyExpiration' => '<string>',
'dateOfLastUpdate' => '<string>',
'status' => '<string>',
'discharge' => '<string>',
'admission' => '<string>'
],
'benefitsRelatedEntity' => [
'entityName' => '<string>',
'entityFirstname' => '<string>',
'entityMiddlename' => '<string>',
'entitySuffix' => '<string>',
'entityIdentificationValue' => '<string>',
'address' => [
'address1' => '<string>',
'address2' => '<string>',
'city' => '<string>',
'postalCode' => '<string>',
'countryCode' => '<string>',
'countrySubDivisionCode' => '<string>'
],
'contactInformation' => [
'name' => '<string>',
'contacts' => [
[
'communicationNumber' => '<string>'
]
]
],
'providerInformation' => [
'referenceIdentification' => '<string>'
]
],
'eligibilityAdditionalInformation' => [
'codeListQualifier' => '<string>',
'industryCode' => '<string>',
'industry' => '<string>',
'codeCategory' => '44',
'injuredBodyPartName' => '<string>'
]
]
]
]
],
'lineItems' => [
[
'id' => '<string>',
'cptCode' => '<string>',
'serviceDate' => '<string>',
'serviceAmount' => 123
]
]
]),
CURLOPT_HTTPHEADER => [
"Content-Type: application/json"
],
]);
$response = curl_exec($curl);
$err = curl_error($curl);
curl_close($curl);
if ($err) {
echo "cURL Error #:" . $err;
} else {
echo $response;
}package main
import (
"fmt"
"strings"
"net/http"
"io"
)
func main() {
url := "https://api.example.com/api/v2/clearinghouse/patient-cost"
payload := strings.NewReader("{\n \"eligibilityResponses\": [\n {\n \"inNetwork\": true,\n \"meta\": {\n \"senderId\": \"<string>\",\n \"submitterId\": \"<string>\",\n \"billerId\": \"<string>\",\n \"traceId\": \"<string>\",\n \"outboundTraceId\": \"<string>\"\n },\n \"controlNumber\": \"<string>\",\n \"reassociationKey\": \"<string>\",\n \"tradingPartnerServiceId\": \"<string>\",\n \"provider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriber\": {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Insured or Subscriber\",\n \"relationToSubscriber\": \"Self\",\n \"relationToSubscriberCode\": \"18\",\n \"insuredIndicator\": \"Y\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriberTraceNumbers\": [\n {\n \"traceTypeCode\": \"<string>\",\n \"traceType\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"originatingCompanyIdentifier\": \"<string>\",\n \"secondaryReferenceIdentification\": \"<string>\"\n }\n ],\n \"payer\": {\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"name\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"naic\": \"<string>\",\n \"npi\": \"<string>\",\n \"centersForMedicareAndMedicaidPlanId\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"etin\": \"<string>\",\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"planInformation\": {\n \"stateLicenseNumber\": \"<string>\",\n \"medicareProviderNumber\": \"<string>\",\n \"medicaidProviderNumber\": \"<string>\",\n \"facilityIdNumber\": \"<string>\",\n \"personalIdentificationNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"caseNumber\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"classOfContractCode\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"contractNumber\": \"<string>\",\n \"medicalRecordIdentificationNumber\": \"<string>\",\n \"electronicDevicePin\": \"<string>\",\n \"submitterIdentificationNumber\": \"<string>\",\n \"patientAccountNumber\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"idCardSerialNumber\": \"<string>\",\n \"idCardNumber\": \"<string>\",\n \"centersForMedicareAndMedicaidServicesNPI\": \"<string>\",\n \"issueNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"userIdentification\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"eligibilityCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"planNetworkIdDescription\": \"<string>\",\n \"facilityNetworkIdentificationNumber\": \"<string>\",\n \"medicaidRecipientIdNumber\": \"<string>\",\n \"priorIdNumber\": \"<string>\",\n \"socialSecurityNumber\": \"<string>\",\n \"federalTaxpayersIdentificationNumber\": \"<string>\",\n \"agencyClaimNumber\": \"<string>\"\n },\n \"planDateInformation\": {\n \"discharge\": \"<string>\",\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"plan\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidToDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admission\": \"<string>\",\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\"\n },\n \"errors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ],\n \"warnings\": [\n {\n \"code\": \"<string>\",\n \"description\": \"<string>\"\n }\n ],\n \"status\": \"<string>\",\n \"transactionSetAcknowledgement\": \"<string>\",\n \"implementationTransactionSetSyntaxError\": \"<string>\",\n \"x12\": \"<string>\",\n \"planStatus\": [\n {\n \"statusCode\": \"<string>\",\n \"status\": \"<string>\",\n \"planDetails\": \"<string>\",\n \"serviceTypeCodes\": []\n }\n ],\n \"dependents\": [\n {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Dependent\",\n \"insuredIndicator\": \"N\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n }\n ],\n \"benefitsInformation\": [\n {\n \"serviceTypeCodes\": [],\n \"serviceTypes\": [],\n \"planCoverage\": \"<string>\",\n \"benefitAmount\": \"<string>\",\n \"benefitPercent\": \"<string>\",\n \"benefitQuantity\": \"<string>\",\n \"headerLoopIdentifierCode\": \"<string>\",\n \"trailerLoopIdentifierCode\": \"<string>\",\n \"compositeMedicalProcedureIdentifier\": {\n \"productOrServiceIdQualifierCode\": \"<string>\",\n \"productOrServiceIdQualifier\": \"<string>\",\n \"procedureCode\": \"<string>\",\n \"procedureModifiers\": [\n \"<string>\"\n ],\n \"productOrServiceID\": \"<string>\",\n \"diagnosisCodePointer\": [\n \"<string>\"\n ]\n },\n \"benefitsAdditionalInformation\": {\n \"planNumber\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"medicaidRecepientIdNumber\": \"<string>\"\n },\n \"benefitsServiceDelivery\": [\n {\n \"quantity\": \"<string>\",\n \"sampleSelectionModulus\": \"<string>\",\n \"numOfPeriods\": \"<string>\"\n }\n ],\n \"additionalInformation\": [\n {\n \"description\": \"<string>\"\n }\n ],\n \"eligibilityAdditionalInformationList\": [\n {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n ],\n \"benefitsRelatedEntities\": [\n {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n }\n ],\n \"benefitsDateInformation\": {\n \"discharges\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"plan\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidtoDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admissions\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"discharge\": \"<string>\",\n \"admission\": \"<string>\"\n },\n \"benefitsRelatedEntity\": {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n },\n \"eligibilityAdditionalInformation\": {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n }\n ]\n }\n ],\n \"lineItems\": [\n {\n \"id\": \"<string>\",\n \"cptCode\": \"<string>\",\n \"serviceDate\": \"<string>\",\n \"serviceAmount\": 123\n }\n ]\n}")
req, _ := http.NewRequest("POST", url, payload)
req.Header.Add("Content-Type", "application/json")
res, _ := http.DefaultClient.Do(req)
defer res.Body.Close()
body, _ := io.ReadAll(res.Body)
fmt.Println(string(body))
}HttpResponse<String> response = Unirest.post("https://api.example.com/api/v2/clearinghouse/patient-cost")
.header("Content-Type", "application/json")
.body("{\n \"eligibilityResponses\": [\n {\n \"inNetwork\": true,\n \"meta\": {\n \"senderId\": \"<string>\",\n \"submitterId\": \"<string>\",\n \"billerId\": \"<string>\",\n \"traceId\": \"<string>\",\n \"outboundTraceId\": \"<string>\"\n },\n \"controlNumber\": \"<string>\",\n \"reassociationKey\": \"<string>\",\n \"tradingPartnerServiceId\": \"<string>\",\n \"provider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriber\": {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Insured or Subscriber\",\n \"relationToSubscriber\": \"Self\",\n \"relationToSubscriberCode\": \"18\",\n \"insuredIndicator\": \"Y\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriberTraceNumbers\": [\n {\n \"traceTypeCode\": \"<string>\",\n \"traceType\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"originatingCompanyIdentifier\": \"<string>\",\n \"secondaryReferenceIdentification\": \"<string>\"\n }\n ],\n \"payer\": {\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"name\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"naic\": \"<string>\",\n \"npi\": \"<string>\",\n \"centersForMedicareAndMedicaidPlanId\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"etin\": \"<string>\",\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"planInformation\": {\n \"stateLicenseNumber\": \"<string>\",\n \"medicareProviderNumber\": \"<string>\",\n \"medicaidProviderNumber\": \"<string>\",\n \"facilityIdNumber\": \"<string>\",\n \"personalIdentificationNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"caseNumber\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"classOfContractCode\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"contractNumber\": \"<string>\",\n \"medicalRecordIdentificationNumber\": \"<string>\",\n \"electronicDevicePin\": \"<string>\",\n \"submitterIdentificationNumber\": \"<string>\",\n \"patientAccountNumber\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"idCardSerialNumber\": \"<string>\",\n \"idCardNumber\": \"<string>\",\n \"centersForMedicareAndMedicaidServicesNPI\": \"<string>\",\n \"issueNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"userIdentification\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"eligibilityCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"planNetworkIdDescription\": \"<string>\",\n \"facilityNetworkIdentificationNumber\": \"<string>\",\n \"medicaidRecipientIdNumber\": \"<string>\",\n \"priorIdNumber\": \"<string>\",\n \"socialSecurityNumber\": \"<string>\",\n \"federalTaxpayersIdentificationNumber\": \"<string>\",\n \"agencyClaimNumber\": \"<string>\"\n },\n \"planDateInformation\": {\n \"discharge\": \"<string>\",\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"plan\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidToDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admission\": \"<string>\",\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\"\n },\n \"errors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ],\n \"warnings\": [\n {\n \"code\": \"<string>\",\n \"description\": \"<string>\"\n }\n ],\n \"status\": \"<string>\",\n \"transactionSetAcknowledgement\": \"<string>\",\n \"implementationTransactionSetSyntaxError\": \"<string>\",\n \"x12\": \"<string>\",\n \"planStatus\": [\n {\n \"statusCode\": \"<string>\",\n \"status\": \"<string>\",\n \"planDetails\": \"<string>\",\n \"serviceTypeCodes\": []\n }\n ],\n \"dependents\": [\n {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Dependent\",\n \"insuredIndicator\": \"N\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n }\n ],\n \"benefitsInformation\": [\n {\n \"serviceTypeCodes\": [],\n \"serviceTypes\": [],\n \"planCoverage\": \"<string>\",\n \"benefitAmount\": \"<string>\",\n \"benefitPercent\": \"<string>\",\n \"benefitQuantity\": \"<string>\",\n \"headerLoopIdentifierCode\": \"<string>\",\n \"trailerLoopIdentifierCode\": \"<string>\",\n \"compositeMedicalProcedureIdentifier\": {\n \"productOrServiceIdQualifierCode\": \"<string>\",\n \"productOrServiceIdQualifier\": \"<string>\",\n \"procedureCode\": \"<string>\",\n \"procedureModifiers\": [\n \"<string>\"\n ],\n \"productOrServiceID\": \"<string>\",\n \"diagnosisCodePointer\": [\n \"<string>\"\n ]\n },\n \"benefitsAdditionalInformation\": {\n \"planNumber\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"medicaidRecepientIdNumber\": \"<string>\"\n },\n \"benefitsServiceDelivery\": [\n {\n \"quantity\": \"<string>\",\n \"sampleSelectionModulus\": \"<string>\",\n \"numOfPeriods\": \"<string>\"\n }\n ],\n \"additionalInformation\": [\n {\n \"description\": \"<string>\"\n }\n ],\n \"eligibilityAdditionalInformationList\": [\n {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n ],\n \"benefitsRelatedEntities\": [\n {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n }\n ],\n \"benefitsDateInformation\": {\n \"discharges\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"plan\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidtoDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admissions\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"discharge\": \"<string>\",\n \"admission\": \"<string>\"\n },\n \"benefitsRelatedEntity\": {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n },\n \"eligibilityAdditionalInformation\": {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n }\n ]\n }\n ],\n \"lineItems\": [\n {\n \"id\": \"<string>\",\n \"cptCode\": \"<string>\",\n \"serviceDate\": \"<string>\",\n \"serviceAmount\": 123\n }\n ]\n}")
.asString();require 'uri'
require 'net/http'
url = URI("https://api.example.com/api/v2/clearinghouse/patient-cost")
http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true
request = Net::HTTP::Post.new(url)
request["Content-Type"] = 'application/json'
request.body = "{\n \"eligibilityResponses\": [\n {\n \"inNetwork\": true,\n \"meta\": {\n \"senderId\": \"<string>\",\n \"submitterId\": \"<string>\",\n \"billerId\": \"<string>\",\n \"traceId\": \"<string>\",\n \"outboundTraceId\": \"<string>\"\n },\n \"controlNumber\": \"<string>\",\n \"reassociationKey\": \"<string>\",\n \"tradingPartnerServiceId\": \"<string>\",\n \"provider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriber\": {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Insured or Subscriber\",\n \"relationToSubscriber\": \"Self\",\n \"relationToSubscriberCode\": \"18\",\n \"insuredIndicator\": \"Y\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"subscriberTraceNumbers\": [\n {\n \"traceTypeCode\": \"<string>\",\n \"traceType\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"originatingCompanyIdentifier\": \"<string>\",\n \"secondaryReferenceIdentification\": \"<string>\"\n }\n ],\n \"payer\": {\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"name\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"naic\": \"<string>\",\n \"npi\": \"<string>\",\n \"centersForMedicareAndMedicaidPlanId\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"etin\": \"<string>\",\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"planInformation\": {\n \"stateLicenseNumber\": \"<string>\",\n \"medicareProviderNumber\": \"<string>\",\n \"medicaidProviderNumber\": \"<string>\",\n \"facilityIdNumber\": \"<string>\",\n \"personalIdentificationNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"caseNumber\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"classOfContractCode\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"contractNumber\": \"<string>\",\n \"medicalRecordIdentificationNumber\": \"<string>\",\n \"electronicDevicePin\": \"<string>\",\n \"submitterIdentificationNumber\": \"<string>\",\n \"patientAccountNumber\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"idCardSerialNumber\": \"<string>\",\n \"idCardNumber\": \"<string>\",\n \"centersForMedicareAndMedicaidServicesNPI\": \"<string>\",\n \"issueNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"userIdentification\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"eligibilityCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"planNetworkIdDescription\": \"<string>\",\n \"facilityNetworkIdentificationNumber\": \"<string>\",\n \"medicaidRecipientIdNumber\": \"<string>\",\n \"priorIdNumber\": \"<string>\",\n \"socialSecurityNumber\": \"<string>\",\n \"federalTaxpayersIdentificationNumber\": \"<string>\",\n \"agencyClaimNumber\": \"<string>\"\n },\n \"planDateInformation\": {\n \"discharge\": \"<string>\",\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"plan\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidToDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admission\": \"<string>\",\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\"\n },\n \"errors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ],\n \"warnings\": [\n {\n \"code\": \"<string>\",\n \"description\": \"<string>\"\n }\n ],\n \"status\": \"<string>\",\n \"transactionSetAcknowledgement\": \"<string>\",\n \"implementationTransactionSetSyntaxError\": \"<string>\",\n \"x12\": \"<string>\",\n \"planStatus\": [\n {\n \"statusCode\": \"<string>\",\n \"status\": \"<string>\",\n \"planDetails\": \"<string>\",\n \"serviceTypeCodes\": []\n }\n ],\n \"dependents\": [\n {\n \"healthCareDiagnosisCodes\": [\n {\n \"diagnosisTypeCode\": \"<string>\",\n \"diagnosisCode\": \"<string>\"\n }\n ],\n \"memberId\": \"<string>\",\n \"firstName\": \"<string>\",\n \"lastName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"uniqueHealthIdentifier\": \"<string>\",\n \"dateOfBirth\": \"<string>\",\n \"description\": \"<string>\",\n \"dateTimePeriod\": \"<string>\",\n \"startDateTimePeriod\": \"<string>\",\n \"endDateTimePeriod\": \"<string>\",\n \"ssn\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"planNumber\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"maintenanceTypeCode\": \"001\",\n \"maintenanceReasonCode\": \"25\",\n \"birthSequenceNumber\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"responseProvider\": {\n \"providerName\": \"<string>\",\n \"providerFirstName\": \"<string>\",\n \"providerOrgName\": \"<string>\",\n \"middleName\": \"<string>\",\n \"suffix\": \"<string>\",\n \"npi\": \"<string>\",\n \"referenceIdentification\": \"<string>\",\n \"ssn\": \"<string>\",\n \"federalTaxpayersIdNumber\": \"<string>\",\n \"payorIdentification\": \"<string>\",\n \"pharmacyProcessorNumber\": \"<string>\",\n \"serviceProviderNumber\": \"<string>\",\n \"servicesPlanID\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"employersId\": \"<string>\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n },\n \"entityIdentifier\": \"Dependent\",\n \"insuredIndicator\": \"N\",\n \"aaaErrors\": [\n {\n \"field\": \"<string>\",\n \"description\": \"<string>\",\n \"location\": \"<string>\",\n \"possibleResolutions\": \"<string>\"\n }\n ]\n }\n ],\n \"benefitsInformation\": [\n {\n \"serviceTypeCodes\": [],\n \"serviceTypes\": [],\n \"planCoverage\": \"<string>\",\n \"benefitAmount\": \"<string>\",\n \"benefitPercent\": \"<string>\",\n \"benefitQuantity\": \"<string>\",\n \"headerLoopIdentifierCode\": \"<string>\",\n \"trailerLoopIdentifierCode\": \"<string>\",\n \"compositeMedicalProcedureIdentifier\": {\n \"productOrServiceIdQualifierCode\": \"<string>\",\n \"productOrServiceIdQualifier\": \"<string>\",\n \"procedureCode\": \"<string>\",\n \"procedureModifiers\": [\n \"<string>\"\n ],\n \"productOrServiceID\": \"<string>\",\n \"diagnosisCodePointer\": [\n \"<string>\"\n ]\n },\n \"benefitsAdditionalInformation\": {\n \"planNumber\": \"<string>\",\n \"policyNumber\": \"<string>\",\n \"memberId\": \"<string>\",\n \"familyUnitNumber\": \"<string>\",\n \"groupNumber\": \"<string>\",\n \"groupDescription\": \"<string>\",\n \"planDescription\": \"<string>\",\n \"planNetworkDescription\": \"<string>\",\n \"referralNumber\": \"<string>\",\n \"alternativeListId\": \"<string>\",\n \"coverageListId\": \"<string>\",\n \"hicNumber\": \"<string>\",\n \"drugFormularyNumber\": \"<string>\",\n \"priorAuthorizationNumber\": \"<string>\",\n \"insurancePolicyNumber\": \"<string>\",\n \"medicalAssistanceCategory\": \"<string>\",\n \"planNetworkIdNumber\": \"<string>\",\n \"medicaidRecepientIdNumber\": \"<string>\"\n },\n \"benefitsServiceDelivery\": [\n {\n \"quantity\": \"<string>\",\n \"sampleSelectionModulus\": \"<string>\",\n \"numOfPeriods\": \"<string>\"\n }\n ],\n \"additionalInformation\": [\n {\n \"description\": \"<string>\"\n }\n ],\n \"eligibilityAdditionalInformationList\": [\n {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n ],\n \"benefitsRelatedEntities\": [\n {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n }\n ],\n \"benefitsDateInformation\": {\n \"discharges\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"issue\": \"<string>\",\n \"effectiveDateOfChange\": \"<string>\",\n \"periodStart\": \"<string>\",\n \"periodEnd\": \"<string>\",\n \"completion\": \"<string>\",\n \"coordinationOfBenefits\": \"<string>\",\n \"plan\": \"<string>\",\n \"benefit\": \"<string>\",\n \"primaryCareProvider\": \"<string>\",\n \"latestVisitOrConsultation\": \"<string>\",\n \"eligibility\": \"<string>\",\n \"added\": \"<string>\",\n \"cobraBegin\": \"<string>\",\n \"cobraEnd\": \"<string>\",\n \"premiumPaidtoDateBegin\": \"<string>\",\n \"premiumPaidToDateEnd\": \"<string>\",\n \"planBegin\": \"<string>\",\n \"planEnd\": \"<string>\",\n \"benefitBegin\": \"<string>\",\n \"benefitEnd\": \"<string>\",\n \"eligibilityBegin\": \"<string>\",\n \"eligibilityEnd\": \"<string>\",\n \"enrollment\": \"<string>\",\n \"admissions\": [\n {\n \"date\": \"<string>\",\n \"startDate\": \"<string>\",\n \"endDate\": \"<string>\"\n }\n ],\n \"dateOfDeath\": \"<string>\",\n \"certification\": \"<string>\",\n \"service\": \"<string>\",\n \"policyEffective\": \"<string>\",\n \"policyExpiration\": \"<string>\",\n \"dateOfLastUpdate\": \"<string>\",\n \"status\": \"<string>\",\n \"discharge\": \"<string>\",\n \"admission\": \"<string>\"\n },\n \"benefitsRelatedEntity\": {\n \"entityName\": \"<string>\",\n \"entityFirstname\": \"<string>\",\n \"entityMiddlename\": \"<string>\",\n \"entitySuffix\": \"<string>\",\n \"entityIdentificationValue\": \"<string>\",\n \"address\": {\n \"address1\": \"<string>\",\n \"address2\": \"<string>\",\n \"city\": \"<string>\",\n \"postalCode\": \"<string>\",\n \"countryCode\": \"<string>\",\n \"countrySubDivisionCode\": \"<string>\"\n },\n \"contactInformation\": {\n \"name\": \"<string>\",\n \"contacts\": [\n {\n \"communicationNumber\": \"<string>\"\n }\n ]\n },\n \"providerInformation\": {\n \"referenceIdentification\": \"<string>\"\n }\n },\n \"eligibilityAdditionalInformation\": {\n \"codeListQualifier\": \"<string>\",\n \"industryCode\": \"<string>\",\n \"industry\": \"<string>\",\n \"codeCategory\": \"44\",\n \"injuredBodyPartName\": \"<string>\"\n }\n }\n ]\n }\n ],\n \"lineItems\": [\n {\n \"id\": \"<string>\",\n \"cptCode\": \"<string>\",\n \"serviceDate\": \"<string>\",\n \"serviceAmount\": 123\n }\n ]\n}"
response = http.request(request)
puts response.read_bodyBody
application/json
Response
200
Default Response
⌘I