API ReferencePre EncounterEligibility ChecksV1
List eligibility checks
Authorization
BearerAuth AuthorizationBearer <token>
Send your Taiga API key as a Bearer token. Create and manage keys in the Taiga developer portal.
In: header
Query Parameters
page_token?|null
limit?integer|null
subscriber_member_id?string|null
payer_id?string|null
provider_npi?string|null
date_of_service?string|null
initiated_at_min?|
Format
date-timeinitiated_at_max?|
Format
date-timeResponse Body
application/json
curl -X GET "https://example.com/eligibility-checks/v1/get-multi/"{ "items": [ { "batch_id": "string", "errors": [ { "source": "TAIGA", "errorDetails": { "field?": "string", "description?": "string", "location?": "string", "possibleResolutions?": "string", "code?": "string", "followupAction?": "string" } } ], "request": { "submitter_transaction_identifier": "string", "payer_id": "string", "provider": { "first_name": "string", "last_name": "string", "npi": "string" }, "subscriber": { "member_id": "string", "first_name": "string", "last_name": "string", "date_of_birth": "2019-08-24" }, "dependent": { "member_id": "string", "first_name": "string", "last_name": "string", "date_of_birth": "2019-08-24" }, "encounter": { "date_of_service": "2019-08-24", "service_type_codes": [ "string" ] }, "get_existing_check_initiated_after": "2019-08-24T14:15:22Z", "source": "string", "portal_password": "string", "portal_username": "string" }, "response": { "benefitsInformation": [ { "additionalInformation": [ { "description": "string" } ], "authOrCertIndicator": "string", "benefitAmount": "string", "benefitPercent": "string", "benefitQuantity": "string", "benefitsAdditionalInformation": {}, "benefitsDateInformation": {}, "benefitsRelatedEntities": [ {} ], "benefitsRelatedEntity": {}, "benefitsServiceDelivery": [ {} ], "code": "string", "coverageLevel": "string", "coverageLevelCode": "string", "eligibilityAdditionalInformation": {}, "eligibilityAdditionalInformationList": [ {} ], "inPlanNetworkIndicator": "string", "inPlanNetworkIndicatorCode": "string", "insuranceType": "string", "insuranceTypeCode": "string", "name": "string", "planCoverage": "string", "quantityQualifier": "string", "quantityQualifierCode": "string", "serviceTypeCodes": [ "string" ], "serviceTypes": [ "string" ], "timeQualifier": "string", "timeQualifierCode": "string" } ], "controlNumber": "string", "dependents": [ {} ], "eligibilitySearchId": "string", "errors": [ {} ], "id": "string", "meta": {}, "payer": {}, "planDateInformation": {}, "planInformation": {}, "planStatus": [ {} ], "provider": {}, "reassociationKey": "string", "subscriber": {}, "subscriberTraceNumbers": [ {} ], "tradingPartnerServiceId": "string", "x12": "string" }, "parsed_response": { "eligibility_status": "ACTIVE", "plan_metadata": { "payer_name": "string", "insurance_type": "string", "insurance_type_code": "string", "plan_name": "string", "member_id": "string", "group_number": "string", "start_date": "2019-08-24", "end_date": "2019-08-24", "plan_dates": [ { "start_date": "2019-08-24", "end_date": "2019-08-24", "field_name": "string" } ], "subscriber": { "member_id": "string", "group_number": "string", "first_name": "string", "middle_name": "string", "last_name": "string", "date_of_birth": "string", "gender": "string", "address": { "address1": "string", "address2": "string", "city": "string", "state": "string", "postal_code": "string", "country_code": "string", "country_sub_division_code": "string" } }, "dependent": { "member_id": "string", "group_number": "string", "first_name": "string", "middle_name": "string", "last_name": "string", "date_of_birth": "string", "gender": "string", "address": { "address1": "string", "address2": "string", "city": "string", "state": "string", "postal_code": "string", "country_code": "string", "country_sub_division_code": "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" } }, "request_corrections": [ { "property": "string", "request_value": "string", "corrected_value": "string" } ] } ], "next_page_token": "string", "prev_page_token": "string", "total": 0}Coordination Of Benefits POST
Sends a coordination of benefits check through Stedi to determine whether a patient has coverage overlap across multiple payers and, if so, which payer is primary. Medicare and Medicare Advantage plans are not supported.
Insurance Discovery POST
Sends an insurance discovery check to find potential coverage matches for a patient through Stedi. Given patient demographics, this endpoint discovers what insurance coverages exist for the patient.