Create Coverage Eligibility Request

POST {{baseUrl}}/api/v2/CoverageEligibilityRequest

Overview:

Adds new eligibility request records to the system, facilitating the seamless integration of updated coverage inquiry information and supporting efficient processing of insurance-related data within healthcare applications.

This is only supported by ATHENA.

Use Cases:

• High Cost Claim Pre-Adjudication: Submit for early member cost estimates

• Clinical Trial Deferred Billing: Register future visits needing deferred evaluation

• Referral Specialist Onboarding: Propagate new provider credentials

• Catastrophic Case Research: Submit descriptions for payer precedent investigation

• Ongoing Therapy Recertification: Post extension requests before expiration

Request Body

{"context"=>{"departmentId"=>"<string>"}, "data"=>{"resourceType"=>"<string>", "servicedDate"=>"<date>", "subject"=>{"reference"=>"<string>"}, "extension"=>[{"url"=>"<string>", "valueString"=>"<string>"}, {"url"=>"<string>", "valueString"=>"<string>"}]}}

HEADERS

RESPONSES

status: OK

{"context":{"requestId":"\u003cstring\u003e","source":"\u003cstring\u003e","quorum":"\u003cboolean\u003e","notify":"\u003cboolean\u003e"},"data":{"id":"\u003cinteger\u003e","status":"\u003cstring\u003e"}}