Get Benefits Check V2

GET /public/v2/benefits-checks/{benefits_check_id}

Get Benefits Check V2

cURL

curl --request GET \
  --url https://app.silnahealth.com/api/public/v2/benefits-checks/{benefits_check_id} \
  --header 'Authorization: Bearer <token>'

200

{
  "id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "patient_plan_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "patient_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "provider_id": "3c90c3cc-0d44-4b50-8888-8dd25736052a",
  "created_at": "2023-11-07T05:31:56Z",
  "specialty_fields": [
    {
      "copay_fields": [
        {
          "value": 123,
          "modifier": null
        }
      ],
      "coinsurance_fields": [
        {
          "value": 123,
          "modifier": null
        }
      ],
      "deductible": null,
      "out_of_pocket": null,
      "visit_limits": [
        {
          "value": 123,
          "modifier": null
        }
      ],
      "dollar_limits": [
        {
          "value": 123,
          "dollars_used": 123,
          "modifier": null
        }
      ],
      "authorization_requirements": [
        {
          "value": false,
          "modifier": null
        }
      ],
      "referral_requirements": [
        {
          "value": false,
          "modifier": null
        }
      ],
      "exclusions": [
        {
          "value": false,
          "modifier": null
        }
      ],
      "reimbursement_rate": null,
      "medicare_dollars_used": null,
      "exclusions_and_limitations": null,
      "patient_cost_estimates": [
        {
          "cost_estimate_name": "<string>",
          "cost_of_service": "<string>",
          "cost_of_service_duration": null
        }
      ]
    }
  ],
  "eligibility_status": null,
  "ineligibility_reason": null,
  "reference": null,
  "note": null,
  "insurance_type": null,
  "date_verified": null,
  "network_status": null,
  "plan_type": null,
  "plan_start_date": null,
  "plan_end_date": null,
  "group_number": null,
  "patient_information": null,
  "other_payor_information": null,
  "other_payor_entity_name": null,
  "independent_physician_association_name": null,
  "silna_url": null
}

Authorizations

Authorization · string · header · required

Bearer authentication header of the form Bearer <token>, where <token> is your auth token.

Path Parameters

benefits_check_id · string · required

Response

200

application/json

id · string<uuid> · required

Benefits Check ID

status · enum<string> · required

Benefits Check Status

Available options: REQUESTED, AWAITING_SILNA, AWAITING_PROVIDER, COMPLETE, WITHDRAWN

patient_plan_id · string<uuid> · required

Patient Plan ID

patient_id · string<uuid> · required

Patient ID

provider_id · string<uuid> · required

Provider ID

created_at · string<date-time> · required

Created at timestamp

specialty_fields · V2SpecialtyFieldsProvider · object[] · required

Specialty specific benefits data

Show child attributes

eligibility_status · enum<string> | null

Eligibility Status

Available options: ELIGIBLE, INELIGIBLE

ineligibility_reason · enum<string> | null

Reason for ineligibility

Available options: PLAN_INACTIVE, PATIENT_HAS_OUT_OF_NETWORK_IPA, PLAN_HAS_TERMINATED, MBI_TERMINATED, NO_MEDICARE_PART_B_COVERAGE, MEMBER_NUMBER_MISMATCH, SPECIALTY_NOT_COVERED, PATIENT_HAS_OTHER_INSURANCE, NO_OUT_OF_NETWORK_BENEFITS, HAS_ACTIVE_HOME_PLAN, ENROLLED_IN_HOSPICE, PROVIDER_PLACE_OF_SERVICE_NOT_COVERED, PATIENT_DECEASED

reference · string | null

Reference number

note · string | null

Note

insurance_type · enum<string> | null

Insurance type

Available options: COMMERCIAL, MEDICARE, MEDICAID, REGIONAL_CENTER, WORKERS_COMPENSATION, AUTO_INSURANCE

date_verified · string<date-time> | null

Date verified

network_status · enum<string> | null

Network status

Available options: IN_NETWORK, OUT_OF_NETWORK

plan_type · string | null

Plan type

plan_start_date · string<date> | null

Plan start date

plan_end_date · string<date> | null

Plan end date

group_number · string | null

Plan group ID

patient_information · BenefitsCheckPatientInformation · object

Patient information

Show child attributes

other_payor_information · BenefitsCheckOtherPayorInformation · object[] | null

Other payor information

Show child attributes

other_payor_entity_name · string | null

Name of the other insurance payor entity when ineligibility reason is patient has other insurance

independent_physician_association_name · string | null

Name of the Independent Physician Association (IPA) managing the provider network for the patient's plan

silna_url · string | null

Silna benefits check URL