POST

/v1/electronic_eligibility_checks

Authorization*
curl --request POST \
  --url https://api.opkit.co/v1/electronic_eligibility_checks \
  --header 'Authorization: <authorization>' \
  --header 'Content-Type: application/json' \
  --data '{
  "clearinghouse_entity_id": "<clearinghouse_entity_id>",
  "insurance_card_id": "<insurance_card_id>",
  "provider_id": "<provider_id>",
  "service_type": "<service_type>"
}'
{
  "benefits": [
    {
      "additional_information": [
        "string"
      ],
      "auth_or_cert_indicator": "no",
      "coverage_level": "children_only",
      "in_plan_network_indicator": "no",
      "insurance_type": "auto_insurance_policy",
      "monetary_amount": "integer",
      "percent_amount": "integer",
      "plan_coverage_description": "string",
      "quantity_amount": "string",
      "quantity_qualifier": "acceptable_unserviceable_quantity",
      "service_type": "abortion",
      "time_period_qualifier": "twelve_hours",
      "type": "active_coverage"
    }
  ],
  "clearinghouse_entity_errors": [
    {
      "follow_up_action": "do_not_resubmit_inquiry_initiated_to_a_third_party",
      "reject_reason": "accident_damage_derail_sideswiped"
    }
  ],
  "clearinghouse_entity_id": "string",
  "created_at": "string",
  "failure_reason": "clearinghouse_error",
  "finished_at": "string",
  "id": "string",
  "insurance_card_id": "string",
  "insurance_card_member_id": "string",
  "patient_date_of_birth": "2022-07-21",
  "patient_first_name": "string",
  "patient_last_name": "string",
  "provider_id": "string",
  "provider_npi": "string",
  "service_type": "abortion",
  "source": "system",
  "status": "pending"
}

Authorizations

Authorizationheaderrequired
string

The Opkit API uses the HTTP Bearer Token scheme for authentication. You should provide your API key in the Authorization header like so: "Authorization: Bearer [api-key]".

Body

application/json
clearinghouse_entity_idrequired
string
insurance_card_idrequired
string
provider_idrequired
string
service_typerequired
enum<string>
Available options:
abortion,
acupuncture,
adjunctive_dental_services,
aids,
air_transportation,
alcoholism,
allergy,
allergy_testing,
alternate_method_dialysis,
ambulatory_service_center_facility,
anesthesia,
anesthesiologist,
audiology_exam,
benefit_disclaimer,
blood_charges,
brand_name_prescription_drug,
brand_name_prescription_drug_formulary,
brand_name_prescription_drug_non_formulary,
burn_care,
cabulance,
cancer,
cardiac,
cardiac_rehabilitation,
case_management,
chemotherapy,
chiropractic,
chiropractic_office_visits,
chronic_renal_disease_crd_equipment,
cognitive_therapy,
consultation,
coronary_care,
day_care_psychiatric,
dental_accident,
dental_care,
dental_crowns,
dermatology,
diabetic_supplies,
diagnostic_dental,
diagnostic_lab,
diagnostic_medical,
diagnostic_x_ray,
dialysis,
donor_procedures,
drug_addiction,
durable_medical_equipment,
durable_medical_equipment_purchase,
durable_medical_equipment_rental,
emergency_services,
endocrine,
endodontics,
escrow_or_impound_service,
experimental_drug_therapy,
eye,
eyewear_and_eyewear_accessories,
family_planning,
flu_vaccination,
frames,
free_standing_prescription_drug,
gastrointestinal,
general_benefits,
generic_prescription_drug,
generic_prescription_drug_formulary,
generic_prescription_drug_non_formulary,
gynecological,
health_benefit_plan_coverage,
home_health_care,
home_health_prescriptions,
home_health_visits,
hospice,
hospital,
hospital_ambulatory_surgical,
hospital_emergency_accident,
hospital_emergency_medical,
hospital_inpatient,
hospital_outpatient,
hospital_room_and_board,
immunizations,
in_vitro_fertilization,
independent_medical_evaluation,
infertility,
inhalation_therapy,
intensive_care,
invasive_procedures,
lenses,
licensed_ambulance,
long_term_care,
lymphatic,
mail_order_prescription_drug,
mail_order_prescription_drug_brand_name,
mail_order_prescription_drug_generic,
major_medical,
mammogram_high_risk_patient,
mammogram_low_risk_patient,
massage_therapy,
maternity,
maxillofacial_prosthetics,
medical_care,
medically_related_transportation,
mental_health,
mental_health_facility_inpatient,
mental_health_facility_outpatient,
mental_health_provider_inpatient,
mental_health_provider_outpatient,
mri_cat_scan,
neonatal_intensive_care,
neurology,
newborn_care,
non_escrow_or_non_impound_service,
nonmedically_necessary_physical,
nursery,
obstetrical,
obstetrical_gynecological,
occupational_therapy,
oncology,
oral_surgery,
orthodontics,
orthopedic,
other_medical,
otological_exam,
partial_hospitalization_psychiatric,
pathology,
pediatric,
periodontics,
pharmacy,
physical_medicine,
physical_therapy,
physician_visit_office_sick,
physician_visit_office_well,
plan_waiting_period,
pneumonia_vaccine,
podiatry,
podiatry_nursing_home_visits,
podiatry_office_visits,
pre_admission_testing,
private_duty_nursing,
private_duty_nursing_home,
private_duty_nursing_inpatient,
professional_physician,
professional_physician_visit_home,
professional_physician_visit_inpatient,
professional_physician_visit_nursing_home,
professional_physician_visit_office,
professional_physician_visit_outpatient,
professional_physician_visit_skilled_nursing_facility,
prosthetic_device,
prosthodontics,
psychiatric,
psychiatric_inpatient,
psychiatric_outpatient,
psychiatric_room_and_board,
psychotherapy,
pulmonary,
pulmonary_rehabilitation,
radiation_therapy,
rehabilitation,
rehabilitation_inpatient,
rehabilitation_outpatient,
rehabilitation_room_and_board,
renal,
renal_supplies_in_the_home,
residential_psychiatric_treatment,
respite_care,
restorative,
routine_exam,
routine_physical,
routine_preventive_dental,
screening_laboratory,
screening_x_ray,
second_surgical_opinion,
skilled_nursing_care,
skilled_nursing_care_room_and_board,
skin,
smoking_cessation,
social_work,
speech_therapy,
substance_abuse,
substance_abuse_facility_inpatient,
substance_abuse_facility_outpatient,
surgical,
surgical_assistance,
surgical_benefits_facility,
surgical_benefits_professional_physician,
third_surgical_opinion,
transitional_care,
transitional_nursery_care,
transplants,
urgent_care,
used_durable_medical_equipment,
vision_optometry,
well_baby_care

Response

200 - application/json
benefits
object[]
clearinghouse_entity_errors
object[]
clearinghouse_entity_idrequired
string
created_atrequired
string
failure_reason
enum<string>
Available options:
clearinghouse_error,
clearinghouse_entity_error
finished_at
string
idrequired
string
insurance_card_idrequired
string
insurance_card_member_id
string
patient_date_of_birthrequired
string
patient_first_namerequired
string
patient_last_namerequired
string
provider_idrequired
string
provider_npirequired
string
service_typerequired
enum<string>
Available options:
abortion,
acupuncture,
adjunctive_dental_services,
aids,
air_transportation,
alcoholism,
allergy,
allergy_testing,
alternate_method_dialysis,
ambulatory_service_center_facility,
anesthesia,
anesthesiologist,
audiology_exam,
benefit_disclaimer,
blood_charges,
brand_name_prescription_drug,
brand_name_prescription_drug_formulary,
brand_name_prescription_drug_non_formulary,
burn_care,
cabulance,
cancer,
cardiac,
cardiac_rehabilitation,
case_management,
chemotherapy,
chiropractic,
chiropractic_office_visits,
chronic_renal_disease_crd_equipment,
cognitive_therapy,
consultation,
coronary_care,
day_care_psychiatric,
dental_accident,
dental_care,
dental_crowns,
dermatology,
diabetic_supplies,
diagnostic_dental,
diagnostic_lab,
diagnostic_medical,
diagnostic_x_ray,
dialysis,
donor_procedures,
drug_addiction,
durable_medical_equipment,
durable_medical_equipment_purchase,
durable_medical_equipment_rental,
emergency_services,
endocrine,
endodontics,
escrow_or_impound_service,
experimental_drug_therapy,
eye,
eyewear_and_eyewear_accessories,
family_planning,
flu_vaccination,
frames,
free_standing_prescription_drug,
gastrointestinal,
general_benefits,
generic_prescription_drug,
generic_prescription_drug_formulary,
generic_prescription_drug_non_formulary,
gynecological,
health_benefit_plan_coverage,
home_health_care,
home_health_prescriptions,
home_health_visits,
hospice,
hospital,
hospital_ambulatory_surgical,
hospital_emergency_accident,
hospital_emergency_medical,
hospital_inpatient,
hospital_outpatient,
hospital_room_and_board,
immunizations,
in_vitro_fertilization,
independent_medical_evaluation,
infertility,
inhalation_therapy,
intensive_care,
invasive_procedures,
lenses,
licensed_ambulance,
long_term_care,
lymphatic,
mail_order_prescription_drug,
mail_order_prescription_drug_brand_name,
mail_order_prescription_drug_generic,
major_medical,
mammogram_high_risk_patient,
mammogram_low_risk_patient,
massage_therapy,
maternity,
maxillofacial_prosthetics,
medical_care,
medically_related_transportation,
mental_health,
mental_health_facility_inpatient,
mental_health_facility_outpatient,
mental_health_provider_inpatient,
mental_health_provider_outpatient,
mri_cat_scan,
neonatal_intensive_care,
neurology,
newborn_care,
non_escrow_or_non_impound_service,
nonmedically_necessary_physical,
nursery,
obstetrical,
obstetrical_gynecological,
occupational_therapy,
oncology,
oral_surgery,
orthodontics,
orthopedic,
other_medical,
otological_exam,
partial_hospitalization_psychiatric,
pathology,
pediatric,
periodontics,
pharmacy,
physical_medicine,
physical_therapy,
physician_visit_office_sick,
physician_visit_office_well,
plan_waiting_period,
pneumonia_vaccine,
podiatry,
podiatry_nursing_home_visits,
podiatry_office_visits,
pre_admission_testing,
private_duty_nursing,
private_duty_nursing_home,
private_duty_nursing_inpatient,
professional_physician,
professional_physician_visit_home,
professional_physician_visit_inpatient,
professional_physician_visit_nursing_home,
professional_physician_visit_office,
professional_physician_visit_outpatient,
professional_physician_visit_skilled_nursing_facility,
prosthetic_device,
prosthodontics,
psychiatric,
psychiatric_inpatient,
psychiatric_outpatient,
psychiatric_room_and_board,
psychotherapy,
pulmonary,
pulmonary_rehabilitation,
radiation_therapy,
rehabilitation,
rehabilitation_inpatient,
rehabilitation_outpatient,
rehabilitation_room_and_board,
renal,
renal_supplies_in_the_home,
residential_psychiatric_treatment,
respite_care,
restorative,
routine_exam,
routine_physical,
routine_preventive_dental,
screening_laboratory,
screening_x_ray,
second_surgical_opinion,
skilled_nursing_care,
skilled_nursing_care_room_and_board,
skin,
smoking_cessation,
social_work,
speech_therapy,
substance_abuse,
substance_abuse_facility_inpatient,
substance_abuse_facility_outpatient,
surgical,
surgical_assistance,
surgical_benefits_facility,
surgical_benefits_professional_physician,
third_surgical_opinion,
transitional_care,
transitional_nursery_care,
transplants,
urgent_care,
used_durable_medical_equipment,
vision_optometry,
well_baby_care
sourcerequired
enum<string>
Available options:
system,
dashboard,
api
statusrequired
enum<string>
Available options:
pending,
success,
failure