Policy Scan

Changed on Nov 3, 2026

Search for a patient’s active policy, without payer_id. Return member_id and payer_Id if found.

post/v1/scan

Request

Base URL
https://coverage-api.meetnirvana.com
URL
https://coverage-api.meetnirvana.com/v1/scan
Auth
none declared

Request body

member_dobstring date required

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

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

next_appointmentstring date

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

office_idstring

An identifier for the office or location being visited.

patient_idstring

Patient's id

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

provider_npistring required

Service Provider’s 10-character NPI

zipstring required

Zip code

Example request

{
  "member_first_name": "NAME",
  "member_last_name": "SURNAME",
  "zip": "10001"
}

Response

Successful Response

bluecard_eligibleboolean

Indicates if the policy belongs to a Bluecard member

group_idstring

The group id of the member's insurance plan

group_namestring

The group name of the member’s insurance plan

insurance_type'HMO' | 'PPO' | 'EPO' | 'POS'

payer_idstring required

Payer ID used to verify benefits

payer_namestring

Payer name

plan_begin_datestring date

The date the member’s plan was activated

plan_end_datestring date

The date the member’s plan expires

plan_namestring

The name of the member’s insurance plan

plan_status'UNKNOWN' | 'INACTIVE' | 'ACTIVE' | 'ACTIVE_AT_RISK'

qmb_statusboolean

Indicates if the member has Qualified Medicare Beneficiary (QMB) status

relationship_to_subscriberstring

The member’s relation to the subscriber of the plan (e.g. self, spouse, child, etc.)

Example response

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

Changes

Nov 3, 2026f90ee559b8c7 Revision changes
- breaking
  removed the required property / from the response with the status
- warning
  added the new ORIGINAL_MEDICARE enum value to the / response property for the response status
- warning
  added the new SUPPLEMENTAL_MEDICARE enum value to the response property for the response status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property / to the response with the status
- info
  added the optional property to the response with the status
- info
  the response property became required for the status
- info
  the response property became required for the status
- info
  the response property became required for the status
- info
  the response property became required for the status
- info
  the response's property default value {"code":"UNABLE_TO_FIND_ACTIVE_COVERAGE","message":"Unable to find active coverage for this member"} was removed for the status
- info
  the response's property default value {"code":"UNABLE_TO_FIND_ACTIVE_COVERAGE","message":"Unable to find active coverage for this member"} was removed for the status
- info
  the response's property default value {"code":"UNABLE_TO_FIND_ACTIVE_COVERAGE","message":"Unable to find active coverage for this member"} was removed for the status
- info
  the response's property default value {"code":"UNABLE_TO_FIND_ACTIVE_COVERAGE","message":"Unable to find active coverage for this member"} was removed for the status
- info
  added the required property / to the response with the status
- info
  added the required property / to the response with the status
- info
  added the required property / to the response with the status
- info
  added the required property / to the response with the status

Operation history