API 💻

Postman Collection

Testing vs Production

After creating an account you can access the test API endpoints on our sandbox server:

This endpoint is identical to our production endpoint but does not allow PHI and only returns dummy card results.

Once you have signed our Business Associate Agreement (BAA) you will be able to access the production server:

Admin Endpoints

The admin endpoints are designed for managing access tokens within our system. These endpoints can only be called using a valid API key. They provide a secure way to generate and manage tokens, ensuring that only authorized users can access sensitive data and functionalities.

Get Access Token

GET https://sandbox.cardscan.ai/v1/access-token

This endpoint generates the JSON Web Token (JWT) for a web or mobile user

Query Parameters

Name
Type
Description

user_id

String

Unique identifier for the user

{
  "IdentityId": "us-east-1:0236cb77-ac53-460d-ba39-60b186af2897",
  "Token": "eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJzdWIiOiIxMjM0NTY3ODkwIiwibmFtZSI6IkpvaG4gRG9lIiwiaWF0IjoxNTE2MjM5MDIyfQ.SflKxwRJSMeKKF2QT4fwpMeJf36POk6yJV_adQssw5c"
}

This endpoint generates a short-lived session token that the web/mobile user will use to directly authenticate with CardScan's servers. See the Authentication page for more details.

See Authentication for code examples.


Insurance Card Scanning Endpoints

Create Card

POST https://sandbox.cardscan.ai/v1/cards

Creates a card object to initiate the scanning process and will be used for generating upload endpoints.

Request Body

Name
Type
Description

enable_backside_scan

boolean

Enabled scanning of both sides of the insurance cards. Important for eligibility checks and prior auth.

Default: False

enable_livescan

boolean

Allows the card to process multiple updates per side. Required for live scanning.

Default: False

{
    "card_id": "171d11c4-9154-4f2f-b4ca-0fb610abe05e",
    "state": "pending",
    "created_at": "2024-02-05 15:50:14.856792"
}
curl --location 'https://sandbox.cardscan.ai/v1/cards' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer endusertokenXXX' \
--data '{
    "enable_backside_scan": true
}'

Generate Upload Url

POST https://sandbox.cardscan.ai/v1/cards/:card_id/generate-upload-url

Generates a URL and signed payload to enable direct image upload to AWS S3.

Path Parameters

Name
Type
Description

card_id*

UUID

For the card entity to link the upload with.

Request Body

Name
Type
Description

orientation*

Enum

'front' - the front face of the insurance card, often containing the name, member_id, etc.

'back' - the back side of the card, often containing the claims address, and various phone number.

{
  "card_id": "4c901279-622f-485f-85cc-aad1f12c2d8e",
  "upload_url": "https://cardscan-sandbox.s3.amazonaws.com/",
  "upload_parameters": {
    "key": "4c901279-622f-485f-85cc-aad1f12c2d8e",
    "x-amz-algorithm": "AWS4-HMAC-SHA256",
    "x-amz-security-token": "BADCAFEb3JpZ2sddsfdsfrIAiACLcnulBVymY22qkf3M8XDvlhXweRzDe8V95X73BextSqDAgiU//////////8BEAAaDDUzNTc5NTY3OTQ2NiIM1ZoFizA0PWXBXfiWKtcBVOcw4ss3VbqdPFO7OTJmxuPLUnPKNbsMaRF5sNEsqecP74+mucNgjAwigvQM3K0Bb/WqTsmGIkGXT7p+St1XpyB9nY+nVE1cVgtkggwU4UDXhBpnZLhQIE5fLjEBU+X0Gwd7WVXJdwXFa5iD+EwsQU2aJihBc1tdxYXmIZIkMQ1UXdFPbRc1vX4wcDgzrfbvT5749d1rOh5u9mKxTNc7z/1G4aYswrODlh5N/hSamcKGlaC/wwxrv8gwY64QEp/nQkUuTdrKPSrQRUb7Z5Fj7m8erRixTtYI2rOfAl5Cl",
    "x-amz-credential": "FAKEKEYSDONOTUSEXZYABC/20210413/us-east-1/s3/aws4_request",
    "x-amz-date": "20210413T210019Z",
    "policy": "eyJleHBpcmF0aW9uIjogIjIwMjEtMDQtMTNUMjI6MDA6MTlaIiwgImNvbmRpdGlvbnMiOiBbeyJidWNrZXQiOiAiY2FyZHNjYW4tc2FuZGJveCJ9LCB7ImtleSI6ICI0YzkwMTI3OS02MjJmLTQ4NWYtODVjYy1hYWQxZjEyYzJkOGUifSwgeyJ4LWFtei1hbGdvcml0aG0iOiAiQVdTNC1ITUFDLVNIQTI1NiJ9LCB7IngtYW16LWNyZWRlbnRpYWwiOiAiQUtJSEFMUk9CSVZGTkZYWllBQkMvMjAyMTA0MTMvdXMtZWFzdC0xL3MzL2F3czRfcmVxdWVzdCJ9LCB7IngtYW16LWRhdGUiOiAiMjAyMTA0MTNUMjEwMDE5WiJ9XX0=",
    "x-amz-signature": "40da5a6814f646d9ded38539e37d6badcafe808494b04c76d37ccc89a3e5d34d"
  }
}

The S3 URL only supports HTTP POSTs, not PUTs.

The upload_parameters may change at any time, please make sure to not hardcode the list in any POST command.

curl --location 'https://sandbox.cardscan.ai/v1/cards/9d709b16-3807-4fc9-b176-4409241beab5/generate-upload-url' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer endusertokenXXX \
--data '{   
    "orientation": "back"
}'

List Scanned Cards

GET https://sandbox.cardscan.ai/v1/cards

Query Parameters

Name
Type
Description

cursor

string

Used to paginate through results when count is greater that limit.

limit

integer

Count of cards to return.

Default: 50

Max: 500

{
    "cards": [
        {
            "card_id": "1bab2f3c-cfbe-4f22-b480-b389ece57f7e",
            "state": "pending",
            "created_at": "2021-07-30 19:56:40.638894+00:00",
        },
        {
            "card_id": "98405a1e-b367-4b3a-876a-e7886b7e1b69",
            "state": "processing",
            "created_at": "2021-07-30 20:26:40.838094+00:00",
        },
        {
            "card_id": "4c901279-622f-485f-85cc-aad1f12c2d8e",
            "state": "error",
            "created_at": "2021-07-30 20:58:50.334343+00:00",
            "error_message": "Failure during OCR process - [E507]"
        },
        {
            "card_id": "a1d743ee-3bb9-468d-a2c5-4e33fa0e1c6e",
            "state": "completed",
            "created_at": "2021-07-31 18:36:33.567313+00:00",
            "details": {
                "group_number": {
                    "value": "98755",
                    "scores": [
                        "0.9994",
                        "0.9828"
                    ]
                },
                "member_number": {
                    "value": "128845682",
                    "scores": [
                        "0.9984",
                        "0.9618"
                    ]
                },
                "member_name": {
                    "value": "emily dickinson",
                    "scores": [
                        "0.9974",
                        "0.8879"
                    ]
                },
                "plan_name": {
                    "value": "unitedhealthcare choice plus",
                    "scores": [
                        "0.9953",
                        "0.9835"
                    ]
                },
                "plan_id": {
                    "value": "(80840) 911-80708-01",
                    "scores": [
                        "0.9942",
                        "0.9939"
                    ]
                }
            }
        }
    ],
    "response_metadata": {
        "limit": 4,
        "next_cursor": "IieuzkckWq0"
    }
}

The next_cursor field is only present in the response_metadata when there are additional results to request.

The completed card in this example is truncated, for a full card and supported states, please see Get Card Details below.

curl --location --request GET 'https://sandbox.cardscan.ai/v1/cards' \
--header 'Authorization: Bearer endusertokenXXX' 

Get Card

GET https://sandbox.cardscan.ai/v1/cards/:cardId

Path Parameters

Name
Type
Description

cardId*

string

UUID of card

{
    "card_id": "a1d743ee-3bb9-468d-a2c5-4e33fa0e1c6e",
    "state": "completed",
    "created_at": "2021-07-31 18:36:33.567313+00:00",
    "details": {
        "group_number": {
            "value": "98755",
            "scores": [
                "0.9994",
                "0.9828"
            ]
        },
        "member_number": {
            "value": "128845682",
            "scores": [
                "0.9984",
                "0.9618"
            ]
        },
        "rx_bin": {
            "value": "610279",
            "scores": [
                "0.9979",
                "0.9842"
            ]
        },
        "rx_pcn": {
            "value": "9987",
            "scores": [
                "0.9991",
                "0.9147"
            ]
        },
        "member_name": {
            "value": "emily dickinson",
            "scores": [
                "0.9974",
                "0.8879"
            ]
        },
        "plan_name": {
            "value": "unitedhealthcare choice plus",
            "scores": [
                "0.9953",
                "0.9835"
            ]
        },
        "plan_id": {
            "value": "(80840) 911-80708-01",
            "scores": [
                "0.9942",
                "0.9939"
            ]
        },
        "card_specific_id": {
            "value": "87726",
            "scores": [
                "0.997",
                "0.9592"
            ]
        }
    }
}

Cards returned by this endpoint and the /v1/cards endpoint have a state field:

Value
Description

pending

This card ID has been reserved but a corresponding file has not yet been uploaded

processing

The card is being processed by our ML pipeline.

completed

Card processing is completed and the card details are available.

error

An error has occurred, see error_message for more details.

unknown

An unknown issue has occurred, please contact support for help.

After being processed by the ML pipeline, each element is labeled and when the probability is above our minimum threshold the results are returned.

Name
Description
Example

group_number

The group number identifies the specific benefits associated with the plan. This is missing with some payers and exchange plans.

98755

member_number

A unique identifier for each member and dependent. This is used to verify coverage and arrange payment for services.

128845682

payer_name

The name of the health insurance payer or 3rd party administrator.

unitedhealthcare

payer_id

The payer ID or EDI for the insurance company. This is as written on the card and not matched to a clearing house.

87726

rx_bin

rx_pcn

rx_group rx_id

These are used to identify how a prescription drug will be reimbursed and where a pharmacy can send a reimbursement claim to

610279

9987

UHC 12458765

member_name

Most often the policyholder, but on some cards this is the dependent the card was issues to.

Emily Dickinson

dependent_names

This is a list of all dependents found on the card.

Richard Dickinson

plan_name

Our best attempt to determine the name of the plan for this card. This is missing on many cards.

unitedhealthcare choice plus

plan_id

An identifier representing the plan associated with this card.

(80840) 911-80708-01

client_name

The name of the employer who is contracted with the 3rd party administrator.

Apple, Inc.

plan_details

When available a list of: deductibles, co-pays, co-insurance, PCP name.

Office: $25

ER: $300

start_date

The date when coverage starts.

04/01/2021

card_specific_id

A non-specific but prominent identifier found on the card.

54243

phone_numbers

A list of all phone numbers found of the front and back of the card.

800-400-5251

addresses

A list of all addresses found on the card.

UnitedHealthcare

P.O. Box 740800

Atlanta, GA 30374-0800

Note: If an element is missing it means it is either not available on this type of card, or we did not have a high enough confidence to return it.

curl --request GET 'https://sandbox.cardscan.ai/v1/cards/a1d743ee-3bb9-468d-a2c5-4e33fa0e1c6e' \
--header 'Authorization: Bearer endusertokenXXX'

Delete Card

DELETE https://sandbox.cardscan.ai/v1/cards/:cardId

This will trigger a soft delete of the specified card.

Path Parameters

Name
Type
Description

cardId*

String

UUID of the card

Note: All of the images, ML results, eligibility results, and PHI will be removed, but the card record and performance statistics will remain.

curl --request DELETE 'https://sandbox.cardscan.ai/v1/cards/a1d743ee-3bb9-468d-a2c5-4e33fa0e1c6e' \
--header 'Authorization: Bearer endusertokenXXX'

Flag Card

POST https://sandbox.cardscan.ai/v1/cards/:cardId/flag

This endpoint allows you to flag a specific card with a particular type of flag. Flags are used to mark cards for special attention or action.

Path Parameters

Name
Type
Description

cardId*

String

UUID of the card

Request Body

Name
Type
Allowed values
Description

flag_type*

String

  • missing_elements

  • incorrect_elements

  • bad_payer_match

  • unreadable_text

  • eligibility_issue

  • other

The flag type used to mark the card

message

String

An optional message to add additional information

{
    "message": "Card flagged successfully"
}

GET /generate-magic-link

Generates a magic link for the currently authenticated user. The generated token expires in one hour. This endpoint is called by the React Widget when using the Web To Mobile Handoff feature.

{
    "magic_link": "https://sandbox.cardscan.ai/v1/validate-magic-link?token=<token>",
    "token": "<token>",
    "expires_at": "2024-06-27T03:48:01.049866"
}

curl --request GET 'https://sandbox.cardscan.ai/v1/generate-magic-link \
--header 'Authorization: Bearer endusertokenXXX'

GET /validate-magic-link?token=<magic-token>

Validates that the provided magic link token is valid and if so, returns an Access Token with limited capabilities. You need to use this endpoint if you want to self-host the Web To Mobile Handoff feature.

{
  "IdentityId": "us-east-1:0236cb77-ac53-460d-ba39-60b186af2897",
  "Token": "eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJzdWIiOiIxMjM0NTY3ODkwIiwibmFtZSI6IkpvaG4gRG9lIiwiaWF0IjoxNTE2MjM5MDIyfQ.SflKxwRJSMeKKF2QT4fwpMeJf36POk6yJV_adQssw5c"
}
curl --request GET 'https://sandbox.cardscan.ai/v1/validate-magic-link?token=<token> \
--header 'Authorization: Bearer endusertokenXXX'

Eligibility Verification

Our Eligibility Verification Endpoints offer a seamless way to check the insurance eligibility of patients. They provide real-time verification of coverage details, ensuring accurate and efficient processing of healthcare services.

Please see the Eligibility Verification page for full details on the product offering.

Our Eligibility Verification Endpoints operate similarly to our Insurance Card Scanning Endpoints. Users can create a new eligibility request, which is processed asynchronously. The system updates the record as the state changes, providing real-time insights into insurance coverage and benefits.

Note: Currently a completed insurance card scan is required to start the eligibility verification process.

Create Eligibility Record

post
Authorizations
Body
card_idstring · uuidRequired

The ID of the card.

Responses
201
Eligibility record created
application/json
post
POST /v1/eligibility HTTP/1.1
Host: sandbox.cardscan.ai
Authorization: Bearer YOUR_SECRET_TOKEN
Content-Type: application/json
Accept: */*
Content-Length: 202

{
  "eligibility": {
    "provider": {
      "firstName": "text",
      "lastName": "text",
      "npi": "text"
    },
    "subscriber": {
      "firstName": "text",
      "lastName": "text",
      "dateOfBirth": "text"
    }
  },
  "card_id": "123e4567-e89b-12d3-a456-426614174000"
}
{
  "eligibility_id": "text",
  "state": "completed",
  "card_id": "text",
  "eligibility_request": {
    "controlNumber": "text",
    "tradingPartnerServiceId": "text",
    "provider": {
      "firstName": "text",
      "lastName": "text",
      "npi": "text"
    },
    "subscriber": {
      "firstName": "text",
      "lastName": "text",
      "dateOfBirth": "text"
    }
  },
  "eligibility_response": {
    "meta": {
      "senderId": "text",
      "submitterId": "text",
      "billerId": "text",
      "applicationMode": "text",
      "traceId": "text",
      "outboundTraceId": "text"
    },
    "controlNumber": "text",
    "reassociationKey": "text",
    "tradingPartnerServiceId": "text",
    "provider": {
      "providerName": "text",
      "providerFirstName": "text",
      "providerOrgName": "text",
      "middleName": "text",
      "suffix": "text",
      "entityIdentifier": "text",
      "entityType": "text",
      "npi": "text",
      "providerCode": "text",
      "referenceIdentification": "text",
      "employersId": "text",
      "ssn": "text",
      "federalTaxpayersIdNumber": "text",
      "payorIdentification": "text",
      "pharmacyProcessorNumber": "text",
      "serviceProviderNumber": "text",
      "servicesPlanID": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      },
      "aaaErrors": [
        {
          "field": "text",
          "code": "text",
          "description": "text",
          "followupAction": "text",
          "location": "text",
          "possibleResolutions": "text"
        }
      ]
    },
    "subscriber": {
      "healthCareDiagnosisCodes": [
        {
          "diagnosisTypeCode": "text",
          "diagnosisCode": "text"
        }
      ],
      "memberId": "text",
      "firstName": "text",
      "lastName": "text",
      "middleName": "text",
      "suffix": "text",
      "gender": "M",
      "entityIdentifier": "text",
      "entityType": "text",
      "uniqueHealthIdentifier": "text",
      "dateOfBirth": "text",
      "informationStatusCode": "text",
      "employmentStatusCode": "text",
      "governmentServiceAffiliationCode": "text",
      "description": "text",
      "militaryServiceRankCode": "text",
      "dateTimePeriodFormatQualifier": "text",
      "dateTimePeriod": "text",
      "endDateTimePeriod": "text",
      "startDateTimePeriod": "text",
      "ssn": "text",
      "groupNumber": "text",
      "planNumber": "text",
      "planNetworkIdNumber": "text",
      "relationToSubscriber": "text",
      "relationToSubscriberCode": "text",
      "insuredIndicator": "text",
      "maintenanceTypeCode": "text",
      "maintenanceReasonCode": "text",
      "birthSequenceNumber": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      },
      "responseProvider": {
        "providerName": "text",
        "providerFirstName": "text",
        "providerOrgName": "text",
        "middleName": "text",
        "suffix": "text",
        "entityIdentifier": "text",
        "entityType": "text",
        "npi": "text",
        "providerCode": "text",
        "referenceIdentification": "text",
        "employersId": "text",
        "ssn": "text",
        "federalTaxpayersIdNumber": "text",
        "payorIdentification": "text",
        "pharmacyProcessorNumber": "text",
        "serviceProviderNumber": "text",
        "servicesPlanID": "text",
        "address": {
          "address1": "123 address1",
          "address2": "text",
          "city": "city1",
          "state": "wa",
          "postalCode": "981010000",
          "countryCode": "text",
          "locationIdentifier": "text",
          "countrySubDivisionCode": "text"
        },
        "aaaErrors": [
          {
            "field": "text",
            "code": "text",
            "description": "text",
            "followupAction": "text",
            "location": "text",
            "possibleResolutions": "text"
          }
        ]
      },
      "aaaErrors": [
        {
          "field": "text",
          "code": "text",
          "description": "text",
          "followupAction": "text",
          "location": "text",
          "possibleResolutions": "text"
        }
      ]
    },
    "subscriberTraceNumbers": [
      {
        "traceTypeCode": "text",
        "traceType": "text",
        "referenceIdentification": "text",
        "originatingCompanyIdentifier": "text",
        "secondaryReferenceIdentification": "text"
      }
    ],
    "dependents": [
      {
        "healthCareDiagnosisCodes": [
          {
            "diagnosisTypeCode": "text",
            "diagnosisCode": "text"
          }
        ],
        "memberId": "text",
        "firstName": "text",
        "lastName": "text",
        "middleName": "text",
        "suffix": "text",
        "gender": "M",
        "entityIdentifier": "text",
        "entityType": "text",
        "uniqueHealthIdentifier": "text",
        "dateOfBirth": "text",
        "informationStatusCode": "text",
        "employmentStatusCode": "text",
        "governmentServiceAffiliationCode": "text",
        "description": "text",
        "militaryServiceRankCode": "text",
        "dateTimePeriodFormatQualifier": "text",
        "dateTimePeriod": "text",
        "endDateTimePeriod": "text",
        "startDateTimePeriod": "text",
        "ssn": "text",
        "groupNumber": "text",
        "planNumber": "text",
        "planNetworkIdNumber": "text",
        "relationToSubscriber": "text",
        "relationToSubscriberCode": "text",
        "insuredIndicator": "text",
        "maintenanceTypeCode": "text",
        "maintenanceReasonCode": "text",
        "birthSequenceNumber": "text",
        "address": {
          "address1": "123 address1",
          "address2": "text",
          "city": "city1",
          "state": "wa",
          "postalCode": "981010000",
          "countryCode": "text",
          "locationIdentifier": "text",
          "countrySubDivisionCode": "text"
        },
        "responseProvider": {
          "providerName": "text",
          "providerFirstName": "text",
          "providerOrgName": "text",
          "middleName": "text",
          "suffix": "text",
          "entityIdentifier": "text",
          "entityType": "text",
          "npi": "text",
          "providerCode": "text",
          "referenceIdentification": "text",
          "employersId": "text",
          "ssn": "text",
          "federalTaxpayersIdNumber": "text",
          "payorIdentification": "text",
          "pharmacyProcessorNumber": "text",
          "serviceProviderNumber": "text",
          "servicesPlanID": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "aaaErrors": [
            {
              "field": "text",
              "code": "text",
              "description": "text",
              "followupAction": "text",
              "location": "text",
              "possibleResolutions": "text"
            }
          ]
        },
        "aaaErrors": [
          {
            "field": "text",
            "code": "text",
            "description": "text",
            "followupAction": "text",
            "location": "text",
            "possibleResolutions": "text"
          }
        ]
      }
    ],
    "payer": {
      "entityIdentifier": "text",
      "entityType": "text",
      "firstName": "text",
      "lastName": "text",
      "name": "text",
      "middleName": "text",
      "suffix": "text",
      "employersId": "text",
      "federalTaxpayersIdNumber": "text",
      "naic": "text",
      "npi": "text",
      "centersForMedicareAndMedicaidPlanId": "text",
      "payorIdentification": "text",
      "contactInformation": {
        "name": "text",
        "contacts": [
          {
            "communicationMode": "text",
            "communicationNumber": "text"
          }
        ]
      },
      "aaaErrors": [
        {
          "field": "text",
          "code": "text",
          "description": "text",
          "followupAction": "text",
          "location": "text",
          "possibleResolutions": "text"
        }
      ],
      "etin": "text"
    },
    "planInformation": {
      "stateLicenseNumber": "text",
      "medicareProviderNumber": "text",
      "medicaidProviderNumber": "text",
      "facilityIdNumber": "text",
      "personalIdentificationNumber": "text",
      "planNumber": "text",
      "planDescription": "text",
      "policyNumber": "text",
      "memberId": "text",
      "caseNumber": "text",
      "familyUnitNumber": "text",
      "groupNumber": "text",
      "groupDescription": "text",
      "referralNumber": "text",
      "alternativeListId": "text",
      "classOfContractCode": "text",
      "coverageListId": "text",
      "contractNumber": "text",
      "medicalRecordIdentificationNumber": "text",
      "electronicDevicePin": "text",
      "submitterIdentificationNumber": "text",
      "patientAccountNumber": "text",
      "hicNumber": "text",
      "drugFormularyNumber": "text",
      "priorAuthorizationNumber": "text",
      "idCardSerialNumber": "text",
      "idCardNumber": "text",
      "centersForMedicareAndMedicaidServicesNPI": "text",
      "issueNumber": "text",
      "insurancePolicyNumber": "text",
      "userIdentification": "text",
      "medicalAssistanceCategory": "text",
      "eligibilityCategory": "text",
      "planNetworkIdNumber": "text",
      "planNetworkIdDescription": "text",
      "facilityNetworkIdentificationNumber": "text",
      "medicaidRecipientIdNumber": "text",
      "priorIdNumber": "text",
      "socialSecurityNumber": "text",
      "federalTaxpayersIdentificationNumber": "text",
      "agencyClaimNumber": "text"
    },
    "planDateInformation": {
      "discharge": "text",
      "issue": "text",
      "effectiveDateOfChange": "text",
      "periodStart": "text",
      "periodEnd": "text",
      "completion": "text",
      "coordinationOfBenefits": "text",
      "plan": "text",
      "benefit": "text",
      "primaryCareProvider": "text",
      "latestVisitOrConsultation": "text",
      "eligibility": "text",
      "added": "text",
      "cobraBegin": "text",
      "cobraEnd": "text",
      "premiumPaidToDateBegin": "text",
      "premiumPaidToDateEnd": "text",
      "planBegin": "text",
      "planEnd": "text",
      "benefitBegin": "text",
      "benefitEnd": "text",
      "eligibilityBegin": "text",
      "eligibilityEnd": "text",
      "enrollment": "text",
      "admission": "text",
      "dateOfDeath": "text",
      "certification": "text",
      "service": "text",
      "policyEffective": "text",
      "policyExpiration": "text",
      "dateOfLastUpdate": "text",
      "status": "text"
    },
    "benefitsInformation": [
      {
        "code": "text",
        "name": "text",
        "coverageLevelCode": "text",
        "coverageLevel": "text",
        "serviceTypeCodes": [
          "text"
        ],
        "serviceTypes": [
          "text"
        ],
        "insuranceTypeCode": "text",
        "insuranceType": "text",
        "planCoverage": "text",
        "timeQualifierCode": "text",
        "timeQualifier": "text",
        "benefitAmount": "text",
        "benefitPercent": "text",
        "quantityQualifierCode": "text",
        "quantityQualifier": "text",
        "benefitQuantity": "text",
        "authOrCertIndicator": "text",
        "inPlanNetworkIndicatorCode": "text",
        "inPlanNetworkIndicator": "text",
        "headerLoopIdentifierCode": "text",
        "trailerLoopIdentifierCode": "text",
        "compositeMedicalProcedureIdentifier": {
          "productOrServiceIdQualifierCode": "text",
          "productOrServiceIdQualifier": "text",
          "procedureCode": "text",
          "procedureModifiers": [
            "text"
          ],
          "productOrServiceID": "text",
          "diagnosisCodePointer": [
            "text"
          ]
        },
        "benefitsAdditionalInformation": {
          "stateLicenseNumber": "text",
          "medicareProviderNumber": "text",
          "medicaidProviderNumber": "text",
          "facilityIdNumber": "text",
          "personalIdentificationNumber": "text",
          "planNumber": "text",
          "policyNumber": "text",
          "memberId": "text",
          "caseNumber": "text",
          "familyUnitNumber": "text",
          "groupNumber": "text",
          "referralNumber": "text",
          "alternativeListId": "text",
          "classOfContractCode": "text",
          "coverageListId": "text",
          "contractNumber": "text",
          "medicalRecordIdentificationNumber": "text",
          "electronicDevicePin": "text",
          "submitterIdentificationNumber": "text",
          "patientAccountNumber": "text",
          "hicNumber": "text",
          "drugFormularyNumber": "text",
          "priorAuthorizationNumber": "text",
          "idCardSerialNumber": "text",
          "idCardNumber": "text",
          "centersForMedicareAndMedicaidServicesNPI": "text",
          "issueNumber": "text",
          "insurancePolicyNumber": "text",
          "userIdentification": "text",
          "medicalAssistanceCategory": "text",
          "eligibilityCategory": "text",
          "planNetworkIdNumber": "text",
          "facilityNetworkIdentificationNumber": "text",
          "medicaidRecepientIdNumber": "text",
          "priorIdNumber": "text",
          "socialSecurityNumber": "text",
          "federalTaxpayersIdentificationNumber": "text",
          "agencyClaimNumber": "text"
        },
        "benefitsDateInformation": {
          "discharge": "text",
          "discharges": [
            {
              "date": "text",
              "startDate": "text",
              "endDate": "text"
            }
          ],
          "issue": "text",
          "effectiveDateOfChange": "text",
          "periodStart": "text",
          "periodEnd": "text",
          "completion": "text",
          "coordinationOfBenefits": "text",
          "plan": "text",
          "benefit": "text",
          "primaryCareProvider": "text",
          "latestVisitOrConsultation": "text",
          "eligibility": "text",
          "added": "text",
          "cobraBegin": "text",
          "cobraEnd": "text",
          "premiumPaidtoDateBegin": "text",
          "premiumPaidToDateEnd": "text",
          "planBegin": "text",
          "planEnd": "text",
          "benefitBegin": "text",
          "benefitEnd": "text",
          "eligibilityBegin": "text",
          "eligibilityEnd": "text",
          "enrollment": "text",
          "admission": "text",
          "admissions": [
            {
              "date": "text",
              "startDate": "text",
              "endDate": "text"
            }
          ],
          "dateOfDeath": "text",
          "certification": "text",
          "service": "text",
          "policyEffective": "text",
          "policyExpiration": "text",
          "dateOfLastUpdate": "text",
          "status": "text"
        },
        "benefitsRelatedEntity": {
          "entityIdentifier": "text",
          "entityType": "text",
          "entityName": "text",
          "entityFirstname": "text",
          "entityMiddlename": "text",
          "entitySuffix": "text",
          "entityIdentification": "text",
          "entityIdentificationValue": "text",
          "entityRelationship": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "contactInformation": {
            "name": "text",
            "contacts": [
              {
                "communicationMode": "text",
                "communicationNumber": "text"
              }
            ]
          },
          "providerInformation": {
            "providerCode": "text",
            "referenceIdentification": "text"
          }
        },
        "benefitsRelatedEntities": [
          {
            "entityIdentifier": "text",
            "entityType": "text",
            "entityName": "text",
            "entityFirstname": "text",
            "entityMiddlename": "text",
            "entitySuffix": "text",
            "entityIdentification": "text",
            "entityIdentificationValue": "text",
            "entityRelationship": "text",
            "address": {
              "address1": "123 address1",
              "address2": "text",
              "city": "city1",
              "state": "wa",
              "postalCode": "981010000",
              "countryCode": "text",
              "locationIdentifier": "text",
              "countrySubDivisionCode": "text"
            },
            "contactInformation": {
              "name": "text",
              "contacts": [
                {
                  "communicationMode": "text",
                  "communicationNumber": "text"
                }
              ]
            },
            "providerInformation": {
              "providerCode": "text",
              "referenceIdentification": "text"
            }
          }
        ],
        "benefitsServiceDelivery": [
          {
            "quantityQualifierCode": "text",
            "quantityQualifier": "text",
            "quantity": "text",
            "unitForMeasurementCode": "text",
            "sampleSelectionModulus": "text",
            "timePeriodQualifierCode": "text",
            "timePeriodQualifier": "text",
            "numOfPeriods": "text",
            "deliveryOrCalendarPatternCode": "text",
            "deliveryPatternTimeCode": "text",
            "unitForMeasurementQualifierCode": "text",
            "unitForMeasurementQualifier": "text",
            "deliveryOrCalendarPatternQualifierCode": "text",
            "deliveryOrCalendarPatternQualifier": "text",
            "deliveryPatternTimeQualifierCode": "text",
            "deliveryPatternTimeQualifier": "text"
          }
        ],
        "additionalInformation": [
          {
            "description": "text"
          }
        ],
        "eligibilityAdditionalInformation": {
          "codeListQualifierCode": "text",
          "industryCode": "text",
          "codeCategory": "text",
          "injuredBodyPartName": "text"
        },
        "eligibilityAdditionalInformationList": [
          {
            "codeListQualifierCode": "text",
            "industryCode": "text",
            "codeCategory": "text",
            "injuredBodyPartName": "text"
          }
        ]
      }
    ],
    "errors": [
      {
        "field": "text",
        "code": "text",
        "description": "text",
        "followupAction": "text",
        "location": "text",
        "possibleResolutions": "text"
      }
    ],
    "status": "text",
    "transactionSetAcknowledgement": "text",
    "implementationTransactionSetSyntaxError": "text",
    "x12": "text"
  },
  "eligibility_summarized_response": {
    "eligibility_request_id": "123e4567-e89b-12d3-a456-426614174000",
    "subscriber_details": {
      "member_id": "text",
      "firstname": "text",
      "lastname": "text",
      "middlename": "text",
      "gender": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      },
      "dob": "2025-06-25"
    },
    "payer_details": {
      "payer_name": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      }
    },
    "plan_details": {
      "plan_number": "text",
      "group_name": "text",
      "group_number": "text",
      "plan_start_date": "2025-06-25",
      "plan_eligibility_start_date": "2025-06-25",
      "plan_name": "text",
      "plan_active": true
    },
    "coverage_summary": {
      "individual_deductible_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      },
      "individual_oop_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      },
      "family_deductible_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      },
      "family_oop_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      }
    },
    "chiropractic": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "emergency_room": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "office_visit": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "urgent_care": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "hospital_outpatient": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    }
  },
  "error": {
    "type": "text",
    "code": "text",
    "message": "text"
  },
  "created_at": "2025-06-25T04:33:07.884Z",
  "update_at": "2025-06-25T04:33:07.884Z"
}

To create an eligibility request, users must provide subscriber and dependent demographics along with provider details, including a National Provider Identifier (NPI). This information is essential for accurately verifying insurance eligibility.

You can locate a providers NPI on the NPPES NPI Registry search page.

Get Eligibility

get
Authorizations
Path parameters
eligibility_idstringRequired
Responses
200
A single eligibility record
application/json
get
GET /v1/eligibility/{eligibility_id} HTTP/1.1
Host: sandbox.cardscan.ai
Authorization: Bearer YOUR_SECRET_TOKEN
Accept: */*
{
  "eligibility_id": "text",
  "state": "completed",
  "card_id": "text",
  "eligibility_request": {
    "controlNumber": "text",
    "tradingPartnerServiceId": "text",
    "provider": {
      "firstName": "text",
      "lastName": "text",
      "npi": "text"
    },
    "subscriber": {
      "firstName": "text",
      "lastName": "text",
      "dateOfBirth": "text"
    }
  },
  "eligibility_response": {
    "meta": {
      "senderId": "text",
      "submitterId": "text",
      "billerId": "text",
      "applicationMode": "text",
      "traceId": "text",
      "outboundTraceId": "text"
    },
    "controlNumber": "text",
    "reassociationKey": "text",
    "tradingPartnerServiceId": "text",
    "provider": {
      "providerName": "text",
      "providerFirstName": "text",
      "providerOrgName": "text",
      "middleName": "text",
      "suffix": "text",
      "entityIdentifier": "text",
      "entityType": "text",
      "npi": "text",
      "providerCode": "text",
      "referenceIdentification": "text",
      "employersId": "text",
      "ssn": "text",
      "federalTaxpayersIdNumber": "text",
      "payorIdentification": "text",
      "pharmacyProcessorNumber": "text",
      "serviceProviderNumber": "text",
      "servicesPlanID": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      },
      "aaaErrors": [
        {
          "field": "text",
          "code": "text",
          "description": "text",
          "followupAction": "text",
          "location": "text",
          "possibleResolutions": "text"
        }
      ]
    },
    "subscriber": {
      "healthCareDiagnosisCodes": [
        {
          "diagnosisTypeCode": "text",
          "diagnosisCode": "text"
        }
      ],
      "memberId": "text",
      "firstName": "text",
      "lastName": "text",
      "middleName": "text",
      "suffix": "text",
      "gender": "M",
      "entityIdentifier": "text",
      "entityType": "text",
      "uniqueHealthIdentifier": "text",
      "dateOfBirth": "text",
      "informationStatusCode": "text",
      "employmentStatusCode": "text",
      "governmentServiceAffiliationCode": "text",
      "description": "text",
      "militaryServiceRankCode": "text",
      "dateTimePeriodFormatQualifier": "text",
      "dateTimePeriod": "text",
      "endDateTimePeriod": "text",
      "startDateTimePeriod": "text",
      "ssn": "text",
      "groupNumber": "text",
      "planNumber": "text",
      "planNetworkIdNumber": "text",
      "relationToSubscriber": "text",
      "relationToSubscriberCode": "text",
      "insuredIndicator": "text",
      "maintenanceTypeCode": "text",
      "maintenanceReasonCode": "text",
      "birthSequenceNumber": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      },
      "responseProvider": {
        "providerName": "text",
        "providerFirstName": "text",
        "providerOrgName": "text",
        "middleName": "text",
        "suffix": "text",
        "entityIdentifier": "text",
        "entityType": "text",
        "npi": "text",
        "providerCode": "text",
        "referenceIdentification": "text",
        "employersId": "text",
        "ssn": "text",
        "federalTaxpayersIdNumber": "text",
        "payorIdentification": "text",
        "pharmacyProcessorNumber": "text",
        "serviceProviderNumber": "text",
        "servicesPlanID": "text",
        "address": {
          "address1": "123 address1",
          "address2": "text",
          "city": "city1",
          "state": "wa",
          "postalCode": "981010000",
          "countryCode": "text",
          "locationIdentifier": "text",
          "countrySubDivisionCode": "text"
        },
        "aaaErrors": [
          {
            "field": "text",
            "code": "text",
            "description": "text",
            "followupAction": "text",
            "location": "text",
            "possibleResolutions": "text"
          }
        ]
      },
      "aaaErrors": [
        {
          "field": "text",
          "code": "text",
          "description": "text",
          "followupAction": "text",
          "location": "text",
          "possibleResolutions": "text"
        }
      ]
    },
    "subscriberTraceNumbers": [
      {
        "traceTypeCode": "text",
        "traceType": "text",
        "referenceIdentification": "text",
        "originatingCompanyIdentifier": "text",
        "secondaryReferenceIdentification": "text"
      }
    ],
    "dependents": [
      {
        "healthCareDiagnosisCodes": [
          {
            "diagnosisTypeCode": "text",
            "diagnosisCode": "text"
          }
        ],
        "memberId": "text",
        "firstName": "text",
        "lastName": "text",
        "middleName": "text",
        "suffix": "text",
        "gender": "M",
        "entityIdentifier": "text",
        "entityType": "text",
        "uniqueHealthIdentifier": "text",
        "dateOfBirth": "text",
        "informationStatusCode": "text",
        "employmentStatusCode": "text",
        "governmentServiceAffiliationCode": "text",
        "description": "text",
        "militaryServiceRankCode": "text",
        "dateTimePeriodFormatQualifier": "text",
        "dateTimePeriod": "text",
        "endDateTimePeriod": "text",
        "startDateTimePeriod": "text",
        "ssn": "text",
        "groupNumber": "text",
        "planNumber": "text",
        "planNetworkIdNumber": "text",
        "relationToSubscriber": "text",
        "relationToSubscriberCode": "text",
        "insuredIndicator": "text",
        "maintenanceTypeCode": "text",
        "maintenanceReasonCode": "text",
        "birthSequenceNumber": "text",
        "address": {
          "address1": "123 address1",
          "address2": "text",
          "city": "city1",
          "state": "wa",
          "postalCode": "981010000",
          "countryCode": "text",
          "locationIdentifier": "text",
          "countrySubDivisionCode": "text"
        },
        "responseProvider": {
          "providerName": "text",
          "providerFirstName": "text",
          "providerOrgName": "text",
          "middleName": "text",
          "suffix": "text",
          "entityIdentifier": "text",
          "entityType": "text",
          "npi": "text",
          "providerCode": "text",
          "referenceIdentification": "text",
          "employersId": "text",
          "ssn": "text",
          "federalTaxpayersIdNumber": "text",
          "payorIdentification": "text",
          "pharmacyProcessorNumber": "text",
          "serviceProviderNumber": "text",
          "servicesPlanID": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "aaaErrors": [
            {
              "field": "text",
              "code": "text",
              "description": "text",
              "followupAction": "text",
              "location": "text",
              "possibleResolutions": "text"
            }
          ]
        },
        "aaaErrors": [
          {
            "field": "text",
            "code": "text",
            "description": "text",
            "followupAction": "text",
            "location": "text",
            "possibleResolutions": "text"
          }
        ]
      }
    ],
    "payer": {
      "entityIdentifier": "text",
      "entityType": "text",
      "firstName": "text",
      "lastName": "text",
      "name": "text",
      "middleName": "text",
      "suffix": "text",
      "employersId": "text",
      "federalTaxpayersIdNumber": "text",
      "naic": "text",
      "npi": "text",
      "centersForMedicareAndMedicaidPlanId": "text",
      "payorIdentification": "text",
      "contactInformation": {
        "name": "text",
        "contacts": [
          {
            "communicationMode": "text",
            "communicationNumber": "text"
          }
        ]
      },
      "aaaErrors": [
        {
          "field": "text",
          "code": "text",
          "description": "text",
          "followupAction": "text",
          "location": "text",
          "possibleResolutions": "text"
        }
      ],
      "etin": "text"
    },
    "planInformation": {
      "stateLicenseNumber": "text",
      "medicareProviderNumber": "text",
      "medicaidProviderNumber": "text",
      "facilityIdNumber": "text",
      "personalIdentificationNumber": "text",
      "planNumber": "text",
      "planDescription": "text",
      "policyNumber": "text",
      "memberId": "text",
      "caseNumber": "text",
      "familyUnitNumber": "text",
      "groupNumber": "text",
      "groupDescription": "text",
      "referralNumber": "text",
      "alternativeListId": "text",
      "classOfContractCode": "text",
      "coverageListId": "text",
      "contractNumber": "text",
      "medicalRecordIdentificationNumber": "text",
      "electronicDevicePin": "text",
      "submitterIdentificationNumber": "text",
      "patientAccountNumber": "text",
      "hicNumber": "text",
      "drugFormularyNumber": "text",
      "priorAuthorizationNumber": "text",
      "idCardSerialNumber": "text",
      "idCardNumber": "text",
      "centersForMedicareAndMedicaidServicesNPI": "text",
      "issueNumber": "text",
      "insurancePolicyNumber": "text",
      "userIdentification": "text",
      "medicalAssistanceCategory": "text",
      "eligibilityCategory": "text",
      "planNetworkIdNumber": "text",
      "planNetworkIdDescription": "text",
      "facilityNetworkIdentificationNumber": "text",
      "medicaidRecipientIdNumber": "text",
      "priorIdNumber": "text",
      "socialSecurityNumber": "text",
      "federalTaxpayersIdentificationNumber": "text",
      "agencyClaimNumber": "text"
    },
    "planDateInformation": {
      "discharge": "text",
      "issue": "text",
      "effectiveDateOfChange": "text",
      "periodStart": "text",
      "periodEnd": "text",
      "completion": "text",
      "coordinationOfBenefits": "text",
      "plan": "text",
      "benefit": "text",
      "primaryCareProvider": "text",
      "latestVisitOrConsultation": "text",
      "eligibility": "text",
      "added": "text",
      "cobraBegin": "text",
      "cobraEnd": "text",
      "premiumPaidToDateBegin": "text",
      "premiumPaidToDateEnd": "text",
      "planBegin": "text",
      "planEnd": "text",
      "benefitBegin": "text",
      "benefitEnd": "text",
      "eligibilityBegin": "text",
      "eligibilityEnd": "text",
      "enrollment": "text",
      "admission": "text",
      "dateOfDeath": "text",
      "certification": "text",
      "service": "text",
      "policyEffective": "text",
      "policyExpiration": "text",
      "dateOfLastUpdate": "text",
      "status": "text"
    },
    "benefitsInformation": [
      {
        "code": "text",
        "name": "text",
        "coverageLevelCode": "text",
        "coverageLevel": "text",
        "serviceTypeCodes": [
          "text"
        ],
        "serviceTypes": [
          "text"
        ],
        "insuranceTypeCode": "text",
        "insuranceType": "text",
        "planCoverage": "text",
        "timeQualifierCode": "text",
        "timeQualifier": "text",
        "benefitAmount": "text",
        "benefitPercent": "text",
        "quantityQualifierCode": "text",
        "quantityQualifier": "text",
        "benefitQuantity": "text",
        "authOrCertIndicator": "text",
        "inPlanNetworkIndicatorCode": "text",
        "inPlanNetworkIndicator": "text",
        "headerLoopIdentifierCode": "text",
        "trailerLoopIdentifierCode": "text",
        "compositeMedicalProcedureIdentifier": {
          "productOrServiceIdQualifierCode": "text",
          "productOrServiceIdQualifier": "text",
          "procedureCode": "text",
          "procedureModifiers": [
            "text"
          ],
          "productOrServiceID": "text",
          "diagnosisCodePointer": [
            "text"
          ]
        },
        "benefitsAdditionalInformation": {
          "stateLicenseNumber": "text",
          "medicareProviderNumber": "text",
          "medicaidProviderNumber": "text",
          "facilityIdNumber": "text",
          "personalIdentificationNumber": "text",
          "planNumber": "text",
          "policyNumber": "text",
          "memberId": "text",
          "caseNumber": "text",
          "familyUnitNumber": "text",
          "groupNumber": "text",
          "referralNumber": "text",
          "alternativeListId": "text",
          "classOfContractCode": "text",
          "coverageListId": "text",
          "contractNumber": "text",
          "medicalRecordIdentificationNumber": "text",
          "electronicDevicePin": "text",
          "submitterIdentificationNumber": "text",
          "patientAccountNumber": "text",
          "hicNumber": "text",
          "drugFormularyNumber": "text",
          "priorAuthorizationNumber": "text",
          "idCardSerialNumber": "text",
          "idCardNumber": "text",
          "centersForMedicareAndMedicaidServicesNPI": "text",
          "issueNumber": "text",
          "insurancePolicyNumber": "text",
          "userIdentification": "text",
          "medicalAssistanceCategory": "text",
          "eligibilityCategory": "text",
          "planNetworkIdNumber": "text",
          "facilityNetworkIdentificationNumber": "text",
          "medicaidRecepientIdNumber": "text",
          "priorIdNumber": "text",
          "socialSecurityNumber": "text",
          "federalTaxpayersIdentificationNumber": "text",
          "agencyClaimNumber": "text"
        },
        "benefitsDateInformation": {
          "discharge": "text",
          "discharges": [
            {
              "date": "text",
              "startDate": "text",
              "endDate": "text"
            }
          ],
          "issue": "text",
          "effectiveDateOfChange": "text",
          "periodStart": "text",
          "periodEnd": "text",
          "completion": "text",
          "coordinationOfBenefits": "text",
          "plan": "text",
          "benefit": "text",
          "primaryCareProvider": "text",
          "latestVisitOrConsultation": "text",
          "eligibility": "text",
          "added": "text",
          "cobraBegin": "text",
          "cobraEnd": "text",
          "premiumPaidtoDateBegin": "text",
          "premiumPaidToDateEnd": "text",
          "planBegin": "text",
          "planEnd": "text",
          "benefitBegin": "text",
          "benefitEnd": "text",
          "eligibilityBegin": "text",
          "eligibilityEnd": "text",
          "enrollment": "text",
          "admission": "text",
          "admissions": [
            {
              "date": "text",
              "startDate": "text",
              "endDate": "text"
            }
          ],
          "dateOfDeath": "text",
          "certification": "text",
          "service": "text",
          "policyEffective": "text",
          "policyExpiration": "text",
          "dateOfLastUpdate": "text",
          "status": "text"
        },
        "benefitsRelatedEntity": {
          "entityIdentifier": "text",
          "entityType": "text",
          "entityName": "text",
          "entityFirstname": "text",
          "entityMiddlename": "text",
          "entitySuffix": "text",
          "entityIdentification": "text",
          "entityIdentificationValue": "text",
          "entityRelationship": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "contactInformation": {
            "name": "text",
            "contacts": [
              {
                "communicationMode": "text",
                "communicationNumber": "text"
              }
            ]
          },
          "providerInformation": {
            "providerCode": "text",
            "referenceIdentification": "text"
          }
        },
        "benefitsRelatedEntities": [
          {
            "entityIdentifier": "text",
            "entityType": "text",
            "entityName": "text",
            "entityFirstname": "text",
            "entityMiddlename": "text",
            "entitySuffix": "text",
            "entityIdentification": "text",
            "entityIdentificationValue": "text",
            "entityRelationship": "text",
            "address": {
              "address1": "123 address1",
              "address2": "text",
              "city": "city1",
              "state": "wa",
              "postalCode": "981010000",
              "countryCode": "text",
              "locationIdentifier": "text",
              "countrySubDivisionCode": "text"
            },
            "contactInformation": {
              "name": "text",
              "contacts": [
                {
                  "communicationMode": "text",
                  "communicationNumber": "text"
                }
              ]
            },
            "providerInformation": {
              "providerCode": "text",
              "referenceIdentification": "text"
            }
          }
        ],
        "benefitsServiceDelivery": [
          {
            "quantityQualifierCode": "text",
            "quantityQualifier": "text",
            "quantity": "text",
            "unitForMeasurementCode": "text",
            "sampleSelectionModulus": "text",
            "timePeriodQualifierCode": "text",
            "timePeriodQualifier": "text",
            "numOfPeriods": "text",
            "deliveryOrCalendarPatternCode": "text",
            "deliveryPatternTimeCode": "text",
            "unitForMeasurementQualifierCode": "text",
            "unitForMeasurementQualifier": "text",
            "deliveryOrCalendarPatternQualifierCode": "text",
            "deliveryOrCalendarPatternQualifier": "text",
            "deliveryPatternTimeQualifierCode": "text",
            "deliveryPatternTimeQualifier": "text"
          }
        ],
        "additionalInformation": [
          {
            "description": "text"
          }
        ],
        "eligibilityAdditionalInformation": {
          "codeListQualifierCode": "text",
          "industryCode": "text",
          "codeCategory": "text",
          "injuredBodyPartName": "text"
        },
        "eligibilityAdditionalInformationList": [
          {
            "codeListQualifierCode": "text",
            "industryCode": "text",
            "codeCategory": "text",
            "injuredBodyPartName": "text"
          }
        ]
      }
    ],
    "errors": [
      {
        "field": "text",
        "code": "text",
        "description": "text",
        "followupAction": "text",
        "location": "text",
        "possibleResolutions": "text"
      }
    ],
    "status": "text",
    "transactionSetAcknowledgement": "text",
    "implementationTransactionSetSyntaxError": "text",
    "x12": "text"
  },
  "eligibility_summarized_response": {
    "eligibility_request_id": "123e4567-e89b-12d3-a456-426614174000",
    "subscriber_details": {
      "member_id": "text",
      "firstname": "text",
      "lastname": "text",
      "middlename": "text",
      "gender": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      },
      "dob": "2025-06-25"
    },
    "payer_details": {
      "payer_name": "text",
      "address": {
        "address1": "123 address1",
        "address2": "text",
        "city": "city1",
        "state": "wa",
        "postalCode": "981010000",
        "countryCode": "text",
        "locationIdentifier": "text",
        "countrySubDivisionCode": "text"
      }
    },
    "plan_details": {
      "plan_number": "text",
      "group_name": "text",
      "group_number": "text",
      "plan_start_date": "2025-06-25",
      "plan_eligibility_start_date": "2025-06-25",
      "plan_name": "text",
      "plan_active": true
    },
    "coverage_summary": {
      "individual_deductible_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      },
      "individual_oop_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      },
      "family_deductible_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      },
      "family_oop_in_network": {
        "total_amount": "text",
        "remaining_amount": "text"
      }
    },
    "chiropractic": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "emergency_room": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "office_visit": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "urgent_care": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    },
    "hospital_outpatient": {
      "co_insurance_in_network": {
        "amount": "text"
      },
      "co_payment_in_network": {
        "amount": "text"
      },
      "service_code": "text"
    }
  },
  "error": {
    "type": "text",
    "code": "text",
    "message": "text"
  },
  "created_at": "2025-06-25T04:33:07.884Z",
  "update_at": "2025-06-25T04:33:07.884Z"
}

List Eligibility

get
Authorizations
Responses
200
Successful response
application/json
get
GET /v1/eligibility HTTP/1.1
Host: sandbox.cardscan.ai
Authorization: Bearer YOUR_SECRET_TOKEN
Accept: */*
{
  "eligibility_requests": [
    {
      "eligibility_id": "text",
      "state": "completed",
      "card_id": "text",
      "eligibility_request": {
        "controlNumber": "text",
        "tradingPartnerServiceId": "text",
        "provider": {
          "firstName": "text",
          "lastName": "text",
          "npi": "text"
        },
        "subscriber": {
          "firstName": "text",
          "lastName": "text",
          "dateOfBirth": "text"
        }
      },
      "eligibility_response": {
        "meta": {
          "senderId": "text",
          "submitterId": "text",
          "billerId": "text",
          "applicationMode": "text",
          "traceId": "text",
          "outboundTraceId": "text"
        },
        "controlNumber": "text",
        "reassociationKey": "text",
        "tradingPartnerServiceId": "text",
        "provider": {
          "providerName": "text",
          "providerFirstName": "text",
          "providerOrgName": "text",
          "middleName": "text",
          "suffix": "text",
          "entityIdentifier": "text",
          "entityType": "text",
          "npi": "text",
          "providerCode": "text",
          "referenceIdentification": "text",
          "employersId": "text",
          "ssn": "text",
          "federalTaxpayersIdNumber": "text",
          "payorIdentification": "text",
          "pharmacyProcessorNumber": "text",
          "serviceProviderNumber": "text",
          "servicesPlanID": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "aaaErrors": [
            {
              "field": "text",
              "code": "text",
              "description": "text",
              "followupAction": "text",
              "location": "text",
              "possibleResolutions": "text"
            }
          ]
        },
        "subscriber": {
          "healthCareDiagnosisCodes": [
            {
              "diagnosisTypeCode": "text",
              "diagnosisCode": "text"
            }
          ],
          "memberId": "text",
          "firstName": "text",
          "lastName": "text",
          "middleName": "text",
          "suffix": "text",
          "gender": "M",
          "entityIdentifier": "text",
          "entityType": "text",
          "uniqueHealthIdentifier": "text",
          "dateOfBirth": "text",
          "informationStatusCode": "text",
          "employmentStatusCode": "text",
          "governmentServiceAffiliationCode": "text",
          "description": "text",
          "militaryServiceRankCode": "text",
          "dateTimePeriodFormatQualifier": "text",
          "dateTimePeriod": "text",
          "endDateTimePeriod": "text",
          "startDateTimePeriod": "text",
          "ssn": "text",
          "groupNumber": "text",
          "planNumber": "text",
          "planNetworkIdNumber": "text",
          "relationToSubscriber": "text",
          "relationToSubscriberCode": "text",
          "insuredIndicator": "text",
          "maintenanceTypeCode": "text",
          "maintenanceReasonCode": "text",
          "birthSequenceNumber": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "responseProvider": {
            "providerName": "text",
            "providerFirstName": "text",
            "providerOrgName": "text",
            "middleName": "text",
            "suffix": "text",
            "entityIdentifier": "text",
            "entityType": "text",
            "npi": "text",
            "providerCode": "text",
            "referenceIdentification": "text",
            "employersId": "text",
            "ssn": "text",
            "federalTaxpayersIdNumber": "text",
            "payorIdentification": "text",
            "pharmacyProcessorNumber": "text",
            "serviceProviderNumber": "text",
            "servicesPlanID": "text",
            "address": {
              "address1": "123 address1",
              "address2": "text",
              "city": "city1",
              "state": "wa",
              "postalCode": "981010000",
              "countryCode": "text",
              "locationIdentifier": "text",
              "countrySubDivisionCode": "text"
            },
            "aaaErrors": [
              {
                "field": "text",
                "code": "text",
                "description": "text",
                "followupAction": "text",
                "location": "text",
                "possibleResolutions": "text"
              }
            ]
          },
          "aaaErrors": [
            {
              "field": "text",
              "code": "text",
              "description": "text",
              "followupAction": "text",
              "location": "text",
              "possibleResolutions": "text"
            }
          ]
        },
        "subscriberTraceNumbers": [
          {
            "traceTypeCode": "text",
            "traceType": "text",
            "referenceIdentification": "text",
            "originatingCompanyIdentifier": "text",
            "secondaryReferenceIdentification": "text"
          }
        ],
        "dependents": [
          {
            "healthCareDiagnosisCodes": [
              {
                "diagnosisTypeCode": "text",
                "diagnosisCode": "text"
              }
            ],
            "memberId": "text",
            "firstName": "text",
            "lastName": "text",
            "middleName": "text",
            "suffix": "text",
            "gender": "M",
            "entityIdentifier": "text",
            "entityType": "text",
            "uniqueHealthIdentifier": "text",
            "dateOfBirth": "text",
            "informationStatusCode": "text",
            "employmentStatusCode": "text",
            "governmentServiceAffiliationCode": "text",
            "description": "text",
            "militaryServiceRankCode": "text",
            "dateTimePeriodFormatQualifier": "text",
            "dateTimePeriod": "text",
            "endDateTimePeriod": "text",
            "startDateTimePeriod": "text",
            "ssn": "text",
            "groupNumber": "text",
            "planNumber": "text",
            "planNetworkIdNumber": "text",
            "relationToSubscriber": "text",
            "relationToSubscriberCode": "text",
            "insuredIndicator": "text",
            "maintenanceTypeCode": "text",
            "maintenanceReasonCode": "text",
            "birthSequenceNumber": "text",
            "address": {
              "address1": "123 address1",
              "address2": "text",
              "city": "city1",
              "state": "wa",
              "postalCode": "981010000",
              "countryCode": "text",
              "locationIdentifier": "text",
              "countrySubDivisionCode": "text"
            },
            "responseProvider": {
              "providerName": "text",
              "providerFirstName": "text",
              "providerOrgName": "text",
              "middleName": "text",
              "suffix": "text",
              "entityIdentifier": "text",
              "entityType": "text",
              "npi": "text",
              "providerCode": "text",
              "referenceIdentification": "text",
              "employersId": "text",
              "ssn": "text",
              "federalTaxpayersIdNumber": "text",
              "payorIdentification": "text",
              "pharmacyProcessorNumber": "text",
              "serviceProviderNumber": "text",
              "servicesPlanID": "text",
              "address": {
                "address1": "123 address1",
                "address2": "text",
                "city": "city1",
                "state": "wa",
                "postalCode": "981010000",
                "countryCode": "text",
                "locationIdentifier": "text",
                "countrySubDivisionCode": "text"
              },
              "aaaErrors": [
                {
                  "field": "text",
                  "code": "text",
                  "description": "text",
                  "followupAction": "text",
                  "location": "text",
                  "possibleResolutions": "text"
                }
              ]
            },
            "aaaErrors": [
              {
                "field": "text",
                "code": "text",
                "description": "text",
                "followupAction": "text",
                "location": "text",
                "possibleResolutions": "text"
              }
            ]
          }
        ],
        "payer": {
          "entityIdentifier": "text",
          "entityType": "text",
          "firstName": "text",
          "lastName": "text",
          "name": "text",
          "middleName": "text",
          "suffix": "text",
          "employersId": "text",
          "federalTaxpayersIdNumber": "text",
          "naic": "text",
          "npi": "text",
          "centersForMedicareAndMedicaidPlanId": "text",
          "payorIdentification": "text",
          "contactInformation": {
            "name": "text",
            "contacts": [
              {
                "communicationMode": "text",
                "communicationNumber": "text"
              }
            ]
          },
          "aaaErrors": [
            {
              "field": "text",
              "code": "text",
              "description": "text",
              "followupAction": "text",
              "location": "text",
              "possibleResolutions": "text"
            }
          ],
          "etin": "text"
        },
        "planInformation": {
          "stateLicenseNumber": "text",
          "medicareProviderNumber": "text",
          "medicaidProviderNumber": "text",
          "facilityIdNumber": "text",
          "personalIdentificationNumber": "text",
          "planNumber": "text",
          "planDescription": "text",
          "policyNumber": "text",
          "memberId": "text",
          "caseNumber": "text",
          "familyUnitNumber": "text",
          "groupNumber": "text",
          "groupDescription": "text",
          "referralNumber": "text",
          "alternativeListId": "text",
          "classOfContractCode": "text",
          "coverageListId": "text",
          "contractNumber": "text",
          "medicalRecordIdentificationNumber": "text",
          "electronicDevicePin": "text",
          "submitterIdentificationNumber": "text",
          "patientAccountNumber": "text",
          "hicNumber": "text",
          "drugFormularyNumber": "text",
          "priorAuthorizationNumber": "text",
          "idCardSerialNumber": "text",
          "idCardNumber": "text",
          "centersForMedicareAndMedicaidServicesNPI": "text",
          "issueNumber": "text",
          "insurancePolicyNumber": "text",
          "userIdentification": "text",
          "medicalAssistanceCategory": "text",
          "eligibilityCategory": "text",
          "planNetworkIdNumber": "text",
          "planNetworkIdDescription": "text",
          "facilityNetworkIdentificationNumber": "text",
          "medicaidRecipientIdNumber": "text",
          "priorIdNumber": "text",
          "socialSecurityNumber": "text",
          "federalTaxpayersIdentificationNumber": "text",
          "agencyClaimNumber": "text"
        },
        "planDateInformation": {
          "discharge": "text",
          "issue": "text",
          "effectiveDateOfChange": "text",
          "periodStart": "text",
          "periodEnd": "text",
          "completion": "text",
          "coordinationOfBenefits": "text",
          "plan": "text",
          "benefit": "text",
          "primaryCareProvider": "text",
          "latestVisitOrConsultation": "text",
          "eligibility": "text",
          "added": "text",
          "cobraBegin": "text",
          "cobraEnd": "text",
          "premiumPaidToDateBegin": "text",
          "premiumPaidToDateEnd": "text",
          "planBegin": "text",
          "planEnd": "text",
          "benefitBegin": "text",
          "benefitEnd": "text",
          "eligibilityBegin": "text",
          "eligibilityEnd": "text",
          "enrollment": "text",
          "admission": "text",
          "dateOfDeath": "text",
          "certification": "text",
          "service": "text",
          "policyEffective": "text",
          "policyExpiration": "text",
          "dateOfLastUpdate": "text",
          "status": "text"
        },
        "benefitsInformation": [
          {
            "code": "text",
            "name": "text",
            "coverageLevelCode": "text",
            "coverageLevel": "text",
            "serviceTypeCodes": [
              "text"
            ],
            "serviceTypes": [
              "text"
            ],
            "insuranceTypeCode": "text",
            "insuranceType": "text",
            "planCoverage": "text",
            "timeQualifierCode": "text",
            "timeQualifier": "text",
            "benefitAmount": "text",
            "benefitPercent": "text",
            "quantityQualifierCode": "text",
            "quantityQualifier": "text",
            "benefitQuantity": "text",
            "authOrCertIndicator": "text",
            "inPlanNetworkIndicatorCode": "text",
            "inPlanNetworkIndicator": "text",
            "headerLoopIdentifierCode": "text",
            "trailerLoopIdentifierCode": "text",
            "compositeMedicalProcedureIdentifier": {
              "productOrServiceIdQualifierCode": "text",
              "productOrServiceIdQualifier": "text",
              "procedureCode": "text",
              "procedureModifiers": [
                "text"
              ],
              "productOrServiceID": "text",
              "diagnosisCodePointer": [
                "text"
              ]
            },
            "benefitsAdditionalInformation": {
              "stateLicenseNumber": "text",
              "medicareProviderNumber": "text",
              "medicaidProviderNumber": "text",
              "facilityIdNumber": "text",
              "personalIdentificationNumber": "text",
              "planNumber": "text",
              "policyNumber": "text",
              "memberId": "text",
              "caseNumber": "text",
              "familyUnitNumber": "text",
              "groupNumber": "text",
              "referralNumber": "text",
              "alternativeListId": "text",
              "classOfContractCode": "text",
              "coverageListId": "text",
              "contractNumber": "text",
              "medicalRecordIdentificationNumber": "text",
              "electronicDevicePin": "text",
              "submitterIdentificationNumber": "text",
              "patientAccountNumber": "text",
              "hicNumber": "text",
              "drugFormularyNumber": "text",
              "priorAuthorizationNumber": "text",
              "idCardSerialNumber": "text",
              "idCardNumber": "text",
              "centersForMedicareAndMedicaidServicesNPI": "text",
              "issueNumber": "text",
              "insurancePolicyNumber": "text",
              "userIdentification": "text",
              "medicalAssistanceCategory": "text",
              "eligibilityCategory": "text",
              "planNetworkIdNumber": "text",
              "facilityNetworkIdentificationNumber": "text",
              "medicaidRecepientIdNumber": "text",
              "priorIdNumber": "text",
              "socialSecurityNumber": "text",
              "federalTaxpayersIdentificationNumber": "text",
              "agencyClaimNumber": "text"
            },
            "benefitsDateInformation": {
              "discharge": "text",
              "discharges": [
                {
                  "date": "text",
                  "startDate": "text",
                  "endDate": "text"
                }
              ],
              "issue": "text",
              "effectiveDateOfChange": "text",
              "periodStart": "text",
              "periodEnd": "text",
              "completion": "text",
              "coordinationOfBenefits": "text",
              "plan": "text",
              "benefit": "text",
              "primaryCareProvider": "text",
              "latestVisitOrConsultation": "text",
              "eligibility": "text",
              "added": "text",
              "cobraBegin": "text",
              "cobraEnd": "text",
              "premiumPaidtoDateBegin": "text",
              "premiumPaidToDateEnd": "text",
              "planBegin": "text",
              "planEnd": "text",
              "benefitBegin": "text",
              "benefitEnd": "text",
              "eligibilityBegin": "text",
              "eligibilityEnd": "text",
              "enrollment": "text",
              "admission": "text",
              "admissions": [
                {
                  "date": "text",
                  "startDate": "text",
                  "endDate": "text"
                }
              ],
              "dateOfDeath": "text",
              "certification": "text",
              "service": "text",
              "policyEffective": "text",
              "policyExpiration": "text",
              "dateOfLastUpdate": "text",
              "status": "text"
            },
            "benefitsRelatedEntity": {
              "entityIdentifier": "text",
              "entityType": "text",
              "entityName": "text",
              "entityFirstname": "text",
              "entityMiddlename": "text",
              "entitySuffix": "text",
              "entityIdentification": "text",
              "entityIdentificationValue": "text",
              "entityRelationship": "text",
              "address": {
                "address1": "123 address1",
                "address2": "text",
                "city": "city1",
                "state": "wa",
                "postalCode": "981010000",
                "countryCode": "text",
                "locationIdentifier": "text",
                "countrySubDivisionCode": "text"
              },
              "contactInformation": {
                "name": "text",
                "contacts": [
                  {
                    "communicationMode": "text",
                    "communicationNumber": "text"
                  }
                ]
              },
              "providerInformation": {
                "providerCode": "text",
                "referenceIdentification": "text"
              }
            },
            "benefitsRelatedEntities": [
              {
                "entityIdentifier": "text",
                "entityType": "text",
                "entityName": "text",
                "entityFirstname": "text",
                "entityMiddlename": "text",
                "entitySuffix": "text",
                "entityIdentification": "text",
                "entityIdentificationValue": "text",
                "entityRelationship": "text",
                "address": {
                  "address1": "123 address1",
                  "address2": "text",
                  "city": "city1",
                  "state": "wa",
                  "postalCode": "981010000",
                  "countryCode": "text",
                  "locationIdentifier": "text",
                  "countrySubDivisionCode": "text"
                },
                "contactInformation": {
                  "name": "text",
                  "contacts": [
                    {
                      "communicationMode": "text",
                      "communicationNumber": "text"
                    }
                  ]
                },
                "providerInformation": {
                  "providerCode": "text",
                  "referenceIdentification": "text"
                }
              }
            ],
            "benefitsServiceDelivery": [
              {
                "quantityQualifierCode": "text",
                "quantityQualifier": "text",
                "quantity": "text",
                "unitForMeasurementCode": "text",
                "sampleSelectionModulus": "text",
                "timePeriodQualifierCode": "text",
                "timePeriodQualifier": "text",
                "numOfPeriods": "text",
                "deliveryOrCalendarPatternCode": "text",
                "deliveryPatternTimeCode": "text",
                "unitForMeasurementQualifierCode": "text",
                "unitForMeasurementQualifier": "text",
                "deliveryOrCalendarPatternQualifierCode": "text",
                "deliveryOrCalendarPatternQualifier": "text",
                "deliveryPatternTimeQualifierCode": "text",
                "deliveryPatternTimeQualifier": "text"
              }
            ],
            "additionalInformation": [
              {
                "description": "text"
              }
            ],
            "eligibilityAdditionalInformation": {
              "codeListQualifierCode": "text",
              "industryCode": "text",
              "codeCategory": "text",
              "injuredBodyPartName": "text"
            },
            "eligibilityAdditionalInformationList": [
              {
                "codeListQualifierCode": "text",
                "industryCode": "text",
                "codeCategory": "text",
                "injuredBodyPartName": "text"
              }
            ]
          }
        ],
        "errors": [
          {
            "field": "text",
            "code": "text",
            "description": "text",
            "followupAction": "text",
            "location": "text",
            "possibleResolutions": "text"
          }
        ],
        "status": "text",
        "transactionSetAcknowledgement": "text",
        "implementationTransactionSetSyntaxError": "text",
        "x12": "text"
      },
      "eligibility_summarized_response": {
        "eligibility_request_id": "123e4567-e89b-12d3-a456-426614174000",
        "subscriber_details": {
          "member_id": "text",
          "firstname": "text",
          "lastname": "text",
          "middlename": "text",
          "gender": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          },
          "dob": "2025-06-25"
        },
        "payer_details": {
          "payer_name": "text",
          "address": {
            "address1": "123 address1",
            "address2": "text",
            "city": "city1",
            "state": "wa",
            "postalCode": "981010000",
            "countryCode": "text",
            "locationIdentifier": "text",
            "countrySubDivisionCode": "text"
          }
        },
        "plan_details": {
          "plan_number": "text",
          "group_name": "text",
          "group_number": "text",
          "plan_start_date": "2025-06-25",
          "plan_eligibility_start_date": "2025-06-25",
          "plan_name": "text",
          "plan_active": true
        },
        "coverage_summary": {
          "individual_deductible_in_network": {
            "total_amount": "text",
            "remaining_amount": "text"
          },
          "individual_oop_in_network": {
            "total_amount": "text",
            "remaining_amount": "text"
          },
          "family_deductible_in_network": {
            "total_amount": "text",
            "remaining_amount": "text"
          },
          "family_oop_in_network": {
            "total_amount": "text",
            "remaining_amount": "text"
          }
        },
        "chiropractic": {
          "co_insurance_in_network": {
            "amount": "text"
          },
          "co_payment_in_network": {
            "amount": "text"
          },
          "service_code": "text"
        },
        "emergency_room": {
          "co_insurance_in_network": {
            "amount": "text"
          },
          "co_payment_in_network": {
            "amount": "text"
          },
          "service_code": "text"
        },
        "office_visit": {
          "co_insurance_in_network": {
            "amount": "text"
          },
          "co_payment_in_network": {
            "amount": "text"
          },
          "service_code": "text"
        },
        "urgent_care": {
          "co_insurance_in_network": {
            "amount": "text"
          },
          "co_payment_in_network": {
            "amount": "text"
          },
          "service_code": "text"
        },
        "hospital_outpatient": {
          "co_insurance_in_network": {
            "amount": "text"
          },
          "co_payment_in_network": {
            "amount": "text"
          },
          "service_code": "text"
        }
      },
      "error": {
        "type": "text",
        "code": "text",
        "message": "text"
      },
      "created_at": "2025-06-25T04:33:07.884Z",
      "update_at": "2025-06-25T04:33:07.884Z"
    }
  ],
  "response_metadata": {
    "cursor": "text",
    "limit": 1,
    "total": 1
  }
}

Last updated

Was this helpful?