Eligibility API Tips
TIPS
- You will see the
serviceTypeCode
value on all the responses, and is repeated several times in thebenefitsInformation
object depending on the length of the response and the business lines of the payer. Visit Service Type Codes for a complete list of the service type codes.- If the payer supports only a single category of inquiry in the Eligibility requests, you will see
serviceCode
30 for Health Benefit Plan Coverage. Some payers typically give aserviceCode
30 to affirm that the patient has active health insurance coverage.- Some payers will reply with shorter responses than others; the Eligibility API Response body example is a briefer one that you can see by testing the
tradingPartnerServiceId
value ofAETNA
in the request.- The
insuranceTypeCode
denotes the type of insurance policy within a specific insurance program. Payers can support numerous types.- For a more in-depth breakdown of each JSON object, see Eligibility response.
Updated 2 months ago