Coverage-GET

Description

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.

Use Cases

: Member Eligibility Checks
: Claims Adjudication
: Referral Insurance Discovery
: Clinical Trial Prequalification
: Care Gap Identification

Request Sample

Athena

Elation

Canvas

cURL

JavaScript

Java

Python

Source Specific Details

EHR	APIs	mandatory filters	optional filters
Athena	`url/v1/practiceId/patients/patient/insurances` `url/v1/practiceId/patients/patient/insurances/insuranceid/benefitdetails` `url/v1/practiceId/patients/patient/insurances/insuranceid/image`	patient departmentId	include departmentId ignore-restrictions _count _offset
Elation	`${url}/patients/${patient}`	patient	deleted
Canvas	`${url}/Coverage`	patient

Filters

FilterName	Description	Default Value
_count	Pagination params
_offset	Pagination params. Athena: Starting point of entries; 0-indexed
birthdate	The date of birth for the individual
deleted	include deleted insurances	false
departmentId	Identifier for the department
dob	The date of birth for the individual
documentUpload	Flag to identify if document should be uploaded
first_name	first name
ignore-restrictions	Set to true to allow ability to find patients with record restrictions and blocked patients
include	List of fields which needed to be shown in result
last_name	last name
name	name
no-refresh-months
patient	Patient reference for any fhir resource
practitioner	Practitioner reference for the any fhir resource
quorum	sets sync/async mode	true
refresh-eligibility

Coverage Export-POST

Coverage ID-DELETE