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GET
/
v1
/
eligibility
/
checks
/
{check_id}
Get Check
curl --request GET \
  --url https://api.example.com/v1/eligibility/checks/{check_id} \
  --header 'X-API-Key: <api-key>'
{
  "id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "eligibility_search_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "request": {
    "trading_partner_service_id": "<string>",
    "trading_partner_name": "<string>",
    "provider": {
      "organization_name": "<string>",
      "npi": "<string>",
      "service_provider_number": "<string>"
    },
    "subscriber": {
      "first_name": "<string>",
      "last_name": "<string>",
      "date_of_birth": "2023-12-25",
      "member_id": "<string>"
    },
    "encounter": {
      "service_type_codes": [
        "1"
      ],
      "date_of_service": "2023-12-25"
    },
    "dependent": {
      "first_name": "<string>",
      "last_name": "<string>",
      "date_of_birth": "2023-12-25",
      "member_id": "<string>",
      "relationship_code": "<string>"
    }
  },
  "created_at": "2023-11-07T05:31:56Z",
  "batch_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "extracted_data": {
    "subscriber": {
      "first_name": "<string>",
      "last_name": "<string>",
      "middle_name": "<string>",
      "member_id": "<string>",
      "dob": "2023-12-25",
      "gender": "male",
      "address": "<string>",
      "address2": "<string>",
      "city": "<string>",
      "state": "alabama",
      "zip": "<string>"
    },
    "payor": {
      "eligibility_status": "active",
      "coverage_from": "2023-12-25",
      "coverage_to": "2023-12-25",
      "group_number": "<string>",
      "group_description": "<string>",
      "plan_name": "<string>",
      "plan_type": "01",
      "cob_notes": "<string>",
      "party_performing_verification": "<string>",
      "party_performing_verification_id": "<string>",
      "benefits_related_entities": [
        {
          "entity_name": "<string>",
          "entity_firstname": "<string>",
          "entity_type": "<string>",
          "entity_identifier": "<string>",
          "address": {
            "address1": "<string>",
            "address2": "<string>",
            "city": "<string>",
            "state": "alabama",
            "postal_code": "<string>"
          },
          "contact_information": {
            "phone_number": "<string>",
            "fax_number": "<string>",
            "email": "<string>",
            "url": "<string>"
          },
          "service_type_codes": [
            "1"
          ],
          "benefit_name": "<string>"
        }
      ],
      "benefits_related_entities_formatted": "<string>",
      "individual_deductible_in_network": 123,
      "individual_deductible_out_network": 123,
      "individual_deductible_remaining_in_network": 123,
      "individual_deductible_remaining_out_network": 123,
      "family_deductible_in_network": 123,
      "family_deductible_out_network": 123,
      "family_deductible_remaining_in_network": 123,
      "family_deductible_remaining_out_network": 123,
      "individual_oop_max_in_network": 123,
      "individual_oop_max_out_network": 123,
      "individual_oop_max_remaining_in_network": 123,
      "individual_oop_max_remaining_out_network": 123,
      "family_oop_max_in_network": 123,
      "family_oop_max_out_network": 123,
      "family_oop_max_remaining_in_network": 123,
      "family_oop_max_remaining_out_network": 123
    },
    "meta": {
      "eligibility_search_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
      "payer_name": "<string>",
      "has_errors": false,
      "check_status": "active"
    },
    "dependent": {
      "first_name": "<string>",
      "last_name": "<string>",
      "middle_name": "<string>",
      "dob": "2023-12-25",
      "gender": "male",
      "relationship_to_subscriber": "spouse",
      "address": "<string>",
      "address2": "<string>",
      "city": "<string>",
      "state": "alabama",
      "zip": "<string>"
    },
    "services": [
      {
        "service_type": "medical_care",
        "service_type_code": "1",
        "copay_in_network": 123,
        "copay_out_network": 123,
        "co_insurance_in_network": 123,
        "co_insurance_out_network": 123,
        "visit_limit_in_network": 123,
        "visit_limit_out_network": 123,
        "visit_limit_remaining_in_network": 123,
        "visit_limit_remaining_out_network": 123,
        "visit_limit_time_period_in_network": "<string>",
        "visit_limit_time_period_out_network": "<string>",
        "has_matching_benefits": false
      }
    ]
  },
  "eligibility_status": "pending",
  "patient_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "payor_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a"
}

Authorizations

X-API-Key
string
header
required

Path Parameters

check_id
string<uuid>
required

Response

Successful Response

Single eligibility check from database

id
string<uuid>
required

Check ID

eligibility_search_id
string<uuid>
required

Eligibility search ID

request
EligibilityCheckRequest · object
required

Original request data (subscriber, provider, encounter)

created_at
string<date-time>
required

Check creation timestamp

batch_id
string<uuid> | null

Parent batch ID (optional for non-batch checks)

extracted_data
EligibilityExtractedData · object

Extracted eligibility data

eligibility_status
enum<string>
default:pending

Eligibility status

Available options:
active,
inactive,
pending,
failed
patient_id
string<uuid> | null

Matched patient ID (if matched)

payor_id
string<uuid> | null

Linked payor ID (if matched)