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Medicaid

post/v1/medicaid

Request body

member_first_namestring required

Member's first name; as printed on the insurance card.

member_last_namestring required

Member's last name; as printed on the insurance card.

member_dobstring date required

Member's date of birth provided in yyyy-mm-dd format

provider_npistring required

Service Provider's 10-character NPI

member_idstring

Member's unique insurance ID, as printed on the insurance card

member_gender'M' | 'F'
office_idstring

An identifier for the office or location being visited.

patient_idstring

Patient's id

payer_idstring

Payer ID used to verify benefits

patient_statestring

Patient's state

next_appointmentstring date

Patient's next appointment date in yyyy-mm-dd format

patient_type'PROSPECT' | 'NEW_PATIENT' | 'EXISTING_PATIENT'
cpt_codestring

CPT (Current Procedural Terminology) code

with_alertsboolean

If true, return the list of OneVerify alerts

modality_code'PMC' | 'PHT' | 'PSC' | 'PSY' | 'MRI' | 'HST' | 'MNT' | 'CT' | 'IOP' | 'PHP' | 'UC' | 'ABA' | 'OBG' | 'MAT' | 'ORP' | 'DER' | 'GI' | 'ST' | 'CAR' | 'OT' | 'LAB'

Example request

{
  "cpt_code": "90834"
}

Response

Successful Response

OR

Example response

{
  "plan_begin_date": "2021-01-01",
  "plan_end_date": "2022-01-01",
  "relationship_to_subscriber": "Self"
}

Changes