SIsilnahealth
V1BenefitsCheckResource

Create Benefits Check

Changed on
post/public/v1/benefits-checks/

Request

  • Base URL
    https://app.silnahealth.com/api
  • URL
    https://app.silnahealth.com/api/public/v1/benefits-checks/
  • Auth
    HTTP bearer

Headers

idempotency-keystring

Unique key to prevent duplicate requests. We support keys up to 255 characters.

Request body

patient_plan_idstring uuid required

Patient Plan ID

specialtiesPublicSpecialty[] required

List of specialties to create benefits check for

template_idstring uuid nullable

Benefits Check Template ID

diagnosis_code_idsstring[] nullable

Diagnosis code IDs to attach to this benefits check. Use GET /diagnosis-codes to look up IDs by code. If not provided, the patient's diagnosis codes are used. If an empty list is sent, the benefits check is not verified against any diagnosis code, even if the patient has diagnosis codes on record. Diagnosis codes are only attached when benefits check diagnosis codes are enabled for the provider. When they are, a benefits check with different diagnosis codes is not treated as a duplicate of an existing benefits check for the same patient plan and specialty.

network_status_override'IN_NETWORK' | 'OUT_OF_NETWORK'
procedure_group_idsstring[] nullable

Procedure group IDs defining the CPT codes this benefits check is verified against. Each procedure group must be configured for one of the requested specialties, and the benefits check template used for this request must allow procedure group selection. Use GET /procedure-groups to look up IDs, optionally by exact CPT codes. A benefits check with different procedure groups is not treated as a duplicate of an existing benefits check for the same patient plan and specialty.

clinician_idstring uuid nullable

Clinician to verify benefits as. If provided, this clinician's NPI is used for eligibility requests and payor calls and portals instead of the contracted group. Cannot be combined with provider_group_id. Must be enabled for the provider. Use GET /clinicians to look up IDs.

provider_group_idstring uuid nullable

Provider group to verify benefits as. If provided, this group's NPI and TIN are used for eligibility requests and payor calls and portals instead of the contracted group. Cannot be combined with clinician_id. Must be enabled for the provider. Use GET /provider-groups to look up IDs.

Example request

{
  "specialties": [
    "PHYSICAL_THERAPY"
  ]
}

Response 

Benefits Check Create Response Schema
benefits_check_idsstring[] required

List of created benefits check IDs

Changes