The Insurance Eligibility Full Report Object - Elation Help Center

The Insurance Eligibility Full Report Object represents the eligibility information for a patient’s insurance. The response includes eligibility details such as service type code, eligibility provider, plan details, and benefits.

Object Definition

{
  "eligibility_check_timestamp": "2022-04-04T01:52:38.662938+00:00",
  "patient_id": 123,
  "patient_insurance_id": 456,
  "practice_id": 789,
  "service_type_code": "30",
  "subscriber": {
    "address": {
      "address_1": "550 15th Street",
      "address_2": "21",
      "city": "San Francisco",
      "postal_code": "94103",
      "state": "CA"
    },
    "first_name": "Paula",
    "last_name": "Patient",
    "member_id": "test_member_id",
    "middle_name": "P",
    "name": "Paula Patient",
    "sex_at_birth": "F"
  },
  "eligibility_provider": {
    "first_name": "Gary",
    "last_name": "Leung",
    "npi": "1234567890",
    "organization_name": "Elation North"
  },
  "plan_details": {
    "carrier": "Blue Cross",
    "end_date": null,
    "group_name": "Elation Health, Inc",
    "group_number": "test_group_number",
    "insurance_type": null,
    "member_id": "test_member_id",
    "plan_name": "Blue Cross Blue Shield",
    "plan_number": "test_plan_number",
    "policy_name": null,
    "policy_number": null,
    "provider": {
      "first_name": "Gary",
      "last_name": "Leung",
      "npi": "1234567890",
      "organization_name": "Elation North"
    },
    "start_date": "2022-04-04"
  },
  "benefits": {
    "copay": [],
    "coinsurance": [],
    "deductible": [],
    "out_of_pocket": [],
    "limitations": []
  }
}

Attribute	Type	Possible Values	Description
eligibility_check_timestamp	string		Eligibility check timestamp in ISO format
patient_id	integer		Patient’s id in Elation system
patient_insurance_id	integer		Patient’s insurance id in Elation system
practice_id	integer		Practice’s id in Elation system
service_type_code	string
subscriber.address.adress_1	string
subscriber.address.adress_2	string
subscriber.address.city	string
subscriber.address.postal_code	string
subscriber.address.state	string
subscriber.date_of_birth	string
subscriber.first_name	string
subscriber.last_name	string
subscriber.member_id	string
subscriber.middle_name	string
subscriber.name	string
subscriber.sex_at_birth	string
eligibility_provider.first_name	string
eligibility_provider.last_name	string
eligibility_provider.npi	string
eligibility_provider.organization_name	string
plan_details.carrier	string
plan_details.end_date	string
plan_details.group_name	string
plan_details.group_number	string
plan_details.insurance_type	string
plan_details.member_id	string
plan_details.plan_name	string
plan_details.plan_number	string
plan_details.policy_name	string
plan_details.policy_number	string
plan_details.provider.first_name	string
plan_details.provider.last_name	string
plan_details.provider.npi	string
plan_details.provider.organiztion_name	string
plan_details.start_date	string
benefits.copay	array of objects
benefits.coinsurance	array of objects
benefits.deductible	array of objects
benefits.out_of_pocket	array of objects
benefits.limitations	array of objects

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