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.
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
}
| Attribute | Type | Possible Values | Description |
|---|---|---|---|
| eligibility_details.copay | decimal | copayment amount in dollars | |
| eligibility_details.copay_ambiguous | boolean | true, false | If true, the given copay value may not be accurate and the full eligibility report will need to be referenced for better details. |
| eligibility_details.coinsurance | string | 0.00 to 1.00 | Coinsurance percentage value as a decimal e.g. 0.25 |
| eligibility_details.coinsurance_ambiguous | boolean | true, false | |
| eligibility_details.deductible | string | Deductible amount in dollars | |
| eligibility_details.deductible_ambiguous | boolean | true, false | |
| eligibility_details.deductible_remaining | string | Remaining deductible amount in dollars | |
| eligibility_details.deductible_remaining_ambiguous | boolean | true, false | |
| eligibility_details.errors | array of objects | Error messages showing reason for failed eligibility check | |
| eligibility_check_timestamp | string | Eligibility check timestamp in ISO format | |
| eligibility_status | string | "active", "inactive", "error" | Status of eligibility check |
| 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 |