Get Coverage by ID
GET {{baseUrl}}/api/v2/Coverage/:coverage-id?patient=<integer>&departmentId=<integer>
Overview:
Retrieves detailed information on insurance coverage, allowing healthcare developers to access and display real-time data regarding patients' insurance plans for streamlined verification and validation within clinical workflows.
This is only supported by ATHENA.
Use Cases:
Claim Status Checks: Verify coverage specifics
Member Service Questions: Answer eligibility questions
Referral Insurance Verification: Validate referral coverage details
Clinical Trial Pre-Check: Check study charges coverage
Care Plan Counseling: Review benefit details
Request Params
| Key | Datatype | Required | Description |
|---|---|---|---|
patient | string | (Required) The patient identifier associated with the coverage. | |
departmentId | string | The department identifier |
HEADERS
| Key | Datatype | Required | Description |
|---|---|---|---|
x-source-id | string | (Required) The source id provided for connecting to the data source | |
Authorization | string |
RESPONSES
status: OK
[{"context":{"requestId":"\u003cstring\u003e","source":"\u003cstring\u003e","quorum":"\u003cboolean\u003e","notify":"\u003cboolean\u003e"},"data":{"resourceType":"\u003cstring\u003e","beneficiary":{"reference":"\u003cstring\u003e","id":"\u003cstring\u003e"},"id":"\u003cstring\u003e","status":"\u003cstring\u003e","identifier":[{"system":"\u003cstring\u003e","value":"\u003cstring\u003e"},{"system":"\u003cstring\u003e","value":"\u003cstring\u003e"}],"policyHolder":{"display":"\u003cstring\u003e","reference":"\u003cstring\u003e","extension":[{"url":"\u003cstring\u003e","valueCode":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueDate":"\u003cdate\u003e","valueAddress":{"state":"\u003cstring\u003e","postalCode":"\u003cstring\u003e","country":"\u003cstring\u003e","line":["\u003cstring\u003e","\u003cstring\u003e"]},"valueHumanName":{"given":["\u003cstring\u003e","\u003cstring\u003e"],"family":"\u003cstring\u003e"}},{"url":"\u003cstring\u003e","valueCode":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueDate":"\u003cdate\u003e","valueAddress":{"state":"\u003cstring\u003e","postalCode":"\u003cstring\u003e","country":"\u003cstring\u003e","line":["\u003cstring\u003e","\u003cstring\u003e"]},"valueHumanName":{"given":["\u003cstring\u003e","\u003cstring\u003e"],"family":"\u003cstring\u003e"}}],"identifier":{}},"period":{"start":"\u003cdateTime\u003e","end":"\u003cdateTime\u003e"},"relationship":{"id":"\u003cinteger\u003e","text":"\u003cstring\u003e"},"class":[{"type":{"text":"\u003cstring\u003e"},"name":"\u003cstring\u003e","value":"\u003cstring\u003e"},{"type":{"text":"\u003cstring\u003e"},"name":"\u003cstring\u003e","value":"\u003cstring\u003e"}],"extension":[{"url":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueInteger":"\u003cinteger\u003e","valueDate":"\u003cdate\u003e"},{"url":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueInteger":"\u003cinteger\u003e","valueDate":"\u003cdate\u003e"}],"type":{"coding":[{"system":"\u003cstring\u003e","display":"\u003cstring\u003e"},{"system":"\u003cstring\u003e","display":"\u003cstring\u003e"}]}}},{"context":{"requestId":"\u003cstring\u003e","source":"\u003cstring\u003e","quorum":"\u003cboolean\u003e","notify":"\u003cboolean\u003e"},"data":{"resourceType":"\u003cstring\u003e","beneficiary":{"reference":"\u003cstring\u003e","id":"\u003cstring\u003e"},"id":"\u003cstring\u003e","status":"\u003cstring\u003e","identifier":[{"system":"\u003cstring\u003e","value":"\u003cstring\u003e"},{"system":"\u003cstring\u003e","value":"\u003cstring\u003e"}],"policyHolder":{"display":"\u003cstring\u003e","reference":"\u003cstring\u003e","extension":[{"url":"\u003cstring\u003e","valueCode":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueDate":"\u003cdate\u003e","valueAddress":{"state":"\u003cstring\u003e","postalCode":"\u003cstring\u003e","country":"\u003cstring\u003e","line":["\u003cstring\u003e","\u003cstring\u003e"]},"valueHumanName":{"given":["\u003cstring\u003e","\u003cstring\u003e"],"family":"\u003cstring\u003e"}},{"url":"\u003cstring\u003e","valueCode":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueDate":"\u003cdate\u003e","valueAddress":{"state":"\u003cstring\u003e","postalCode":"\u003cstring\u003e","country":"\u003cstring\u003e","line":["\u003cstring\u003e","\u003cstring\u003e"]},"valueHumanName":{"given":["\u003cstring\u003e","\u003cstring\u003e"],"family":"\u003cstring\u003e"}}],"identifier":{}},"period":{"start":"\u003cdateTime\u003e","end":"\u003cdateTime\u003e"},"relationship":{"id":"\u003cinteger\u003e","text":"\u003cstring\u003e"},"class":[{"type":{"text":"\u003cstring\u003e"},"name":"\u003cstring\u003e","value":"\u003cstring\u003e"},{"type":{"text":"\u003cstring\u003e"},"name":"\u003cstring\u003e","value":"\u003cstring\u003e"}],"extension":[{"url":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueInteger":"\u003cinteger\u003e","valueDate":"\u003cdate\u003e"},{"url":"\u003cstring\u003e","valueString":"\u003cstring\u003e","valueInteger":"\u003cinteger\u003e","valueDate":"\u003cdate\u003e"}],"type":{"coding":[{"system":"\u003cstring\u003e","display":"\u003cstring\u003e"},{"system":"\u003cstring\u003e","display":"\u003cstring\u003e"}]}}}]