Workflow-run
Task
Document
- GETDocument metadata
- GETFull document details
- GETDocument CSV content
- POSTUnzip file and return PDFs
- POSTUnzip file and return PDFs (async)
- POSTCreate PDF format from a Word document
- POSTGenerate CSV document
- POSTPresigned URL for upload
- POSTClassify document (async)
- POSTLegacy split document (async)
- POSTSplit document (async)
- POSTCreate documents from splits
- POSTLegacy extract document (async)
- POSTDocument extraction (async)
- POSTRender document body
- POSTGenerate document from template (async)
- POSTTransform JSON to HTML
- POSTDocument reasoning (async)
- POSTSearch across documents
- GETPDF template document metadata
- POSTCombine PDF documents
Async-result
Communication
Clearinghouse
Diagnostics Ledger
Integration - Snowflake
Integration - Careviso
Integration - Glidian
- GETGet Glidian Payers
- GETGet Glidian Services
- GETGet Glidian Submission Requirements
- POSTCreate Prior Authorization Draft
- GETGet Prior Authorization Record
- PUTUpdate Prior Authorization Record
- GETGet Clinical Questions for Prior Authorization Record
- PUTUpdate Clinical Questions
- POSTSubmit Prior Authorization
Integration - Kno2
Integration - xCures
Integration - Salesforce
Integration - WellSky
Candid Health
Dashboard
Events
Browser Automation
Browser Agents
Database
Python
Copy
from samplehc import SampleHealthcare
client = SampleHealthcare(
api_key="My API Key",
)
client.v2.clearinghouse.calculate_patient_cost(
eligibility_responses=[{
"in_network": True
}],
line_items=[{
"id": "id",
"cpt_code": "cptCode",
"service_amount": 0,
"service_date": "serviceDate",
}],
)Clearinghouse
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
Python
Copy
from samplehc import SampleHealthcare
client = SampleHealthcare(
api_key="My API Key",
)
client.v2.clearinghouse.calculate_patient_cost(
eligibility_responses=[{
"in_network": True
}],
line_items=[{
"id": "id",
"cpt_code": "cptCode",
"service_amount": 0,
"service_date": "serviceDate",
}],
)Body
application/json
The eligibility responses that the patient has in order of preference (primary, secondary, etc.).
Show child attributes
Show child attributes
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Available options:
production, test, information Show child attributes
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Available options:
Provider, Third-Party Administrator, Employer, Hospital, Facility, Gateway Provider, Plan Sponsor, Payer Available options:
Person, Non-Person Entity Available options:
AD, AT, BI, CO, CV, H, HH, LA, OT, P1, P2, PC, PE, R, RF, SB, SK, SU Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2Required string length:
1 - 3Show child attributes
Show child attributes
Available options:
15, 41, 43, 44, 45, 46, 47, 48, 50, 51, 79, 97, T4 Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Show child attributes
Show child attributes
Available options:
M, F, U Available options:
Person, Non-Person Entity Available options:
A, C, L, O, P, S, T Available options:
AE, AO, AS, AT, AU, CC, DD, HD, IR, LX, PE, RE, RM, RR, RU Available options:
A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, Q, R, S, U, W Available options:
A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, C6, C7, C8, C9, E1, F1, F2, F3, F4, G1, G4, L1, L2, L3, L4, L5, L6, M1, M2, M3, M4, M5, M6, P1, P2, P3, P4, P5, R1, R2, S1, S2, S3, S4, S5, S6, S7, S8, S9, SA, SB, SC, T1, V1, W1 Available options:
D8, RD8 Available options:
001 Available options:
25 Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2Required string length:
1 - 3Show child attributes
Show child attributes
Available options:
Provider, Third-Party Administrator, Employer, Hospital, Facility, Gateway Provider, Plan Sponsor, Payer Available options:
Person, Non-Person Entity Available options:
AD, AT, BI, CO, CV, H, HH, LA, OT, P1, P2, PC, PE, R, RF, SB, SK, SU Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2Required string length:
1 - 3Show child attributes
Show child attributes
Available options:
15, 41, 43, 44, 45, 46, 47, 48, 50, 51, 79, 97, T4 Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Available options:
Insured or Subscriber Available options:
Self Available options:
18 Available options:
Y Show child attributes
Show child attributes
Available options:
15, 33, 35, 42, 43, 45, 47, 48, 49, 51, 52, 53, 54, 55, 56, 57, 58, 60, 61, 62, 63, 69, 70, 71, 72, 73, 74, 75, 76, 78, 98, AA, AE, AF, AG, AO, CI, E8, IA, MA Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Show child attributes
Show child attributes
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Show child attributes
Available options:
Third-Party Administrator, Employer, Gateway Provider, Plan Sponsor, Payer Available options:
Person, Non-Person Entity Show child attributes
Show child attributes
Show child attributes
Show child attributes
Show child attributes
Show child attributes
Available options:
04, 41, 42, 79, 80, T4 Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Please Resubmit Original Transaction, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Show child attributes
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Show child attributes
Show child attributes
Show child attributes
Available options:
04, 15, 33, 35, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 97, 98, AA, AE, AF, AG, AO, CI, E8, IA, MA, T4 Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Please Resubmit Original Transaction, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Show child attributes
Show child attributes
Available options:
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 30, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, A0, A1, A2, A3, A4, A5, A6, A7, A8, A9, AA, AB, AC, AD, AE, AF, AG, AH, AI, AJ, AK, AL, AM, AN, AO, AQ, AR, B1, B2, B3, BA, BB, BC, BD, BE, BF, BG, BH, BI, BJ, BK, BL, BM, BN, BP, BQ, BR, BS, BT, BU, BV, BW, BX, BY, BZ, C1, CA, CB, CC, CD, CE, CF, CG, CH, CI, CJ, CK, CL, CM, CN, CO, CP, CQ, DG, DM, DS, GF, GN, GY, IC, MH, NI, ON, PT, PU, RN, RT, TC, TN, UC Show child attributes
Show child attributes
Available options:
M, F, U Available options:
Person, Non-Person Entity Available options:
A, C, L, O, P, S, T Available options:
AE, AO, AS, AT, AU, CC, DD, HD, IR, LX, PE, RE, RM, RR, RU Available options:
A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, Q, R, S, U, W Available options:
A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, C6, C7, C8, C9, E1, F1, F2, F3, F4, G1, G4, L1, L2, L3, L4, L5, L6, M1, M2, M3, M4, M5, M6, P1, P2, P3, P4, P5, R1, R2, S1, S2, S3, S4, S5, S6, S7, S8, S9, SA, SB, SC, T1, V1, W1 Available options:
D8, RD8 Available options:
001 Available options:
25 Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2Required string length:
1 - 3Show child attributes
Show child attributes
Available options:
Provider, Third-Party Administrator, Employer, Hospital, Facility, Gateway Provider, Plan Sponsor, Payer Available options:
Person, Non-Person Entity Available options:
AD, AT, BI, CO, CV, H, HH, LA, OT, P1, P2, PC, PE, R, RF, SB, SK, SU Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2Required string length:
1 - 3Show child attributes
Show child attributes
Available options:
15, 41, 43, 44, 45, 46, 47, 48, 50, 51, 79, 97, T4 Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Available options:
Dependent Available options:
Spouse, Child, Employee, Unknown, Organ Donor, Cadaver Donor, Life Partner, Other Relationship Available options:
01, 19, 20, 21, 39, 40, 53, G8, Unknown Available options:
N Show child attributes
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Available options:
15, 33, 35, 42, 43, 45, 47, 48, 49, 51, 52, 53, 54, 55, 56, 57, 58, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 77, 98, AA, AE, AF, AG, AO, CI, E8, IA, MA Available options:
Please Correct and Resubmit, Resubmission Not Allowed, Resubmission Allowed, Do Not Resubmit; Inquiry Initiated to a Third Party, Please Wait 30 Days and Resubmit, Please Wait 10 Days and Resubmit, Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly Show child attributes
Show child attributes
Available options:
1, 2, 3, 4, 5, 6, 7, 8, A, B, C, CB, D, E, F, G, H, I, J, K, L, M, MC, N, O, P, Q, R, S, T, U, V, W, X, Y Available options:
Active Coverage, Active - Full Risk Capitation, Active - Services Capitated, Active - Services Capitated to Primary Care Physician, Active - Pending Investigation, Inactive, Inactive - Pending Eligibility Update, Inactive - Pending Investigation, Co-Insurance, Co-Payment, Deductible, Coverage Basis, Benefit Description, Exclusions, Limitations, Out of Pocket (Stop Loss), Unlimited, Non-Covered, Cost Containment, Reserve, Primary Care Provider, Pre-existing Condition, Managed Care Coordinator, Services Restricted to Following Provider, Not Deemed a Medical Necessity, Benefit Disclaimer, Second Surgical Opinion Required, Other or Additional Payor, Prior Year(s) History, Card(s) Reported Lost/Stolen, Contact Following Entity for Eligibility or Benefit Information, Cannot Process, Other Source of Data, Health Care Facility, Spend Down Available options:
CHD, DEP, ECH, EMP, ESP, FAM, IND, SPC, SPO Available options:
Children Only, Dependents Only, Employee and Children, Employee Only, Employee and Spouse, Family, Individual, Spouse and Children, Spouse Only Available options:
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 30, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, A0, A1, A2, A3, A4, A5, A6, A7, A8, A9, AA, AB, AC, AD, AE, AF, AG, AH, AI, AJ, AK, AL, AM, AN, AO, AQ, AR, B1, B2, B3, BA, BB, BC, BD, BE, BF, BG, BH, BI, BJ, BK, BL, BM, BN, BP, BQ, BR, BS, BT, BU, BV, BW, BX, BY, BZ, C1, CA, CB, CC, CD, CE, CF, CG, CH, CI, CJ, CK, CL, CM, CN, CO, CP, CQ, DG, DM, DS, GF, GN, GY, IC, MH, NI, ON, PT, PU, RN, RT, TC, TN, UC Available options:
Medical Care, Surgical, Consultation, Diagnostic X-Ray, Diagnostic Lab, Radiation Therapy, Anesthesia, Surgical Assistance, Other Medical, Blood Charges, Used Durable Medical Equipment, Durable Medical Equipment Purchase, Ambulatory Service Center Facility, Renal Supplies in the Home, Alternate Method Dialysis, Chronic Renal Disease (CRD) Equipment, Pre-Admission Testing, Durable Medical Equipment Rental, Pneumonia Vaccine, Second Surgical Opinion, Third Surgical Opinion, Social Work, Diagnostic Dental, Periodontics, Restorative, Endodontics, Maxillofacial Prosthetics, Adjunctive Dental Services, Health Benefit Plan Coverage, Plan Waiting Period, Chiropractic, Chiropractic Office Visits, Dental Care, Dental Crowns, Dental Accident, Orthodontics, Prosthodontics, Oral Surgery, Routine (Preventive) Dental, Home Health Care, Home Health Prescriptions, Home Health Visits, Hospice, Respite Care, Hospital, Hospital - Inpatient, Hospital - Room and Board, Hospital - Outpatient, Hospital - Emergency Accident, Hospital - Emergency Medical, Hospital - Ambulatory Surgical, Long Term Care, Major Medical, Medically Related Transportation, Air Transportation, Cabulance, Licensed Ambulance, General Benefits, In-vitro Fertilization, MRI/CAT Scan, Donor Procedures, Acupuncture, Newborn Care, Pathology, Smoking Cessation, Well Baby Care, Maternity, Transplants, Audiology Exam, Inhalation Therapy, Diagnostic Medical, Private Duty Nursing, Prosthetic Device, Dialysis, Otological Exam, Chemotherapy, Allergy Testing, Immunizations, Routine Physical, Family Planning, Infertility, Abortion, AIDS, Emergency Services, Cancer, Pharmacy, Free Standing Prescription Drug, Mail Order Prescription Drug, Brand Name Prescription Drug, Generic Prescription Drug, Podiatry, Podiatry - Office Visits, Podiatry - Nursing Home Visits, Professional (Physician), Anesthesiologist, Professional (Physician) Visit - Office, Professional (Physician) Visit - Inpatient, Professional (Physician) Visit - Outpatient, Professional (Physician) Visit - Nursing Home, Professional (Physician) Visit - Skilled Nursing Facility, Professional (Physician) Visit - Home, Psychiatric, Psychiatric - Room and Board, Psychotherapy, Psychiatric - Inpatient, Psychiatric - Outpatient, Rehabilitation, Rehabilitation - Room and Board, Rehabilitation - Inpatient, Rehabilitation - Outpatient, Occupational Therapy, Physical Medicine, Speech Therapy, Skilled Nursing Care, Skilled Nursing Care - Room and Board, Substance Abuse, Alcoholism, Drug Addiction, Vision (Optometry), Frames, Routine Exam, Lenses, Nonmedically Necessary Physical, Experimental Drug Therapy, Burn Care, Brand Name Prescription Drug - Formulary, Brand Name Prescription Drug - Non-Formulary, Independent Medical Evaluation, Partial Hospitalization (Psychiatric), Day Care (Psychiatric), Cognitive Therapy, Massage Therapy, Pulmonary Rehabilitation, Cardiac Rehabilitation, Pediatric, Nursery, Skin, Orthopedic, Cardiac, Lymphatic, Gastrointestinal, Endocrine, Neurology, Eye, Invasive Procedures, Gynecological, Obstetrical, Obstetrical/Gynecological, Mail Order Prescription Drug - Formulary, Mail Order Prescription Drug - Non-Formulary, Physician Visit - Office: Sick, Physician Visit - Office: Well, Coronary Care, Private Duty Nursing - Inpatient, Private Duty Nursing - Home, Surgical Benefits - Professional (Physician), Surgical Benefits - Facility, Mental Health Provider- Inpatient, Mental Health Provider - Outpatient, Mental Health Facility - Inpatient, Mental Health Facility - Outpatient, Substance Abuse Facility - Inpatient, Substance Abuse Facility - Outpatient, Screening X-ray, Screening laboratory, Mammogram, High Risk Patient, Mammogram, Low Risk Patient, Flu Vaccination, Eyewear and Eyewear Accessories, Case Management, Dermatology, Durable Medical Equipment, Diabetic Supplies, Generic Prescription Drug - Formulary, Generic Prescription Drug - Non-Formulary, Allergy, Intensive Care, Mental Health, Neonatol Intensive Care, Oncology, Physical Therapy, Pulmonary, Renal, Residential Psychiatric Treatment, Transitional Care, Transitional Nursery Care, Urgent Care Available options:
12, 13, 14, 15, 16, 41, 42, 43, 47, AP, C1, CO, CP, D, DB, EP, FF, GP, HM, HN, HS, IN, IP, LC, LD, LI, LT, MA, MB, MC, MH, MI, MP, OT, PE, PL, PP, PR, PS, QM, RP, SP, TF, WC, WU Available options:
Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan, Medicare Secondary End-Stage Renal Disease Beneficiary in the Mandated Coordination Period with an Employer's Group Health Plan, Medicare Secondary, No-fault Insurance including Auto is Primary, Medicare Secondary Worker's Compensation, Medicare Secondary Public Health Service (PHS)or Other Federal Agency, Medicare Secondary Black Lung, Medicare Secondary Veteran's Administration, Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP), Medicare Secondary, Other Liability Insurance is Primary, Auto Insurance Policy, Commercial, Consolidated Omnibus Budget Reconciliation Act (COBRA), Medicare Conditionally Primary, Disability, Disability Benefits, Exclusive Provider Organization, Family or Friends, Group Policy, Health Maintenance Organization (HMO), Health Maintenance Organization (HMO) - Medicare Risk, Special Low Income Medicare Beneficiary, Indemnity, Individual Policy, Long Term Care, Long Term Policy, Life Insurance, Litigation, Medicare Part A, Medicare Part B, Medicaid, Medigap Part A, Medigap Part B, Medicare Primary, Other, Property Insurance - Personal, Personal, Personal Payment (Cash - No Insurance), Preferred Provider Organization (PPO), Point of Service (POS), Qualified Medicare Beneficiary, Property Insurance - Real, Supplemental Policy, Tax Equity Fiscal Responsibility Act (TEFRA), Workers Compensation, Wrap Up Policy Available options:
6, 7, 13, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 Available options:
Hour, Day, 24 Hours, Years, Service Year, Calendar Year, Year to Date, Contract, Episode, Visit, Outlier, Remaining, Exceeded, Not Exceeded, Lifetime, Lifetime Remaining, Month, Week, Admission Available options:
8H, 99, CA, CE, D3, DB, DY, HS, LA, LE, M2, MN, P6, QA, S7, S8, VS, YY Available options:
Minimum, Quantity Used, Covered - Actual, Covered - Estimated, Number of Co-insurance Days, Deductible Blood Units, Days, Hours, Life-time Reserve - Actual, Life-time Reserve - Estimated, Maximum, Month, Number of Services or Procedures, Quantity Approved, Age, High Value, Age, Low Value, Visits, Years Available options:
N, U, Y Available options:
Y, N, U, W Available options:
Yes, No, Unknown, Not Applicable Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.compositeMedicalProcedureIdentifier.productOrServiceIdQualifierCode
string
eligibilityResponses.benefitsInformation.compositeMedicalProcedureIdentifier.productOrServiceIdQualifier
string
eligibilityResponses.benefitsInformation.compositeMedicalProcedureIdentifier.procedureModifiers
string[]
eligibilityResponses.benefitsInformation.compositeMedicalProcedureIdentifier.productOrServiceID
string
eligibilityResponses.benefitsInformation.compositeMedicalProcedureIdentifier.diagnosisCodePointer
string[]
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eligibilityResponses.benefitsInformation.benefitsAdditionalInformation.planNetworkDescription
string
eligibilityResponses.benefitsInformation.benefitsAdditionalInformation.priorAuthorizationNumber
string
eligibilityResponses.benefitsInformation.benefitsAdditionalInformation.medicalAssistanceCategory
string
eligibilityResponses.benefitsInformation.benefitsAdditionalInformation.medicaidRecepientIdNumber
string
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Available options:
DY, FL, HS, MN, VS Available options:
Days, Units, Hours, Month, Visits eligibilityResponses.benefitsInformation.benefitsServiceDelivery.unitForMeasurementCode
enum<string>
Available options:
Days, Months, Visits, Week, Years eligibilityResponses.benefitsInformation.benefitsServiceDelivery.unitForMeasurementQualifierCode
enum<string>
Available options:
DA, MO, VS, WK, YR eligibilityResponses.benefitsInformation.benefitsServiceDelivery.unitForMeasurementQualifier
enum<string>
Available options:
Days, Months, Visits, Week, Years eligibilityResponses.benefitsInformation.benefitsServiceDelivery.timePeriodQualifierCode
enum<string>
Available options:
6, 7, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35 Available options:
Hour, Day, Years, Service Year, Calendar Year, Year to Date, Contract, Episode, Visit, Outlier, Remaining, Exceeded, Not Exceeded, Lifetime, Lifetime Remaining, Month, Week eligibilityResponses.benefitsInformation.benefitsServiceDelivery.deliveryOrCalendarPatternCode
enum<string>
Available options:
1st Week of the Month, 2nd Week of the Month, 3rd Week of the Month, 4th Week of the Month, 5th Week of the Month, 1st & 3rd Week of the Month, 2nd & 4th Week of the Month, 1st Working Day of Period, Last Working Day of Period, Monday through Friday, Monday through Saturday, Monday through Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday, Monday through Thursday, Immediately, As Directed, Daily Mon. Through Fri., 1/2 Mon. & 1/2 Tues., 1/2 Tues. & 1/2 Thurs., 1/2 Wed. & 1/2 Fri., Once Anytime Mon. through Fri., Tuesday through Friday, Monday, Tuesday and Thursday, Monday, Tuesday and Friday, Wednesday and Thursday, Monday, Wednesday and Thursday, Tuesday, Thursday and Friday, 1/2 Tues. & 1/2 Fri., 1/2 Mon. & 1/2 Wed., 1/3 Mon., 1/3 Wed., 1/3 Fri., Whenever Necessary, 1/2 By Wed. Bal. By Fri., None (Also Used to Cancel or Override a Previous Pattern) eligibilityResponses.benefitsInformation.benefitsServiceDelivery.deliveryOrCalendarPatternQualifierCode
enum<string>
Available options:
1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L, M, N, O, P, Q, R, S, SG, SL, SP, SX, SY, SZ, T, U, V, W, X, Y eligibilityResponses.benefitsInformation.benefitsServiceDelivery.deliveryOrCalendarPatternQualifier
enum<string>
Available options:
1st Week of the Month, 2nd Week of the Month, 3rd Week of the Month, 4th Week of the Month, 5th Week of the Month, 1st & 3rd Week of the Month, 2nd & 4th Week of the Month, 1st Working Day of Period, Last Working Day of Period, Monday through Friday, Monday through Saturday, Monday through Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday, Monday through Thursday, Immediately, As Directed, Daily Mon. Through Fri., 1/2 Mon. & 1/2 Tues., 1/2 Tues. & 1/2 Thurs., 1/2 Wed. & 1/2 Fri., Once Anytime Mon. through Fri., Tuesday through Friday, Monday, Tuesday and Thursday, Monday, Tuesday and Friday, Wednesday and Thursday, Monday, Wednesday and Thursday, Tuesday, Thursday and Friday, 1/2 Tues. & 1/2 Fri., 1/2 Mon. & 1/2 Wed., 1/3 Mon., 1/3 Wed., 1/3 Fri., Whenever Necessary, 1/2 By Wed. Bal. By Fri., None (Also Used to Cancel or Override a Previous Pattern) eligibilityResponses.benefitsInformation.benefitsServiceDelivery.deliveryPatternTimeCode
enum<string>
Available options:
1st Shift (Normal Working Hours), 2nd Shift, 3rd Shift, A.M., P.M., As Directed, Any Shift, None (Also Used to Cancel or Override a Previous Pattern) eligibilityResponses.benefitsInformation.benefitsServiceDelivery.deliveryPatternTimeQualifierCode
enum<string>
Available options:
A, B, C, D, E, F, G, Y eligibilityResponses.benefitsInformation.benefitsServiceDelivery.deliveryPatternTimeQualifier
enum<string>
Available options:
1st Shift (Normal Working Hours), 2nd Shift, 3rd Shift, A.M., P.M., As Directed, Any Shift, None (Also Used to Cancel or Override a Previous Pattern) Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.eligibilityAdditionalInformationList.codeListQualifierCode
enum<string>
Available options:
GR, NI, ZZ eligibilityResponses.benefitsInformation.eligibilityAdditionalInformationList.codeListQualifier
string
eligibilityResponses.benefitsInformation.eligibilityAdditionalInformationList.codeCategory
enum<string>
Available options:
44 eligibilityResponses.benefitsInformation.eligibilityAdditionalInformationList.injuredBodyPartName
string
Show child attributes
Show child attributes
Available options:
Contracted Service Provider, Preferred Provider Organization (PPO), Provider, Third-Party Administrator, Employer, Other Physician, Facility, Gateway Provider, Group, Independent Physicians Association (IPA), Insured or Subscriber, Legal Representative, Origin Carrier, Primary Care Provider, Prior Insurance Carrier, Plan Sponsor, Payer, Primary Payer, Secondary Payer, Tertiary Payer, Party Performing Verification, Vendor, Organization Completing Configuration Change, Utilization Management Organization, Managed Care Organization Available options:
Person, Non-Person Entity Available options:
24, 34, 46, FA, FI, II, MI, NI, PI, PP, SV, XV, XX Available options:
01, 02, 27, 41, 48, 65, 72 Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2eligibilityResponses.benefitsInformation.benefitsRelatedEntities.address.countrySubDivisionCode
string
Required string length:
1 - 3Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.benefitsRelatedEntities.contactInformation.contacts
object[]
Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.benefitsRelatedEntities.contactInformation.contacts.communicationMode
enum<string>
Available options:
Electronic Data Interchange Access Number, Electronic Mail, Facsimile, Telephone, Uniform Resource Locator (URL) eligibilityResponses.benefitsInformation.benefitsRelatedEntities.contactInformation.contacts.communicationNumber
string
Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.benefitsRelatedEntities.providerInformation.providerCode
enum<string>
Available options:
AD, AT, BI, CO, CV, H, HH, LA, OT, P1, P2, PC, PE, R, RF, SB, SK, SU eligibilityResponses.benefitsInformation.benefitsRelatedEntities.providerInformation.referenceIdentification
string
Show child attributes
Show child attributes
Show child attributes
Show child attributes
Available options:
Contracted Service Provider, Preferred Provider Organization (PPO), Provider, Third-Party Administrator, Employer, Other Physician, Facility, Gateway Provider, Group, Independent Physicians Association (IPA), Insured or Subscriber, Legal Representative, Origin Carrier, Primary Care Provider, Prior Insurance Carrier, Plan Sponsor, Payer, Primary Payer, Secondary Payer, Tertiary Payer, Party Performing Verification, Vendor, Organization Completing Configuration Change, Utilization Management Organization, Managed Care Organization Available options:
Person, Non-Person Entity Available options:
24, 34, 46, FA, FI, II, MI, NI, PI, PP, SV, XV, XX Available options:
01, 02, 27, 41, 48, 65, 72 Show child attributes
Show child attributes
Required string length:
1 - 55Required string length:
1 - 55Required string length:
2 - 30Available options:
NL, PE, NS, NB, QC, ON, MB, SK, AB, BC, YT, NT, NU, DC, AS, GU, MP, PR, UM, VI, AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY Required string length:
5 - 9Required string length:
2eligibilityResponses.benefitsInformation.benefitsRelatedEntity.address.countrySubDivisionCode
string
Required string length:
1 - 3Show child attributes
Show child attributes
Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.benefitsRelatedEntity.contactInformation.contacts.communicationMode
enum<string>
Available options:
Electronic Data Interchange Access Number, Electronic Mail, Facsimile, Telephone, Uniform Resource Locator (URL) eligibilityResponses.benefitsInformation.benefitsRelatedEntity.contactInformation.contacts.communicationNumber
string
Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.benefitsRelatedEntity.providerInformation.providerCode
enum<string>
Available options:
AD, AT, BI, CO, CV, H, HH, LA, OT, P1, P2, PC, PE, R, RF, SB, SK, SU eligibilityResponses.benefitsInformation.benefitsRelatedEntity.providerInformation.referenceIdentification
string
Show child attributes
Show child attributes
eligibilityResponses.benefitsInformation.eligibilityAdditionalInformation.codeListQualifierCode
enum<string>
Available options:
GR, NI, ZZ Available options:
44 eligibilityResponses.benefitsInformation.eligibilityAdditionalInformation.injuredBodyPartName
string
Response
200
Default Response
⌘I