eligibility requests

Create Eligibility Request

post
/organizations/{organizationId}/fhir/3/EligibilityRequest

The EligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an EligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug

Body

resourceType*stringEligibilityRequestThis is a EligibilityRequest resource
identifierarray(Identifier)The Response business identifier.
statusstringThe status of the resource instance.
priorityCodeableConceptImmediate (STAT), best effort (NORMAL), deferred (DEFER).
patientReferencePatient Resource.
servicedDatestringThe date or dates when the enclosed suite of services were performed or completed.
servicedPeriodPeriodThe date or dates when the enclosed suite of services were performed or completed.
createdstringThe date when this resource was created.
entererReferencePerson who created the invoice/claim/pre-determination or pre-authorization.
providerReferenceThe practitioner who is responsible for the services rendered to the patient.
organizationReferenceThe organization which is responsible for the services rendered to the patient.
insurerReferenceThe Insurer who is target of the request.
facilityReferenceFacility where the services were provided.
coverageReferenceFinancial instrument by which payment information for health care.
businessArrangementstringThe contract number of a business agreement which describes the terms and conditions.
benefitCategoryCodeableConceptDental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategoryCodeableConceptDental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

Patch Eligibility Request

patch
/organizations/{organizationId}/fhir/3/EligibilityRequest/{resourceId}

The EligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an EligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.

Request

Headers

content-type*stringapplication/json-patch+jsonapplication/json-patch+json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Body

resourceType*stringEligibilityRequestThis is a EligibilityRequest resource
identifierarray(Identifier)The Response business identifier.
statusstringThe status of the resource instance.
priorityCodeableConceptImmediate (STAT), best effort (NORMAL), deferred (DEFER).
patientReferencePatient Resource.
servicedDatestringThe date or dates when the enclosed suite of services were performed or completed.
servicedPeriodPeriodThe date or dates when the enclosed suite of services were performed or completed.
createdstringThe date when this resource was created.
entererReferencePerson who created the invoice/claim/pre-determination or pre-authorization.
providerReferenceThe practitioner who is responsible for the services rendered to the patient.
organizationReferenceThe organization which is responsible for the services rendered to the patient.
insurerReferenceThe Insurer who is target of the request.
facilityReferenceFacility where the services were provided.
coverageReferenceFinancial instrument by which payment information for health care.
businessArrangementstringThe contract number of a business agreement which describes the terms and conditions.
benefitCategoryCodeableConceptDental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategoryCodeableConceptDental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

Read Eligibility Request

get
/organizations/{organizationId}/fhir/3/EligibilityRequest/{resourceId}

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Response

Read History Eligibility Request

get
/organizations/{organizationId}/fhir/3/EligibilityRequest/{resourceId}/_history

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_countstring
_sincestring

Params

organizationId*string|stringid|slug
resourceId*

Response

Read Version Eligibility Request

get
/organizations/{organizationId}/fhir/3/EligibilityRequest/{resourceId}/_history/{versionId}

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*
versionId*

Response

Remove Eligibility Request

delete
/organizations/{organizationId}/fhir/3/EligibilityRequest/{resourceId}

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Response

Search Get Eligibility Request

get
/organizations/{organizationId}/fhir/3/EligibilityRequest

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_idstring
_languagestring
createdstring
entererstring
facilitystring
identifierstring
organizationstring
patientstring
providerstring

Params

organizationId*string|stringid|slug

Response

Search History Eligibility Request

get
/organizations/{organizationId}/fhir/3/EligibilityRequest/_history

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_countstring
_sincestring

Params

organizationId*string|stringid|slug

Response

Search Post Eligibility Request

post
/organizations/{organizationId}/fhir/3/EligibilityRequest/_search

The EligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an EligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.

Request

Headers

content-type*stringapplication/json|application/x-www-form-urlencodedapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_idstring
_languagestring
createdstring
entererstring
facilitystring
identifierstring
organizationstring
patientstring
providerstring

Params

organizationId*string|stringid|slug

Body

resourceType*stringEligibilityRequestThis is a EligibilityRequest resource
identifierarray(Identifier)The Response business identifier.
statusstringThe status of the resource instance.
priorityCodeableConceptImmediate (STAT), best effort (NORMAL), deferred (DEFER).
patientReferencePatient Resource.
servicedDatestringThe date or dates when the enclosed suite of services were performed or completed.
servicedPeriodPeriodThe date or dates when the enclosed suite of services were performed or completed.
createdstringThe date when this resource was created.
entererReferencePerson who created the invoice/claim/pre-determination or pre-authorization.
providerReferenceThe practitioner who is responsible for the services rendered to the patient.
organizationReferenceThe organization which is responsible for the services rendered to the patient.
insurerReferenceThe Insurer who is target of the request.
facilityReferenceFacility where the services were provided.
coverageReferenceFinancial instrument by which payment information for health care.
businessArrangementstringThe contract number of a business agreement which describes the terms and conditions.
benefitCategoryCodeableConceptDental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategoryCodeableConceptDental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

Update Eligibility Request

put
/organizations/{organizationId}/fhir/3/EligibilityRequest/{resourceId}

The EligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an EligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.

Request

Headers

content-type*stringapplication/jsonapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Body

resourceType*stringEligibilityRequestThis is a EligibilityRequest resource
identifierarray(Identifier)The Response business identifier.
statusstringThe status of the resource instance.
priorityCodeableConceptImmediate (STAT), best effort (NORMAL), deferred (DEFER).
patientReferencePatient Resource.
servicedDatestringThe date or dates when the enclosed suite of services were performed or completed.
servicedPeriodPeriodThe date or dates when the enclosed suite of services were performed or completed.
createdstringThe date when this resource was created.
entererReferencePerson who created the invoice/claim/pre-determination or pre-authorization.
providerReferenceThe practitioner who is responsible for the services rendered to the patient.
organizationReferenceThe organization which is responsible for the services rendered to the patient.
insurerReferenceThe Insurer who is target of the request.
facilityReferenceFacility where the services were provided.
coverageReferenceFinancial instrument by which payment information for health care.
businessArrangementstringThe contract number of a business agreement which describes the terms and conditions.
benefitCategoryCodeableConceptDental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategoryCodeableConceptDental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response