New Discovery Request

POST {{url}}/rcm/eligibility/v1/coverage-discovery

Request Body

{"canonicalEligibilityRequest"=>{"submitterTransactionIdentifier"=>"string", "controlNumber"=>"123456789", "tradingPartnerServiceId"=>"serviceId", "tradingPartnerName"=>"string", "provider"=>{"organizationName"=>"provider_name", "firstName"=>"string", "lastName"=>"string", "npi"=>"0123456789", "serviceProviderNumber"=>"54321", "payorId"=>"string", "taxId"=>"string", "ssn"=>"string", "pharmacyProcessorNumber"=>"string", "servicesPlanID"=>"string", "employersId"=>"string", "providerCode"=>"AD", "referenceIdentification"=>"54321g", "providerType"=>"payer"}, "portalUsername"=>"string", "portalPassword"=>"string", "informationReceiverName"=>{"stateLicenceNumber"=>"string", "medicareProviderNumber"=>"string", "medicaidProviderNumber"=>"string", "facilityIdNumber"=>"string", "contactNumber"=>"string", "devicePinNumber"=>"string", "submitterIdNumber"=>"string", "nationalProviderIdentifier"=>"string", "providerPlanNetworkIdNumber"=>"string", "facilityNetworkIdNumber"=>"string", "priorIdentifierNumber"=>"string", "socialSecurityNumber"=>"string", "federalTaxpayerIdentificationNumber"=>"string", "informationReceiverAdditionalIdentifierState"=>"string", "address"=>{"address1"=>"123 address1", "address2"=>"string", "city"=>"city1", "state"=>"wa", "postalCode"=>"981010000", "countryCode"=>"string", "locationIdentifier"=>"string", "countrySubDivisionCode"=>"string"}}, "subscriber"=>{"birthSequenceNumber"=>"685287577", "caseNumber"=>"tItvY4JZ4iHrMJqh0E5", "medicaidRecipientIdentificationNumber"=>"ZGXHxKI4", "spendDownAmount"=>"string", "spendDownTotalBilledAmount"=>"string", "coverageLevelCode"=>"str", "memberId"=>"0000000000", "firstName"=>"johnOne", "middleName"=>"string", "lastName"=>"doeOne", "suffix"=>"string", "gender"=>"M", "dateOfBirth"=>"18800102", "ssn"=>"string", "groupNumber"=>"1111111111", "idCard"=>"string", "providerCode"=>"AD", "referenceIdentificationQualifier"=>"9K", "providerIdentifier"=>"XgCgBLP3fqAmzNESjDhiTZ0A2LBNwwhiwpwfmdrjNycvS2iPxx", "beginningCardIssueDate"=>"string", "endCardIssueDate"=>"string", "idCardIssueDate"=>"string", "planIssueDate"=>"string", "beginningPlanIssueDate"=>"string", "endPlanIssueDate"=>"string", "healthCareCodeInformation"=>[{"diagnosisTypeCode"=>"BK", "diagnosisCode"=>"edb6AHQ9MsZXWizTlkkB0aaPqnh4m6"}], "address"=>{"address1"=>"123 address1", "address2"=>"string", "city"=>"city1", "state"=>"wa", "postalCode"=>"981010000", "countryCode"=>"string", "locationIdentifier"=>"string", "countrySubDivisionCode"=>"string"}, "additionalIdentification"=>{"planNumber"=>"string", "policyNumber"=>"string", "memberIdentificationNumber"=>"string", "contractNumber"=>"string", "medicalRecordIdentificationNumber"=>"string", "patientAccountNumber"=>"string", "healthInsuranceClaimNumber"=>"string", "identificationCardSerialNumber"=>"string", "insurancePolicyNumber"=>"string", "planNetworkIdentificationNumber"=>"string", "agencyClaimNumber"=>"string"}}, "dependents"=>[{"birthSequenceNumber"=>"580966991", "individualRelationshipCode"=>"01", "issueNumber"=>"string", "eligibilityCategory"=>"string", "memberId"=>"0000000000", "firstName"=>"janeOne", "middleName"=>"string", "lastName"=>"doeOne", "suffix"=>"string", "gender"=>"F", "dateOfBirth"=>"18160421", "ssn"=>"string", "groupNumber"=>"1111111111", "idCard"=>"string", "providerCode"=>"AD", "referenceIdentificationQualifier"=>"9K", "providerIdentifier"=>"keqsxE4Mmn0oJnZaHfADODfTl4fJVfwsVeljrvZnTgWAR6sfxP", "beginningCardIssueDate"=>"string", "endCardIssueDate"=>"string", "idCardIssueDate"=>"string", "planIssueDate"=>"string", "beginningPlanIssueDate"=>"string", "endPlanIssueDate"=>"string", "healthCareCodeInformation"=>[{"diagnosisTypeCode"=>"BK", "diagnosisCode"=>"46ym"}], "address"=>{"address1"=>"123 address1", "address2"=>"string", "city"=>"city1", "state"=>"wa", "postalCode"=>"981010000", "countryCode"=>"string", "locationIdentifier"=>"string", "countrySubDivisionCode"=>"string"}, "additionalIdentification"=>{"planNumber"=>"string", "policyNumber"=>"string", "memberIdentificationNumber"=>"string", "contractNumber"=>"string", "medicalRecordIdentificationNumber"=>"string", "patientAccountNumber"=>"string", "healthInsuranceClaimNumber"=>"string", "identificationCardSerialNumber"=>"string", "insurancePolicyNumber"=>"string", "planNetworkIdentificationNumber"=>"string", "agencyClaimNumber"=>"string"}}], "encounter"=>{"beginningDateOfService"=>"string", "endDateOfService"=>"string", "dateOfService"=>"string", "serviceTypeCodes"=>["1"], "priorAuthorizationOrReferralNumber"=>"string", "referenceIdentificationQualifier"=>"9F", "industryCode"=>"01", "productOrServiceIDQualifier"=>"AD", "procedureCode"=>"string", "procedureModifiers"=>["string"], "diagnosisCodePointer"=>["string"], "medicalProcedures"=>[{"productOrServiceIDQualifier"=>"AD", "procedureCode"=>"string", "procedureModifiers"=>["string"], "diagnosisCodePointer"=>["string"]}]}}, "canonicalEligibilityResponse"=>{"id"=>"36743735-3303-4d9d-9f21-20dd5f6d7ab2", "hash"=>"foo", "status"=>{"value"=>"eligible_non_primary", "timestamp"=>"2017-09-21T17:32:28Z", "description"=>"Eligible with non-primary insurance"}, "metadata"=>{"clearinghouse"=>"IMN", "sourceId"=>"string", "sourceType"=>"new", "canonicalizerVersion"=>"1.0.0", "x12-270"=>"string", "x12-271"=>"string", "errors"=>["string"]}}, "dryRun"=>true, "callbackUrl"=>"http://customer.apis.healthcare.com/rcmc/eligibility/coverage-discovery/responses"}

HEADERS