API ReferencePre EncounterCoveragesV1
Get coverage
gets a specific Coverage
Authorization
BearerAuth AuthorizationBearer <token>
Send your Taiga API key as a Bearer token. Create and manage keys in the Taiga developer portal.
In: header
Path Parameters
id*pre-encounterCoverageId
The unique identifier for a Coverage in the database
Format
uuidResponse Body
application/json
curl -X GET "https://example.com/coverages/v1/497f6eca-6276-4993-bfeb-53cbbbba6f08"{ "id": "497f6eca-6276-4993-bfeb-53cbbbba6f08", "organization_id": "string", "deactivated": true, "version": 0, "updated_at": "2019-08-24T14:15:22Z", "updating_user_id": "string", "status": "ACTIVE", "subscriber": { "name": { "family": "string", "given": [ "string" ], "use": "USUAL", "period": { "start": "2019-08-24", "end": "2019-08-24" }, "suffix": "string" }, "date_of_birth": "2019-08-24", "biological_sex": "FEMALE", "address": { "use": "HOME", "line": [ "string" ], "city": "string", "state": "string", "postal_code": "string", "country": "string", "county": "string", "period": { "start": "2019-08-24", "end": "2019-08-24" } }, "employer_name": "string" }, "relationship": "SELF", "patient": "string", "insurance_plan": { "member_id": "string", "payer_id": "string", "payer_name": "string", "additional_payer_information": { "availity_eligibility_id": "string", "availity_payer_id": "string", "availity_payer_name": "string", "availity_remittance_payer_id": "string" }, "group_number": "string", "name": "string", "plan_type": "09", "type": "01", "period": { "start": "2019-08-24", "end": "2019-08-24" }, "insurance_card_image_locator": "string", "address": { "use": "HOME", "line": [ "string" ], "city": "string", "state": "string", "postal_code": "string", "country": "string", "county": "string", "period": { "start": "2019-08-24", "end": "2019-08-24" } }, "payer_plan_group_id": "166be4f9-7019-434a-a528-4fd642d5501d", "carve_outs": [ { "carve_out": "BEHAVIORAL", "member_id": "string", "payer_id": "string", "payer_name": "string", "group_number": "string", "plan_type": "09", "type": "01", "payer_plan_group_id": "166be4f9-7019-434a-a528-4fd642d5501d" } ] }, "verified": true, "eligibility_checks": [ { "check_id": "string", "service_code": "1", "status": "COMPLETED", "initiated_by": "string", "initiated_at": "2019-08-24T14:15:22Z" } ], "latest_eligibility_check": { "check_id": "string", "status": "ACTIVE", "initiated_at": "2019-08-24T14:15:22Z", "errors": [ { "field?": "string", "description?": "string", "location?": "string", "possibleResolutions?": "string", "code?": "string", "followupAction?": "string" } ] }, "benefits": { "plan_coverage": { "in_network": { "deductible": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "deductible_contract": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "deductible_remaining": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "deductible_year_to_date": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max_contract": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max_remaining": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max_year_to_date": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "additional_notes": "string" }, "in_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 0.1, "additional_notes": "string" } ], "out_of_network": { "deductible": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "deductible_contract": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "deductible_remaining": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "deductible_year_to_date": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max_contract": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max_remaining": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "oop_max_year_to_date": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "additional_notes": "string" }, "out_of_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 0.1, "additional_notes": "string" } ] }, "service_specific_coverage": [ { "service_code": "1", "in_network": { "copay": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "coinsurance": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "visits": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "visits_remaining": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "additional_notes": "string" }, "in_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 0.1, "additional_notes": "string" } ], "out_of_network": { "copay": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "coinsurance": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "visits": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "visits_remaining": { "family": 0, "individual": 0, "employeeAndSpouse": 0, "employeeAndChildren": 0 }, "additional_notes": "string" }, "out_of_network_flat": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 0.1, "additional_notes": "string" } ] } ], "benefits_related_entities": [ { "entityIdentifier": "string", "entityType": "string", "entityName": "string", "contactInformation": [ { "mode": "string", "value": "string" } ], "serviceTypeCodes": [ "1" ] } ], "non_covered_details": [ { "type": "DEDUCTIBLE", "coverageLevel": "EMPLOYEE_AND_CHILDREN", "unit": "PERCENT", "value": 0.1, "additional_notes": "string", "service_type_codes": [ "1" ] } ], "notes": "string", "autoUpdatedEligibilityCheckId": "string" }, "orcon": true, "auto_update_enabled": true, "previous_appointment_copays": { "property1": 0, "property2": 0 }}Scan coverage updates GET
Scans up to 100 coverage updates. The since query parameter is inclusive, and the result list is ordered by updatedAt ascending. **Polling Pattern:** To continuously poll for updates without gaps: 1. Make your initial request with a `since` timestamp (e.g., `since=2020-01-01T13:00:00.000Z`) 2. The API returns up to 100 coverage records, sorted by `updated_at` ascending 3. Find the `updated_at` value from the last record in the response 4. Use that `updated_at` value as the `since` parameter in your next request 5. Repeat steps 2-4 to ingest updates until you receive an empty list **Important Notes:** - The `since` parameter is inclusive, so you may receive the last record from the previous batch again (you can deduplicate by ID and version) - All coverage records include `updated_at`, `id`, `version`, `deactivated`, and `updating_user` fields for tracking changes - Timestamps have millisecond resolution for precise ordering
Check eligibility POST
Initiates an eligibility check. Returns the metadata of the check if successfully initiated.