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date.","format":"date-time","type":"string"},"coverageEndDate":{"description":"The end date of the coverage.","format":"date-time","type":"string"},"coverageStartDate":{"description":"The start date of the coverage.","format":"date-time","type":"string"},"deliveryInformation":{"description":"Health care service delivery information.","items":{"$ref":"#/definitions/HealthCareServiceDelivery"},"type":"array"},"description":{"description":"A description of this benefit.","type":"string"},"dischargeDate":{"description":"The discharge date.","format":"date-time","type":"string"},"eligibilityEndDate":{"description":"The eligibility end date.","format":"date-time","type":"string"},"eligibilityStartDate":{"description":"The eligibility start date.","format":"date-time","type":"string"},"familyUnitNumber":{"description":"The family unit number.","type":"string"},"groupName":{"description":"The benefit's group name.","type":"string"},"groupNumber":{"description":"The benefit's group number.","type":"string"},"healthInsuranceClaimNumber":{"description":"The patient's health insurance claim number.","type":"string"},"insurancePolicyNumber":{"description":"The insurance policy number.","type":"string"},"insuranceType":{"description":"The type of insurance.","type":"string"},"insuranceTypeCode":{"description":"The code of the type of insurance.","type":"string"},"lastUpdateDate":{"description":"The date this was last updated","format":"date-time","type":"string"},"lastVisitDate":{"description":"The date of the latest visit or consultation.","format":"date-time","type":"string"},"level":{"description":"The level of coverage.","type":"string"},"levelCode":{"description":"The code of the level of coverage.","type":"string"},"medicaidRecipientIdentificationNumber":{"description":"The patient's medicaid recipient identification number.","type":"string"},"memberIdentificationNumber":{"description":"The member's identification number.","type":"string"},"payerNotes":{"description":"Free form notes from the payer that apply to this benefit.","items":{"type":"string"},"type":"array"},"periodEndDate":{"description":"The end date of the period.","format":"date-time","type":"string"},"periodStartDate":{"description":"The start date of the period.","format":"date-time","type":"string"},"placeOfService":{"description":"The place where this service should be performed.","type":"string"},"placeOfServiceCode":{"description":"The code of the place where this service should be performed.","type":"string"},"planName":{"description":"The plan name.","type":"string"},"planNetworkId":{"description":"The plan network identification number.","type":"string"},"planNetworkName":{"description":"The plan network name.","type":"string"},"planNumber":{"description":"The plan number.","type":"string"},"planStartDate":{"description":"The start date of the plan.","format":"date-time","type":"string"},"policyNumber":{"description":"The policy number.","type":"string"},"primaryCareProviderDate":{"description":"The primary care provider date.","format":"date-time","type":"string"},"priorAuthorizationNumber":{"description":"The patient's prior authorization number.","type":"string"},"quantity":{"description":"The quantity covered by this benefit.","type":"string"},"quantityQualifier":{"description":"The qualifier for the quantity amount.","type":"string"},"quantityQualifierCode":{"description":"The qualifier code for the quantity amount.","type":"string"},"referralNumber":{"description":"The referral number.","type":"string"},"remaining":{"description":"The remaining amount.","type":"string"},"remainingTimePeriod":{"description":"The time period that the remaining benefit applies to.","type":"string"},"remainingTimePeriodCode":{"description":"The code of the remaining time period for this benefit.","type":"string"},"serviceDate":{"description":"The service date.","format":"date-time","type":"string"},"status":{"description":"The status of coverage for this benefit.","type":"string"},"statusCode":{"description":"The status code of the coverage for this benefit.","type":"string"},"statusDate":{"description":"The status date.","format":"date-time","type":"string"},"total":{"description":"The total amount.","type":"string"},"totalTimePeriod":{"description":"The time period that the total benefit applies to.","type":"string"},"totalTimePeriodCode":{"description":"The code of the total time period for this benefit.","type":"string"},"units":{"description":"The units of the amount.","type":"string"}},"type":"object"},"Payer":{"properties":{"addedDate":{"description":"The added date of the plan.","format":"date-time","type":"string"},"address":{"$ref":"#/definitions/Address"},"admissionDate":{"description":"The admission date.","format":"date-time","type":"string"},"benefitBeginDate":{"description":"The benefit begin date.","format":"date-time","type":"string"},"benefitEndDate":{"description":"The benefit end date.","format":"date-time","type":"string"},"completionDate":{"description":"The completion date.","format":"date-time","type":"string"},"contactInformation":{"description":"Contact information for the payer.","items":{"$ref":"#/definitions/ContactInformation"},"type":"array"},"coordinationOfBenefitsBeginDate":{"description":"The coordination of benefits begin date.","format":"date-time","type":"string"},"coordinationOfBenefitsDate":{"description":"The coordination of benefits date.","format":"date-time","type":"string"},"coordinationOfBenefitsEndDate":{"description":"The coordination of benefits end date.","format":"date-time","type":"string"},"coverageEndDate":{"description":"The end date of the coverage.","format":"date-time","type":"string"},"coverageStartDate":{"description":"The start date of the coverage.","format":"date-time","type":"string"},"dischargeDate":{"description":"The discharge date.","format":"date-time","type":"string"},"eligibilityEndDate":{"description":"The eligibility end date.","format":"date-time","type":"string"},"eligibilityStartDate":{"description":"The eligibility start date.","format":"date-time","type":"string"},"familyUnitNumber":{"description":"The family unit number.","type":"string"},"groupName":{"description":"The plan's group name.","type":"string"},"groupNumber":{"description":"The plan's group number.","type":"string"},"healthInsuranceClaimNumber":{"description":"The patient's health insurance claim number.","type":"string"},"insuredAddress":{"$ref":"#/definitions/Address"},"insuredContactInformation":{"description":"Contact information for the insured person.","items":{"$ref":"#/definitions/ContactInformation"},"type":"array"},"insuredFirstName":{"description":"The insured person's first name.","type":"string"},"insuredLastName":{"description":"The insured person's last name.","type":"string"},"insuredMemberId":{"description":"The insured person's member id.","type":"string"},"insuredMiddleName":{"description":"The insured person's middle name.","type":"string"},"lastUpdateDate":{"description":"The date this was last updated","format":"date-time","type":"string"},"lastVisitDate":{"description":"The date of the latest visit or consultation.","format":"date-time","type":"string"},"medicaidRecipientIdentificationNumber":{"description":"The patient's medicaid recipient identification number.","type":"string"},"memberIdentificationNumber":{"description":"The member's identification number.","type":"string"},"name":{"description":"The payer's name.","type":"string"},"payerId":{"description":"The payer's id.","type":"string"},"payerNotes":{"description":"Notes from the payer about this additional payer.","items":{"type":"string"},"type":"array"},"periodEndDate":{"description":"The end date of the period.","format":"date-time","type":"string"},"periodStartDate":{"description":"The start date of the period.","format":"date-time","type":"string"},"planName":{"description":"The plan name.","type":"string"},"planNetworkId":{"description":"The network id.","type":"string"},"planNetworkName":{"description":"The network name.","type":"string"},"planNumber":{"description":"The plan number.","type":"string"},"planStartDate":{"description":"The start date of the plan.","format":"date-time","type":"string"},"policyNumber":{"description":"The policy number.","type":"string"},"primary":{"description":"Indicates whether or not this is the primary payer.","type":"boolean"},"primaryCareProviderDate":{"description":"The primary care provider date.","format":"date-time","type":"string"},"responseName":{"description":"The payer's response name.","type":"string"},"responsePayerId":{"description":"The payer's response id.","type":"string"},"secondary":{"description":"Indicates whether or not this is the seconday payer.","type":"boolean"},"serviceDate":{"description":"The service date.","format":"date-time","type":"string"},"serviceTypeCode":{"description":"The service type code with which this payer is associated.","type":"string"},"statusDate":{"description":"The status date.","format":"date-time","type":"string"},"tertiary":{"description":"Indicates whether or not this is the tertiary payer.","type":"boolean"},"thirdPartyAdministrator":{"description":"Indicates if this payer is a Third-Party Administrator.","type":"string"},"type":{"description":"The payer's type.","type":"string"},"typeCode":{"description":"The payer's type code.","type":"string"}},"type":"object"},"PayerNote":{"properties":{"message":{"description":"The message from the payer.","type":"string"},"type":{"description":"The type of note.","type":"string"},"typeCode":{"description":"The type code of the note.","type":"string"}},"type":"object"},"ResultSet":{"properties":{"count":{"description":"Number of assets in the result set.","type":"integer"},"coverages":{"description":"list of coverages","items":{"$ref":"#/definitions/CoverageSummary"},"type":"array"},"limit":{"description":"Paging limit.","type":"integer"},"links":{"additionalProperties":{"$ref":"#/definitions/Link"},"description":"Links.","type":"object"},"offset":{"description":"Paging offset.","type":"integer"},"totalCount":{"description":"Total number of assets.","type":"integer"}},"type":"object"}},"host":"api.availity.com","info":{"description":"The Availity Coverages 1.0.0 API is designed to support real-time eligibility and benefits inquiries in compliance with HIPAA standards.","title":"Coverages","version":"1.0.0","x-custom-api-description":"The Availity Coverages 1.0.0 API is designed to support real-time eligibility and benefits inquiries in compliance with HIPAA standards."},"paths":{"/coverages":{"post":{"consumes":["application/x-www-form-urlencoded"],"operationId":"createCoverage","parameters":[{"description":"The Availity payer id of the member.","in":"formData","name":"payerId","type":"string"},{"description":"The provider's last name.","in":"formData","name":"providerLastName","type":"string"},{"description":"The provider's first name.","in":"formData","name":"providerFirstName","type":"string"},{"description":"The type of provider as required.","in":"formData","name":"providerType","type":"string"},{"description":"The NPI of the requesting provider.","in":"formData","name":"providerNpi","type":"string"},{"description":"The tax id of the requesting provider.","in":"formData","name":"providerTaxId","type":"string"},{"description":"The payer assigned provider id of the requesting provider.","in":"formData","name":"payerAssignedProviderId","type":"string"},{"description":"The social security number of the requesting provider.","in":"formData","name":"providerSSN","type":"string"},{"description":"The social security number of the requesting provider.","in":"formData","name":"providerPIN","type":"string"},{"description":"The Medicaid assigned provider id of the requesting provider.","in":"formData","name":"medicaidProviderNumber","type":"string"},{"description":"The requesting provider's system's provider id.","in":"formData","name":"providerOfficeId","type":"string"},{"description":"The requesting provider's system's user id.","in":"formData","name":"providerUserId","type":"string"},{"description":"This code is to be used only to identify the provider's contract number of the provider identified in the PRV segment of Loop 2100C. This code is only to be used once the CMS National Provider Identifier has been mandated for use, and must be sent if required in the contract between the Information Receiver identified in Loop 2100B and the Information Source identified in Loop 2100A.","in":"formData","name":"contractNumber","type":"string"},{"description":"The city of the requesting provider.","in":"formData","name":"providerCity","type":"string"},{"description":"The two character state code of the requesting provider.","in":"formData","name":"providerState","type":"string"},{"description":"The ZIP code of the requesting provider.","in":"formData","name":"providerZipCode","type":"string"},{"description":"The specialty code the requesting provider.","in":"formData","name":"providerSpecialty","type":"string"},{"description":"The place of service.","in":"formData","name":"placeOfService","type":"string"},{"description":"Your payer assigned submitter id.","in":"formData","name":"submitterId","type":"string"},{"description":"The coverage as of date.","format":"date-time","in":"formData","name":"asOfDate","type":"string"},{"description":"The coverage to date.","format":"date-time","in":"formData","name":"toDate","type":"string"},{"description":"The issue date of the card.","format":"date-time","in":"formData","name":"cardIssueDate","type":"string"},{"description":"The service type(s) you are looking for.","in":"formData","name":"serviceType","type":"string"},{"description":"The procedure code(s) you are looking for.","in":"formData","name":"procedureCode","type":"string"},{"description":"The member id of the patient or subscriber.","in":"formData","name":"memberId","type":"string"},{"description":"The Social Security Number of the patient or subscriber.","in":"formData","name":"patientSSN","type":"string"},{"description":"The medicaid id of the patient or subscriber.","in":"formData","name":"medicaidId","type":"string"},{"description":"The patient's medical record id number.","in":"formData","name":"medicalRecordIdentificationNumber","type":"string"},{"description":"The patient's account number.","in":"formData","name":"patientAccountNumber","type":"string"},{"description":"Use this code when the Identification Card has a number in addition to the Member Identification Number or Identity Card Number. The Identification Card Serial Number uniquely identifies the card when multiple cards have been or will be issued to a member (e.g., on a monthly basis, replacement cards).","in":"formData","name":"identificationCardSerialNumber","type":"string"},{"description":"Use this code when the Identity Card Number is different than the Member Identification Number.","in":"formData","name":"identityCardNumber","type":"string"},{"description":"The patient's insurance policy number.","in":"formData","name":"insurancePolicyNumber","type":"string"},{"description":"The patient's plan network identification number.","in":"formData","name":"planNetworkIdentificationNumber","type":"string"},{"description":"This code is only to be used when submitting an eligibility request to a Property and Casualty payer. Use this code to identify the Property and Casualty Claim Number associated with the subscriber.","in":"formData","name":"agencyClaimNumber","type":"string"},{"description":"The patient's last name.","in":"formData","name":"patientLastName","type":"string"},{"description":"The patient's zip code.","in":"formData","name":"patientZipCode","type":"string"},{"description":"The patient's first name.","in":"formData","name":"patientFirstName","type":"string"},{"description":"The patient's middle name.","in":"formData","name":"patientMiddleName","type":"string"},{"description":"The patient's suffix.","in":"formData","name":"patientSuffix","type":"string"},{"description":"The patient's birth date.","format":"date-time","in":"formData","name":"patientBirthDate","type":"string"},{"description":"The patient's gender.","in":"formData","name":"patientGender","type":"string"},{"description":"The subscriber's patient of residence.","in":"formData","name":"patientState","type":"string"},{"description":"The patient's group number.","in":"formData","name":"groupNumber","type":"string"},{"description":"Use this code only if it cannot be determined if the number is a Group Number or a Policy number. Use codes IG or 6P when they can be determined.","in":"formData","name":"groupOrPolicyNumber","type":"string"},{"description":"The patient's plan number.","in":"formData","name":"planNumber","type":"string"},{"description":"The patient's HIC number.","in":"formData","name":"healthInsuranceClaimNumber","type":"string"},{"description":"The patient's relationship to the subscriber.","in":"formData","name":"subscriberRelationship","type":"string"},{"description":"Use this code to identify the Case Number assigned to the subscriber by the information source.","in":"formData","name":"caseNumber","type":"string"}],"produces":["application/json","application/xml"],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CoverageSummary"}},"202":{"description":"Accepted","schema":{"$ref":"#/definitions/CoverageSummary"}},"400":{"description":"Bad Request","schema":{"$ref":"#/definitions/ErrorResponse"}},"401":{"description":"Not Authorized","schema":{"$ref":"#/definitions/ErrorResponse"}},"403":{"description":"Forbidden","schema":{"$ref":"#/definitions/ErrorResponse"}},"500":{"description":"Internal Server Error","schema":{"$ref":"#/definitions/ErrorResponse"}}},"summary":"Initiate a new coverage request or view an existing request."}},"/coverages/{id}":{"delete":{"operationId":"deleteCoverageById","parameters":[{"in":"path","name":"id","required":true,"type":"string"}],"produces":["application/json","application/xml"],"responses":{"204":{"description":"No Content"},"401":{"description":"Not Authorized","schema":{"$ref":"#/definitions/ErrorResponse"}},"403":{"description":"Forbidden","schema":{"$ref":"#/definitions/ErrorResponse"}},"404":{"description":"Not Found","schema":{"$ref":"#/definitions/ErrorResponse"}},"500":{"description":"Internal Server Error","schema":{"$ref":"#/definitions/ErrorResponse"}}},"summary":"Delete a coverage information by id."},"get":{"operationId":"getCoverageById","parameters":[{"in":"path","name":"id","required":true,"type":"string"}],"produces":["application/json","application/xml"],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/Coverage"}},"401":{"description":"Not Authorized","schema":{"$ref":"#/definitions/ErrorResponse"}},"403":{"description":"Forbidden","schema":{"$ref":"#/definitions/ErrorResponse"}},"404":{"description":"Not Found","schema":{"$ref":"#/definitions/ErrorResponse"}},"500":{"description":"Internal Server Error","schema":{"$ref":"#/definitions/ErrorResponse"}}},"summary":"Get the full coverage information by id."},"parameters":[{"description":"A coverage id","in":"path","name":"id","required":true,"type":"string"}]}},"schemes":["https"],"security":[{"oauth2":["hipaa"]}],"securityDefinitions":{"oauth2":{"description":"","flow":"application","scopes":{"healthcare-hipaa-transactions":"Healthcare HIPAA Transactions","healthcare-hipaa-transactions-demo":"Demo","healthcare-hipaa-transactions-highvolume":"Healthcare HIPAA Transactions High Volume","healthcare-hipaa-transactions-highvolume-standard":"Standard","healthcare-hipaa-transactions-highvolume-unlimited":"Unlimited","healthcare-hipaa-transactions-standard":"Standard","rcm-coverages":"RCM Coverages","rcm-coverages-standard":"Standard"},"tokenUrl":"https://api.availity.com/v1/token","type":"oauth2"}},"swagger":"2.0"}