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GET
Get Patient Policy

Authorizations

X-API-Key
string
header
required

Path Parameters

id
string
required

The patient policy ID

Query Parameters

expand[]
string[] | null

Expand ('insurance')

Response

Successful Response

A patient policy: one coverage a patient holds.

Its verifications (its VOBs' results) are not nested here: each is read with its VOB, through /v1/verification-of-benefits (filter by patient_policy_id, include=result). current_version is the one exception: the policy's current verification — the result of its latest completed VOB — embedded for convenience, and null while the policy is not verified yet.

id
string<uuid>
required
created_at
string<date-time>
required
updated_at
string<date-time>
required
patient_id
string
required
insurance_id
string
required
member_number
string
required
coverage_tier
enum<string>
required

Insurance tier enum matching Prisma

Available options:
primary,
secondary,
tertiary,
quaternary
insurance_display_name
string | null
group_number
string | null
group_description
string | null
medicaid_id
string | null
plan_name
string | null
insurance_type
enum<string> | null

Insurance plan type enum matching Prisma - X12 standard codes

Available options:
01,
02,
03,
12,
13,
14,
15,
16,
17,
18,
19,
41,
42,
43,
47,
48,
49,
AP,
C1,
CO,
CP,
D,
DB,
EP,
FF,
GP,
HB,
HD,
HG,
HM,
HN,
HP,
HS,
IN,
IP,
LC,
LD,
LI,
LT,
M,
MA,
MB,
MC,
MD,
ME,
MH,
MI,
MJ,
MK,
ML,
MM,
MN,
MO,
MP,
MR,
MT,
OA,
OT,
PE,
PL,
PP,
PR,
PS,
QM,
RP,
SA,
SP,
TF,
WC,
WU
start_date
string<date> | null
end_date
string<date> | null
relationship_to_subscriber
enum<string> | null

Relationship to subscriber enum matching Prisma @map values

Available options:
spouse,
self,
child,
employee,
unknown,
organ_donor,
cadaver_donor,
life_partner,
other_relationship
subscriber
PolicySubscriber · object | null

Null when every subscriber field is null

external_id
string | null
active
boolean
default:true
version
integer
default:0
current_version
Payor · object | null

The current verification: the result of the policy's latest completed VOB. Null when no VOB of the policy has completed yet.

insurance
Insurance · object | null
patient
Patient · object | null