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Documentation Index

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The Insurance Eligibility Object represents the eligibility information for a patient’s insurance. The response includes eligibility details such as co-pay, coinsurance, deductible, and remaining deductible.

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Object Definition

{
  "eligibility_details": {
    "copay": null,
    "copay_ambiguous": true,
    "coinsurance": "0",
    "coinsurance_ambiguous": false,
    "deductible": "2000",
    "deductible_ambiguous": false,
    "deductible_remaining": "1827.12",
    "deductible_remaining_ambiguous": false,
    "errors": []
  },
  "eligibility_check_timestamp": "2022-05-05T19:39:26+00:00",
  "eligibility_status": "active",
  "patient_id": 140658474356545,
  "patient_insurance_id": 130754515763059,
  "practice_id": 6558432
}
AttributeTypePossible ValuesDescription
eligibility_details.copaydecimalcopayment amount in dollars
eligibility_details.copay_ambiguousbooleantrue, falseIf true, the given copay value may not be accurate and the full eligibility report will need to be referenced for better details.
eligibility_details.coinsurancestring0.00 to 1.00Coinsurance percentage value as a decimal
eligibility_details.coinsurance_ambiguousbooleantrue, false
eligibility_details.deductiblestringDeductible amount in dollars
eligibility_details.deductible_ambiguousbooleantrue, false
eligibility_details.deductible_remainingstringRemaining deductible amount in dollars
eligibility_details.deductible_remaining_ambiguousbooleantrue, false
eligibility_details.errorsarray of objectsError messages showing reason for failed eligibility check
eligibility_check_timestampstringEligibility check timestamp in ISO format
eligibility_statusstring”active”, “inactive”, “error”Status of eligibility check
patient_idintegerPatient’s id in Elation system
patient_insurance_idintegerPatient’s insurance id in Elation system
practice_idintegerPractice’s id in Elation system