Skip to main content
GET
/
v1
/
eligibility
/
checks
List Checks
curl --request GET \
  --url https://api.example.com/v1/eligibility/checks \
  --header 'X-API-Key: <api-key>'
{
  "data": [
    {
      "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"
    }
  ],
  "pagination": {
    "has_more": true,
    "total": 123,
    "page": 123,
    "limit": 123
  }
}

Authorizations

X-API-Key
string
header
required

Query Parameters

page
integer
default:1

Page number (1-based)

Required range: x >= 1
limit
integer
default:50

Items per page

Required range: 1 <= x <= 200
payor_id
string<uuid> | null

Filter by payor ID

patient_id
string<uuid> | null

Filter by patient ID

batch_id
string<uuid> | null

Filter by batch ID

eligibility_status
enum<string> | null

Filter by eligibility status Eligibility check status enum matching Prisma EligibilityStatus

Available options:
active,
inactive,
pending,
failed

Response

Successful Response

Paginated list of eligibility checks

data
EligibilityCheckItem · object[]
required

List of eligibility checks

pagination
Pagination · object
required

Pagination metadata