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*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Params


organizationId*	string\|string		id\|slug

Body


resourceType*	string	EligibilityRequest	This is a EligibilityRequest resource
identifier	array(Identifier)		The Response business identifier.
status	string		The status of the resource instance.
priority	CodeableConcept		Immediate (STAT), best effort (NORMAL), deferred (DEFER).
patient	Reference		Patient Resource.
servicedDate	string		The date or dates when the enclosed suite of services were performed or completed.
servicedPeriod	Period		The date or dates when the enclosed suite of services were performed or completed.
created	string		The date when this resource was created.
enterer	Reference		Person who created the invoice/claim/pre-determination or pre-authorization.
provider	Reference		The practitioner who is responsible for the services rendered to the patient.
organization	Reference		The organization which is responsible for the services rendered to the patient.
insurer	Reference		The Insurer who is target of the request.
facility	Reference		Facility where the services were provided.
coverage	Reference		Financial instrument by which payment information for health care.
businessArrangement	string		The contract number of a business agreement which describes the terms and conditions.
benefitCategory	CodeableConcept		Dental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategory	CodeableConcept		Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

200 400 401 404

Patch Eligibility Request

patch

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

Request

Headers


content-type*	string	application/json-patch+json	application/json-patch+json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Params


organizationId*	string\|string		id\|slug
resourceId*

Body


resourceType*	string	EligibilityRequest	This is a EligibilityRequest resource
identifier	array(Identifier)		The Response business identifier.
status	string		The status of the resource instance.
priority	CodeableConcept		Immediate (STAT), best effort (NORMAL), deferred (DEFER).
patient	Reference		Patient Resource.
servicedDate	string		The date or dates when the enclosed suite of services were performed or completed.
servicedPeriod	Period		The date or dates when the enclosed suite of services were performed or completed.
created	string		The date when this resource was created.
enterer	Reference		Person who created the invoice/claim/pre-determination or pre-authorization.
provider	Reference		The practitioner who is responsible for the services rendered to the patient.
organization	Reference		The organization which is responsible for the services rendered to the patient.
insurer	Reference		The Insurer who is target of the request.
facility	Reference		Facility where the services were provided.
coverage	Reference		Financial instrument by which payment information for health care.
businessArrangement	string		The contract number of a business agreement which describes the terms and conditions.
benefitCategory	CodeableConcept		Dental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategory	CodeableConcept		Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

200 400 401 404 409

Read Eligibility Request

get

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Params


organizationId*	string\|string		id\|slug
resourceId*

Response

200 401 404

Read History Eligibility Request

get

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Query params


_count	string
_since	string

Params


organizationId*	string\|string		id\|slug
resourceId*

Response

200 401 404

Read Version Eligibility Request

get

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Params


organizationId*	string\|string	id\|slug
resourceId*
versionId*

Response

200 400 401 404

Remove Eligibility Request

delete

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Params


organizationId*	string\|string		id\|slug
resourceId*

Response

200 400 401 404 409

Search Get Eligibility Request

get

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Query params


_id	string
_language	string
created	string
enterer	string
facility	string
identifier	string
organization	string
patient	string
provider	string

Params


organizationId*	string\|string		id\|slug

Response

200 401 404

Search History Eligibility Request

get

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Query params


_count	string
_since	string

Params


organizationId*	string\|string		id\|slug

Response

200 401 404

Search Post Eligibility Request

post

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

Request

Headers


content-type*	string	application/json\|application/x-www-form-urlencoded	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Query params


_id	string
_language	string
created	string
enterer	string
facility	string
identifier	string
organization	string
patient	string
provider	string

Params


organizationId*	string\|string		id\|slug

Body


resourceType*	string	EligibilityRequest	This is a EligibilityRequest resource
identifier	array(Identifier)		The Response business identifier.
status	string		The status of the resource instance.
priority	CodeableConcept		Immediate (STAT), best effort (NORMAL), deferred (DEFER).
patient	Reference		Patient Resource.
servicedDate	string		The date or dates when the enclosed suite of services were performed or completed.
servicedPeriod	Period		The date or dates when the enclosed suite of services were performed or completed.
created	string		The date when this resource was created.
enterer	Reference		Person who created the invoice/claim/pre-determination or pre-authorization.
provider	Reference		The practitioner who is responsible for the services rendered to the patient.
organization	Reference		The organization which is responsible for the services rendered to the patient.
insurer	Reference		The Insurer who is target of the request.
facility	Reference		Facility where the services were provided.
coverage	Reference		Financial instrument by which payment information for health care.
businessArrangement	string		The contract number of a business agreement which describes the terms and conditions.
benefitCategory	CodeableConcept		Dental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategory	CodeableConcept		Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

200 401 404

Update Eligibility Request

put

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

Request

Headers


content-type*	string	application/json	application/json
log-cdata	string
log-cdata-format	string	kv\|json	kv
Authorization	string	Bearer <token>

Params


organizationId*	string\|string		id\|slug
resourceId*

Body


resourceType*	string	EligibilityRequest	This is a EligibilityRequest resource
identifier	array(Identifier)		The Response business identifier.
status	string		The status of the resource instance.
priority	CodeableConcept		Immediate (STAT), best effort (NORMAL), deferred (DEFER).
patient	Reference		Patient Resource.
servicedDate	string		The date or dates when the enclosed suite of services were performed or completed.
servicedPeriod	Period		The date or dates when the enclosed suite of services were performed or completed.
created	string		The date when this resource was created.
enterer	Reference		Person who created the invoice/claim/pre-determination or pre-authorization.
provider	Reference		The practitioner who is responsible for the services rendered to the patient.
organization	Reference		The organization which is responsible for the services rendered to the patient.
insurer	Reference		The Insurer who is target of the request.
facility	Reference		Facility where the services were provided.
coverage	Reference		Financial instrument by which payment information for health care.
businessArrangement	string		The contract number of a business agreement which describes the terms and conditions.
benefitCategory	CodeableConcept		Dental, Vision, Medical, Pharmacy, Rehab etc.
benefitSubCategory	CodeableConcept		Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Response

200 400 401 404 409