openapi: 3.2.0
info:
  title: Reference Eligibility Checks API
  version: 1.0.0
servers:
- url: https://pre-api.joincandidhealth.com
  description: Production
- url: https://pre-api-staging.joincandidhealth.com
  description: Staging
- url: https://sandbox-pre-api.joincandidhealth.com
  description: CandidSandbox
- url: https://staging-pre-api.joincandidhealth.com
  description: CandidStaging
- url: http://localhost:4000
  description: Local
- url: https://api.joincandidhealth.com
  description: Production
- url: https://api-staging.joincandidhealth.com
  description: Staging
- url: https://sandbox-api.joincandidhealth.com
  description: CandidSandbox
- url: https://staging-api.joincandidhealth.com
  description: CandidStaging
- url: http://localhost:5050
  description: Local
tags:
- name: Eligibility Checks
paths:
  /eligibility-checks/v1:
    post:
      operationId: post
      summary: Post
      description: Sends real-time eligibility checks to payers through Stedi.
      tags:
      - Eligibility Checks
      parameters:
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityResponse'
      requestBody:
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRequest'
  /eligibility-checks/v1/batch:
    post:
      operationId: batch
      summary: Batch
      description: Sends a batch of eligibility checks to payers through Stedi.
      tags:
      - Eligibility Checks
      parameters:
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_BatchEligibilityResponse'
      requestBody:
        content:
          application/json:
            schema:
              type: array
              items:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRequest'
  /eligibility-checks/v1/batch/{batch_id}:
    get:
      operationId: poll-batch
      summary: Poll Batch
      description: Polls the status of a batch eligibility check.
      tags:
      - Eligibility Checks
      parameters:
      - name: batch_id
        in: path
        required: true
        schema:
          type: string
      - name: page_token
        in: query
        required: false
        schema:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckPage'
  /eligibility-checks/v1/payer/search:
    get:
      operationId: payer-search
      summary: Payer Search
      description: Searches for payers that match the query parameters.
      tags:
      - Eligibility Checks
      parameters:
      - name: page_size
        in: query
        required: false
        schema:
          type: integer
      - name: page_token
        in: query
        required: false
        schema:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
      - name: query
        in: query
        required: false
        schema:
          type: string
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_PayerSearchResponse'
  /eligibility-checks/v1/recommendation:
    get:
      operationId: recommendation
      summary: Recommendation
      description: 'Gets recommendation for eligibility checks based on filters. This endpoint will retrieve all the latest eligibility recommendations for each

        eligibility recommendation type for the given filters. If you want to get a specific recommendation type, you can use the `type` query parameter.'
      tags:
      - Eligibility Checks
      parameters:
      - name: filters
        in: query
        required: false
        schema:
          $ref: '#/components/schemas/type_pre-encounter_common_FilterQueryString'
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                type: array
                items:
                  $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendation'
    post:
      operationId: create-recommendation
      summary: Create Recommendation
      description: Create an eligibiilty recommendation based on the request.
      tags:
      - Eligibility Checks
      parameters:
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendation'
      requestBody:
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_PostEligibilityRecommendationRequest'
  /eligibility-checks/v1/recommendation/{recommendation_id}/{version}/vote:
    put:
      operationId: vote-recommendation
      summary: Vote Recommendation
      description: Submit user feedback on an eligibility recommendation. The path must contain the next version number to prevent race conditions. For example, if the current version of the recommendation is n, you will need to send a request to this endpoint with `/{recommendation_id}/{n+1}/vote` to update the vote.
      tags:
      - Eligibility Checks
      parameters:
      - name: recommendation_id
        in: path
        required: true
        schema:
          type: string
      - name: version
        in: path
        required: true
        schema:
          type: string
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendation'
        '404':
          description: Error response with status 404
          content:
            application/json:
              schema:
                type: object
                properties:
                  errorName:
                    type: string
                    enum:
                    - NotFoundError
                  content:
                    $ref: '#/components/schemas/type_pre-encounter_common_ErrorBase4xx'
                required:
                - errorName
                - content
        '409':
          description: Error response with status 409
          content:
            application/json:
              schema:
                type: object
                properties:
                  errorName:
                    type: string
                    enum:
                    - VersionConflictError
                  content:
                    $ref: '#/components/schemas/type_pre-encounter_common_VersionConflictErrorBody'
                required:
                - errorName
                - content
      requestBody:
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_Vote'
  /eligibility-checks/v1/get-multi/:
    get:
      operationId: get-multi
      summary: Get Multi
      tags:
      - Eligibility Checks
      parameters:
      - name: page_token
        in: query
        required: false
        schema:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
      - name: limit
        in: query
        required: false
        schema:
          type: integer
      - name: subscriber_member_id
        in: query
        required: false
        schema:
          type: string
      - name: payer_id
        in: query
        required: false
        schema:
          type: string
      - name: provider_npi
        in: query
        required: false
        schema:
          type: string
      - name: date_of_service
        in: query
        required: false
        schema:
          type: string
      - name: initiated_at_min
        in: query
        required: false
        schema:
          type: string
          format: date-time
      - name: initiated_at_max
        in: query
        required: false
        schema:
          type: string
          format: date-time
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckPage'
  /eligibility-checks/v1/insurance-discovery:
    post:
      operationId: insurance-discovery
      summary: Insurance Discovery
      description: '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.'
      tags:
      - Eligibility Checks
      parameters:
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryResponse'
      requestBody:
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryRequest'
  /eligibility-checks/v1/coordination-of-benefits:
    post:
      operationId: coordination-of-benefits
      summary: Coordination Of Benefits
      description: '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.'
      tags:
      - Eligibility Checks
      parameters:
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CoordinationOfBenefitsResponse'
      requestBody:
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CoordinationOfBenefitsRequest'
components:
  schemas:
    type_pre-encounter_eligibilityChecks_v1_EligibilityRequest:
      type: object
      properties:
        submitter_transaction_identifier:
          type: string
          description: 'A unique identifier for the eligibility check within the batch. Candid returns this identifier in the response for the

            /batch/{batch_id} polling endpoint so you can correlate benefit responses with the original eligibility check.'
        payer_id:
          type: string
          description: Supported payer ID values can be found [here](https://www.stedi.com/healthcare/network).
        provider:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_Provider'
        subscriber:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_MemberInfo'
          description: The primary policyholder for the insurance plan or a dependent with a unique member ID. <Note>If a dependent has a unique member ID, include their information here and leave dependent undefined.</Note>
        dependent:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_MemberInfo'
          description: <Note>If a dependent has a unique member ID, include their information as subscriber and leave this field undefined.</Note>
        encounter:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_Encounter'
        get_existing_check_initiated_after:
          type: string
          format: date-time
          description: If not provided, this endpoint will run a fresh eligibility check. If provided, it will return an existing successful eligibility check if one exists that was initiated after provided date with the same parameters (Date of Service, Payer ID, Provider, Subscriber, Dependent, and Encounter).
        source:
          type: string
        portal_password:
          type: string
          description: The password that the provider uses to log in to the payer's portal. This is not commonly used.
        portal_username:
          type: string
          description: The username that the provider uses to log in to the payer's portal. This is not commonly used.
      required:
      - payer_id
      - provider
      - subscriber
      description: An object representing the data for an eligibility request.
      title: EligibilityRequest
    type_pre-encounter_coverages_v1_CoverageDetails:
      type: object
      properties:
        type:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_BenefitType'
        coverageLevel:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageLevel'
        unit:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValueUnit'
        value:
          type: number
          format: double
        additional_notes:
          type: string
      required:
      - type
      - coverageLevel
      - unit
      - value
      title: CoverageDetails
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryResponse:
      type: object
      properties:
        discovery_id:
          type: string
          description: A unique ID for this insurance discovery check.
        status:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryStatus'
          description: The status of the discovery check. COMPLETE means items are populated. PENDING means the check is still in progress.
        items:
          type: array
          items:
            description: Any type
          description: "An array of potential coverage matches for the patient. Only populated when status is COMPLETE.\nEach item is a raw passthrough of Stedi's deeply nested coverage-match object (provider, subscriber, \npayer, plan, and benefits details)."
        coverages_found:
          type: integer
          description: The number of potential coverage matches found. 0 if no matching coverage was found.
        errors:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails'
      description: An object representing the data for an insurance discovery response.
      title: InsuranceDiscoveryResponse
    type_pre-encounter_common_PageToken:
      type: string
      description: A token that can be used to retrieve the next or previous page of results
      title: PageToken
    type_pre-encounter_coverages_v1_ServiceCoverageDetails:
      type: object
      properties:
        copay:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        coinsurance:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        visits:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        visits_remaining:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        additional_notes:
          type: string
      title: ServiceCoverageDetails
    type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorSource:
      type: string
      enum:
      - CANDID
      - STEDI
      description: enum to represent the source of an error in an eligibility check
      title: EligibilityCheckErrorSource
    type_pre-encounter_common_CoverageId:
      type: string
      format: uuid
      description: The unique identifier for a Coverage in the database
      title: CoverageId
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryStatus:
      type: string
      enum:
      - PENDING
      - COMPLETE
      description: The status of the insurance discovery check.
      title: InsuranceDiscoveryStatus
    type_pre-encounter_eligibilityChecks_v1_EligibilityStatus:
      type: string
      enum:
      - ACTIVE
      - INACTIVE
      - UNKNOWN
      description: enum to represent the status of a patient's coverage
      title: EligibilityStatus
    type_pre-encounter_eligibilityChecks_v1_CobEncounter:
      type: object
      properties:
        date_of_service:
          type: string
          description: The date of service. Defaults to the current date if not specified.
        beginning_date_of_service:
          type: string
          description: The beginning date of service. If included, end_date_of_service is also required.
        end_date_of_service:
          type: string
          description: The end date of service. If included, beginning_date_of_service is also required.
      description: 'Information about the encounter for the COB check.

        Service dates must be within the past 2 years and must not be in the future.'
      title: CobEncounter
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoverySubscriber:
      type: object
      properties:
        first_name:
          type: string
          description: The subscriber's first name.
        last_name:
          type: string
          description: The subscriber's last name.
        middle_name:
          type: string
          description: The subscriber's middle name or initial.
        date_of_birth:
          type: string
          description: The subscriber's date of birth, formatted as YYYYMMDD.
        ssn:
          type: string
          description: The subscriber's Social Security Number (SSN). Full SSN is preferred, but even the last 4 digits can help.
        gender:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryGender'
        address:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryAddress'
      required:
      - first_name
      - last_name
      description: 'Demographic information for the patient when they are the health plan subscriber.

        Providing as much information as possible improves the probability of finding matching coverage.

        SSN and address (especially zip code) are strongly recommended.'
      title: InsuranceDiscoverySubscriber
    type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendation:
      type: object
      properties:
        organization_id:
          $ref: '#/components/schemas/type_pre-encounter_common_OrganizationId'
          description: The organization that owns this object.
        deactivated:
          type: boolean
          description: True if the object is deactivated.  Deactivated objects are not returned in search results but are returned in all other endpoints including scan.
        version:
          type: integer
          description: The version of the object. Any update to any property of an object object will create a new version.
        updated_at:
          type: string
          format: date-time
        updating_user_id:
          $ref: '#/components/schemas/type_pre-encounter_common_UserId'
          description: The user ID of the user who last updated the object.
        id:
          type: string
          description: The unique UUID identifier for an EligibilityRecommendation.
        eligibility_check_id:
          type: string
        recommendation:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendationPayload'
        coverage_id:
          $ref: '#/components/schemas/type_pre-encounter_common_CoverageId'
        patient:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendationPatientInfo'
        votes:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_Vote'
          description: Array of votes for this recommendation
      required:
      - organization_id
      - deactivated
      - version
      - updated_at
      - updating_user_id
      - id
      - eligibility_check_id
      - recommendation
      - patient
      description: An eligibility recommendation object that contains an EligibilityRecommendationType and a payload of data denoting the recommendation.
      title: EligibilityRecommendation
    type_pre-encounter_eligibilityChecks_v1_CopayEstimationRecommendationPayload:
      type: object
      properties:
        structured_response:
          type: integer
          description: The estimated copay amount in cents
        exposition:
          type: string
          description: The AI's explanation of the copay estimate
      required:
      - exposition
      description: Payload for MD visit copay estimation from AI analysis
      title: CopayEstimationRecommendationPayload
    type_pre-encounter_coverages_v1_BenefitType:
      type: string
      enum:
      - DEDUCTIBLE
      - DEDUCTIBLE_CONTRACT
      - DEDUCTIBLE_REMAINING
      - DEDUCTIBLE_YEAR_TO_DATE
      - OOP_MAX
      - OOP_MAX_CONTRACT
      - OOP_MAX_REMAINING
      - OOP_MAX_YEAR_TO_DATE
      - COPAY
      - COINSURANCE
      - NON_COVERED
      - LIMITATION
      title: BenefitType
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryDependent:
      type: object
      properties:
        first_name:
          type: string
          description: The dependent's first name.
        last_name:
          type: string
          description: The dependent's last name.
        middle_name:
          type: string
          description: The dependent's middle name or initial.
        date_of_birth:
          type: string
          description: The dependent's date of birth, formatted as YYYYMMDD.
        ssn:
          type: string
          description: The dependent's Social Security Number (SSN).
        gender:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryGender'
        address:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryAddress'
      required:
      - first_name
      - last_name
      description: 'Demographic information for the patient when they are a dependent on a health plan.

        If you only have the dependent''s information, identify them in the subscriber object instead and leave this empty.'
      title: InsuranceDiscoveryDependent
    type_pre-encounter_eligibilityChecks_v1_Cob:
      type: object
      properties:
        classification:
          type: string
          description: 'The classification for the discovered benefits. One of: `CobInstanceExistsPrimacyDetermined`,

            `CobInstanceExistsPrimacyUndetermined`, `CoverageOverlapNoBenefitOverlap`,

            `CoverageOverlapExistsNotSubjectToCob`, or `MemberFoundNoCob`.'
        instance_exists:
          type: boolean
          description: If true, the COB response contains at least one coordination of benefits instance.
        primacy_determined:
          type: boolean
          description: If true, Stedi was able to determine the primary payer for the patient.
        coverage_overlap:
          type: boolean
          description: If true, the patient has active coverage with two or more payers during the service date.
        benefit_overlap:
          type: boolean
          description: If true, the patient has active coverage from two or more payers for the same service type code.
      description: 'An overview of the COB response. Indicates whether there is a coverage overlap, whether that

        overlap creates a coordination of benefits instance, and whether Stedi was able to identify

        payer primacy (when a COB instance exists).'
      title: Cob
    type_pre-encounter_coverages_v1_PlanCoverage:
      type: object
      properties:
        in_network:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_PlanCoverageDetails'
        in_network_flat:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageDetails'
        out_of_network:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_PlanCoverageDetails'
        out_of_network_flat:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageDetails'
      title: PlanCoverage
    type_pre-encounter_eligibilityChecks_v1_UserConfiguredPromptsResult:
      type: object
      properties:
        user_prompt_id:
          type: string
          description: Reference to the user prompt in eligibility config
        prompt_name:
          type: string
          description: User-defined name for the prompt
        structured_response:
          description: The AI's structured answer (boolean, number, or string)
        exposition:
          type: string
          description: The AI's explanation of the answer
      required:
      - user_prompt_id
      - prompt_name
      - structured_response
      - exposition
      description: Individual result from a single user-configured prompt execution
      title: UserConfiguredPromptsResult
    type_pre-encounter_coverages_v1_CoverageValueUnit:
      type: string
      enum:
      - PERCENT
      - CURRENCY
      - COUNT
      title: CoverageValueUnit
    type_pre-encounter_eligibilityChecks_v1_CobProvider:
      type: object
      properties:
        organization_name:
          type: string
          description: The provider's business name. Required if the provider is an organization.
        first_name:
          type: string
          description: The provider's first name. Required if the provider is an individual.
        last_name:
          type: string
          description: The provider's last name. Required if the provider is an individual.
        npi:
          type: string
          description: The provider's National Provider Identifier (NPI).
      required:
      - npi
      description: 'Information about the entity requesting the COB check.

        Provide either organization_name (for organizations) or first_name and last_name (for individuals), plus npi.'
      title: CobProvider
    type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendationPatientInfo:
      type: object
      properties:
        id:
          $ref: '#/components/schemas/type_pre-encounter_common_PatientId'
        mrn:
          type: string
        organization_id:
          $ref: '#/components/schemas/type_pre-encounter_common_OrganizationId'
        last_name:
          type: string
        first_name:
          type: string
        date_of_birth:
          type: string
          format: date
        member_id:
          type: string
      description: "An object representing patient information for an eligibility recommendation. \nThis is used to find recommendations. Each field helps us find the right corresponding\neligibility recommendation for the patient."
      title: EligibilityRecommendationPatientInfo
    type_pre-encounter_eligibilityChecks_v1_Encounter:
      type: object
      properties:
        date_of_service:
          type: string
          format: date
          description: Defaults to the current date if not provided.
        service_type_codes:
          type: array
          items:
            type: string
          description: 'Defaults to HealthBenefitPlanCoverage (30) if not provided.

            <Note>Not all payers support multiple service type codes, so it is recommended to only include a single code per request.</Note>'
      title: Encounter
    type_pre-encounter_coverages_v1_BenefitsRelatedEntity:
      type: object
      properties:
        entityIdentifier:
          type: string
        entityType:
          type: string
        entityName:
          type: string
        contactInformation:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_RelatedEntityContact'
        serviceTypeCodes:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ServiceTypeCode'
      title: BenefitsRelatedEntity
    type_pre-encounter_eligibilityChecks_v1_EligibilityCheckError:
      type: object
      properties:
        source:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorSource'
        errorDetails:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails'
      required:
      - source
      - errorDetails
      title: EligibilityCheckError
    type_pre-encounter_coverages_v1_CoverageBenefits:
      type: object
      properties:
        plan_coverage:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_PlanCoverage'
        service_specific_coverage:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ServiceCoverage'
        benefits_related_entities:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_BenefitsRelatedEntity'
        non_covered_details:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_NonCoveredDetail'
        notes:
          type: string
        autoUpdatedEligibilityCheckId:
          type: string
      title: CoverageBenefits
    type_pre-encounter_coverages_v1_PlanDate:
      type: object
      properties:
        start_date:
          type: string
          format: date
        end_date:
          type: string
          format: date
        field_name:
          type: string
      required:
      - start_date
      - field_name
      title: PlanDate
    type_pre-encounter_coverages_v1_PlanCoverageDetails:
      type: object
      properties:
        deductible:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        deductible_contract:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        deductible_remaining:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        deductible_year_to_date:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        oop_max:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        oop_max_contract:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        oop_max_remaining:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        oop_max_year_to_date:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValue'
        additional_notes:
          type: string
      title: PlanCoverageDetails
    type_pre-encounter_eligibilityChecks_v1_CobPayer:
      type: object
      properties:
        name:
          type: string
          description: The payer's name, such as `CIGNA`.
        payer_identification:
          type: string
          description: The trading_partner_service_id (Payer ID) used to identify the payer in the COB request.
      description: Information about the payer listed in the COB request.
      title: CobPayer
    type_pre-encounter_common_FilterQueryString:
      type: string
      description: 'A serialized list of filters separated by commas indicating filters to apply.  Each filter is of the form ''path:operator:value''. Example: ''patient.mrn|eq|12345''.  Filters are separated by commas. Example: ''patient.mrn|eq|12345,appointment.startDate|gt|67890''. All filters are ANDed together.  Valid operators are ''eq'', ''gt'', ''lt'', ''contains'', ''ieq'', ''in''. ieq is a case-insensitive equality operator. in allows searching for values that match any item in a semicolon-separated list (e.g., ''patient.id|in|foo;bar;baz''). Path values are camelCase.'
      title: FilterQueryString
    type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendationPayload:
      oneOf:
      - type: object
        properties:
          type:
            type: string
            enum:
            - MEDICARE_ADVANTAGE
            description: 'Discriminator value: MEDICARE_ADVANTAGE'
          payload:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_MedicareAdvantageRecommendationPayload'
        required:
        - type
        - payload
      - type: object
        properties:
          type:
            type: string
            enum:
            - MEDICAID_MANAGED_CARE
            description: 'Discriminator value: MEDICAID_MANAGED_CARE'
          payload:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_MedicareAdvantageRecommendationPayload'
        required:
        - type
        - payload
      - type: object
        properties:
          type:
            type: string
            enum:
            - COORDINATION_OF_BENEFITS
            description: 'Discriminator value: COORDINATION_OF_BENEFITS'
          payload:
            description: Any type
        required:
        - type
        - payload
      - type: object
        properties:
          type:
            type: string
            enum:
            - COPAY_ESTIMATION
            description: 'Discriminator value: COPAY_ESTIMATION'
          payload:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CopayEstimationRecommendationPayload'
        required:
        - type
        - payload
      - type: object
        properties:
          type:
            type: string
            enum:
            - USER_CONFIGURED_PROMPTS
            description: 'Discriminator value: USER_CONFIGURED_PROMPTS'
          payload:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_UserConfiguredPromptsRecommendationPayload'
        required:
        - type
        - payload
      discriminator:
        propertyName: type
      title: EligibilityRecommendationPayload
    type_pre-encounter_eligibilityChecks_v1_Provider:
      oneOf:
      - $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_IndividualProvider'
      - $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_OrganizationProvider'
      title: Provider
    type_pre-encounter_coverages_v1_RelatedEntityContact:
      type: object
      properties:
        mode:
          type: string
        value:
          type: string
      title: RelatedEntityContact
    type_pre-encounter_eligibilityChecks_v1_PayerSearchResponse:
      type: object
      properties:
        next_page_token:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
        prev_page_token:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
        total:
          type: integer
        items:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_StediPayerItem'
        stats:
          description: Any type
      required:
      - total
      - items
      - stats
      title: PayerSearchResponse
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryEncounter:
      type: object
      properties:
        date_of_service:
          type: string
          description: A single date of service, formatted as YYYYMMDD.
        beginning_date_of_service:
          type: string
          description: The beginning date of service, formatted as YYYYMMDD.
        end_date_of_service:
          type: string
          description: The end date of service, formatted as YYYYMMDD.
      description: 'The date range for the service. If not specified, Stedi defaults to the current date.

        You can specify either a single date_of_service or a beginning_date_of_service and end_date_of_service.'
      title: InsuranceDiscoveryEncounter
    type_pre-encounter_eligibilityChecks_v1_EligibilityCheck:
      type: object
      properties:
        batch_id:
          type: string
        errors:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckError'
        request:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRequest'
        response:
          description: Any type
        parsed_response:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_ParsedResponse'
        request_corrections:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_RequestCorrection'
      required:
      - response
      title: EligibilityCheck
    type_pre-encounter_eligibilityChecks_v1_CobSubscriber:
      type: object
      properties:
        first_name:
          type: string
          description: The subscriber's first name.
        last_name:
          type: string
          description: The subscriber's last name.
        date_of_birth:
          type: string
          description: The subscriber's date of birth.
        member_id:
          type: string
          description: The member ID for the subscriber's insurance policy.
        ssn:
          type: string
          description: The subscriber's Social Security Number (SSN).
      required:
      - first_name
      - last_name
      - date_of_birth
      description: 'The primary policyholder for the insurance plan or a dependent with a unique member ID.

        You must provide at least one of member_id or ssn.'
      title: CobSubscriber
    type_pre-encounter_eligibilityChecks_v1_OrganizationProvider:
      type: object
      properties:
        organization_name:
          type: string
        npi:
          type: string
      required:
      - npi
      title: OrganizationProvider
    type_pre-encounter_common_PatientId:
      type: string
      description: The unique identifier for a Patient
      title: PatientId
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryAddress:
      type: object
      properties:
        address_1:
          type: string
        address_2:
          type: string
        city:
          type: string
        state:
          type: string
        postal_code:
          type: string
        country_code:
          type: string
      description: The patient's address. Providing a zip code improves the probability of finding matching coverage.
      title: InsuranceDiscoveryAddress
    type_pre-encounter_eligibilityChecks_v1_CobPlanDateInformation:
      type: object
      properties:
        plan_begin:
          type: string
          description: When the patient's health plan coverage begins.
        plan_end:
          type: string
          description: When the patient's health plan coverage ends.
      description: Dates associated with the patient's health plan coverage.
      title: CobPlanDateInformation
    type_pre-encounter_coverages_v1_MemberInfo:
      type: object
      properties:
        member_id:
          type: string
          description: "Stedi requires that you supply at least one of these fields in the request: memberId, dateOfBirth, or lastName.  \nHowever, each payer has different requirements, so you should supply as many of the fields necessary for each payer \nto identify the subscriber/dependent in their system."
        first_name:
          type: string
        last_name:
          type: string
        date_of_birth:
          type: string
          format: date
          description: "Stedi requires that you supply at least one of these fields in the request: memberId, dateOfBirth, or lastName.  \nHowever, each payer has different requirements, so you should supply as many of the fields necessary for each payer \nto identify the subscriber/dependent in their system."
      required:
      - first_name
      - last_name
      title: MemberInfo
    type_pre-encounter_coverages_v1_PlanMetadata:
      type: object
      properties:
        payer_name:
          type: string
        insurance_type:
          type: string
        insurance_type_code:
          type: string
        plan_name:
          type: string
        member_id:
          type: string
        group_number:
          type: string
        start_date:
          type: string
          format: date
        end_date:
          type: string
          format: date
        plan_dates:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_PlanDate'
        subscriber:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ExpandedMemberInfo'
        dependent:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ExpandedMemberInfo'
      title: PlanMetadata
    type_pre-encounter_eligibilityChecks_v1_ParsedResponse:
      type: object
      properties:
        eligibility_status:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityStatus'
        plan_metadata:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_PlanMetadata'
        benefits:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageBenefits'
      required:
      - eligibility_status
      title: ParsedResponse
    type_pre-encounter_eligibilityChecks_v1_Vote:
      type: object
      properties:
        user_id:
          $ref: '#/components/schemas/type_pre-encounter_common_UserId'
          description: The user who voted
        value:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_VoteValue'
          description: The vote value
      required:
      - user_id
      - value
      description: User feedback on a recommendation
      title: Vote
    type_pre-encounter_eligibilityChecks_v1_IndividualProvider:
      type: object
      properties:
        first_name:
          type: string
        last_name:
          type: string
        npi:
          type: string
      required:
      - npi
      title: IndividualProvider
    type_pre-encounter_eligibilityChecks_v1_BatchEligibilityResponse:
      type: object
      properties:
        batch_id:
          type: string
        submitted_at:
          type: string
          format: date-time
      required:
      - batch_id
      - submitted_at
      description: An object representing the data for a batch eligibility response.
      title: BatchEligibilityResponse
    type_pre-encounter_common_UserId:
      type: string
      description: The unique identifier for a User in the database
      title: UserId
    type_pre-encounter_coverages_v1_CoverageLevel:
      type: string
      enum:
      - EMPLOYEE_AND_CHILDREN
      - EMPLOYEE_ONLY
      - EMPLOYEE_AND_SPOUSE
      - FAMILY
      - INDIVIDUAL
      title: CoverageLevel
    type_pre-encounter_eligibilityChecks_v1_EligibilityResponse:
      $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheck'
      description: An object representing the data for an eligibility response.
      title: EligibilityResponse
    type_pre-encounter_coverages_v1_Address:
      type: object
      properties:
        address1:
          type: string
        address2:
          type: string
        city:
          type: string
        state:
          type: string
        postal_code:
          type: string
        country_code:
          type: string
        country_sub_division_code:
          type: string
      title: Address
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryRequest:
      type: object
      properties:
        provider:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryProvider'
        subscriber:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoverySubscriber'
        dependent:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryDependent'
        encounter:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryEncounter'
      required:
      - provider
      - subscriber
      description: An object representing the data for an insurance discovery request.
      title: InsuranceDiscoveryRequest
    type_pre-encounter_coverages_v1_ServiceCoverage:
      type: object
      properties:
        service_code:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ServiceTypeCode'
        in_network:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ServiceCoverageDetails'
        in_network_flat:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageDetails'
        out_of_network:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ServiceCoverageDetails'
        out_of_network_flat:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageDetails'
      required:
      - service_code
      title: ServiceCoverage
    type_pre-encounter_eligibilityChecks_v1_StediPayerItem:
      type: object
      properties:
        score:
          type: integer
        payer:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_StediPayer'
      required:
      - score
      - payer
      title: StediPayerItem
    type_pre-encounter_eligibilityChecks_v1_CobAddress:
      type: object
      properties:
        address_1:
          type: string
        address_2:
          type: string
        city:
          type: string
        state:
          type: string
          description: 'The US state or Canadian province code. Kept as a string rather than an enum because,

            per Stedi, payers may sometimes return non-compliant values.'
        postal_code:
          type: string
        country_code:
          type: string
        country_sub_division_code:
          type: string
      description: A patient's address as returned in a coordination of benefits response.
      title: CobAddress
    type_pre-encounter_eligibilityChecks_v1_PostEligibilityRecommendationRequest:
      type: object
      properties:
        eligibility_check_id:
          type: string
        patient:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendationPatientInfo'
        recommendation:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityRecommendationPayload'
      required:
      - eligibility_check_id
      - patient
      - recommendation
      title: PostEligibilityRecommendationRequest
    type_pre-encounter_eligibilityChecks_v1_CobResponseSubscriber:
      type: object
      properties:
        member_id:
          type: string
          description: The member ID for the subscriber's insurance policy.
        first_name:
          type: string
        last_name:
          type: string
        middle_name:
          type: string
        gender:
          type: string
          description: The subscriber's gender. Typically `F` - Female, `M` - Male, or `U` - Unknown.
        date_of_birth:
          type: string
        ssn:
          type: string
        group_number:
          type: string
          description: The group number associated with the subscriber's insurance policy.
        birth_sequence_number:
          type: string
          description: Birth order when there are multiple births associated with the provided birth date.
        address:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobAddress'
        aaa_errors:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails'
          description: AAA errors specifying reasons for rejection and recommended follow-up actions.
      description: Information about the primary policyholder for the insurance plan listed in the COB request.
      title: CobResponseSubscriber
    type_pre-encounter_eligibilityChecks_v1_VoteValue:
      type: string
      enum:
      - UPVOTE
      - DOWNVOTE
      description: Possible vote values for recommendation quality
      title: VoteValue
    type_pre-encounter_common_OrganizationId:
      type: string
      description: The unique identifier for an Organization in the database
      title: OrganizationId
    type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails:
      type: object
      properties:
        field?:
          type: string
        description?:
          type: string
        location?:
          type: string
        possibleResolutions?:
          type: string
        code?:
          type: string
        followupAction?:
          type: string
      description: This object is our fern representation of Stedi's EligbilityCheckError object from their API.
      title: EligibilityCheckErrorDetails
    type_pre-encounter_eligibilityChecks_v1_UserConfiguredPromptsRecommendationPayload:
      type: object
      properties:
        results:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_UserConfiguredPromptsResult'
          description: Array of results from all enabled user-configured prompts
      required:
      - results
      description: Payload for user-configured prompt recommendations from AI analysis
      title: UserConfiguredPromptsRecommendationPayload
    type_pre-encounter_eligibilityChecks_v1_StediPayer:
      type: object
      properties:
        stedi_id:
          type: string
        display_name:
          type: string
        primary_payer_id:
          type: string
        aliases:
          type: array
          items:
            type: string
        names:
          type: array
          items:
            type: string
        transaction_support:
          description: Any type
        employer_identification_numbers:
          type: array
          items:
            type: string
        payer_enrollment:
          description: Any type
        parent_payer_group:
          type: string
        coverage_types:
          type: array
          items:
            type: string
      required:
      - stedi_id
      - display_name
      - primary_payer_id
      - aliases
      - names
      - transaction_support
      title: StediPayer
    type_pre-encounter_eligibilityChecks_v1_CobDependent:
      type: object
      properties:
        first_name:
          type: string
          description: The dependent's first name.
        last_name:
          type: string
          description: The dependent's last name.
        date_of_birth:
          type: string
          description: The dependent's date of birth.
        ssn:
          type: string
          description: The dependent's Social Security Number (SSN).
      required:
      - first_name
      - last_name
      - date_of_birth
      description: 'A dependent for which you want to check coordination of benefits.

        If the dependent has their own member ID, include their information in the subscriber object instead.'
      title: CobDependent
    type_pre-encounter_eligibilityChecks_v1_CoordinationOfBenefitsRequest:
      type: object
      properties:
        trading_partner_service_id:
          type: string
          description: 'The Payer ID. Each check must be for a participating health plan for which the patient has coverage.

            Medicare and Medicare Advantage plans are not supported.'
        provider:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobProvider'
        subscriber:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobSubscriber'
        dependent:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobDependent'
        encounter:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobEncounter'
      required:
      - trading_partner_service_id
      - provider
      - subscriber
      - encounter
      description: An object representing the data for a coordination of benefits request.
      title: CoordinationOfBenefitsRequest
    type_pre-encounter_eligibilityChecks_v1_EligibilityCheckPage:
      type: object
      properties:
        next_page_token:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
        prev_page_token:
          $ref: '#/components/schemas/type_pre-encounter_common_PageToken'
        total:
          type: integer
        items:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheck'
      required:
      - total
      - items
      title: EligibilityCheckPage
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryGender:
      type: string
      enum:
      - M
      - F
      title: InsuranceDiscoveryGender
    type_pre-encounter_common_ErrorBase4xx:
      type: object
      properties:
        message:
          type: string
        data:
          description: Any type
      required:
      - message
      title: ErrorBase4xx
    type_pre-encounter_coverages_v1_ServiceTypeCode:
      type: string
      enum:
      - '1'
      - '2'
      - '3'
      - '4'
      - '5'
      - '6'
      - '7'
      - '8'
      - '9'
      - '10'
      - '11'
      - '12'
      - '13'
      - '14'
      - '15'
      - '16'
      - '17'
      - '18'
      - '19'
      - '20'
      - '21'
      - '22'
      - '23'
      - '24'
      - '25'
      - '26'
      - '27'
      - '28'
      - '30'
      - '32'
      - '33'
      - '34'
      - '35'
      - '36'
      - '37'
      - '38'
      - '39'
      - '40'
      - '41'
      - '42'
      - '43'
      - '44'
      - '45'
      - '46'
      - '47'
      - '48'
      - '49'
      - '50'
      - '51'
      - '52'
      - '53'
      - '54'
      - '55'
      - '56'
      - '57'
      - '58'
      - '59'
      - '60'
      - '61'
      - '62'
      - '63'
      - '64'
      - '65'
      - '66'
      - '67'
      - '68'
      - '69'
      - '70'
      - '71'
      - '72'
      - '73'
      - '74'
      - '75'
      - '76'
      - '77'
      - '78'
      - '79'
      - '80'
      - '81'
      - '82'
      - '83'
      - '84'
      - '85'
      - '86'
      - '87'
      - '88'
      - '89'
      - '90'
      - '91'
      - '92'
      - '93'
      - '94'
      - '95'
      - '96'
      - '97'
      - '98'
      - '99'
      - A0
      - A1
      - A2
      - A3
      - A4
      - A5
      - A6
      - A7
      - A8
      - A9
      - AA
      - AB
      - AC
      - AD
      - AE
      - AF
      - AG
      - AH
      - AI
      - AJ
      - AK
      - AL
      - AM
      - AN
      - AO
      - AQ
      - AR
      - B1
      - B2
      - B3
      - BA
      - BB
      - BC
      - BD
      - BE
      - BF
      - BG
      - BH
      - BI
      - BJ
      - BK
      - BL
      - BM
      - BN
      - BP
      - BQ
      - BR
      - BS
      - BT
      - BU
      - BV
      - BW
      - BX
      - BY
      - BZ
      - C1
      - CA
      - CB
      - CC
      - CD
      - CE
      - CF
      - CG
      - CH
      - CI
      - CJ
      - CK
      - CL
      - CM
      - CN
      - CO
      - CP
      - CQ
      - DG
      - DM
      - DS
      - GF
      - GN
      - GY
      - IC
      - MH
      - NI
      - 'ON'
      - PT
      - PU
      - RN
      - RT
      - TC
      - TN
      - UC
      description: Code identifying the type of service or benefit within a specific insurance policy (X12 008010 Element 1365)
      title: ServiceTypeCode
    type_pre-encounter_eligibilityChecks_v1_CobResponseProvider:
      type: object
      properties:
        provider_name:
          type: string
          description: The provider's last name. Applies to providers that are an individual.
        provider_first_name:
          type: string
          description: The provider's first name. Applies to providers that are an individual.
        provider_org_name:
          type: string
          description: The provider's organization name.
        npi:
          type: string
          description: The provider's National Provider Identifier (NPI).
        aaa_errors:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails'
          description: AAA errors specifying reasons for rejection and recommended follow-up actions.
      description: Information about the entity that submitted the original COB request.
      title: CobResponseProvider
    type_pre-encounter_common_VersionConflictErrorBody:
      type: object
      properties:
        message:
          type: string
        data:
          description: Any type
        latest_version:
          type: integer
      required:
      - message
      title: VersionConflictErrorBody
    type_pre-encounter_eligibilityChecks_v1_InsuranceDiscoveryProvider:
      type: object
      properties:
        npi:
          type: string
          description: The provider's National Provider Identifier (NPI).
      required:
      - npi
      description: Information about the provider requesting the insurance discovery check.
      title: InsuranceDiscoveryProvider
    type_pre-encounter_eligibilityChecks_v1_CobResponseDependent:
      type: object
      properties:
        member_id:
          type: string
          description: The member ID for the subscriber's insurance policy.
        first_name:
          type: string
        last_name:
          type: string
        middle_name:
          type: string
        gender:
          type: string
          description: The dependent's gender. Typically `F` - Female, `M` - Male, or `U` - Unknown.
        date_of_birth:
          type: string
        ssn:
          type: string
        group_number:
          type: string
          description: The group number associated with the subscriber's insurance policy.
        relation_to_subscriber:
          type: string
          description: The name of the relation_to_subscriber_code. For example, `Child` when the code is `19`.
        relation_to_subscriber_code:
          type: string
          description: 'The dependent''s relationship to the subscriber. For example `01` - Spouse, `19` - Child,

            `20` - Employee, `21` - Unknown, `39` - Organ Donor, `40` - Cadaver Donor,

            `53` - Life Partner, or `G8` - Other Relationship.'
        birth_sequence_number:
          type: string
          description: Birth order when there are multiple births associated with the provided birth date.
        address:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobAddress'
        aaa_errors:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails'
          description: AAA errors specifying reasons for rejection and recommended follow-up actions.
      description: Information about the dependent listed in the original COB request.
      title: CobResponseDependent
    type_pre-encounter_eligibilityChecks_v1_RequestCorrection:
      type: object
      properties:
        property:
          type: string
        request_value:
          type: string
        corrected_value:
          type: string
      required:
      - property
      - request_value
      - corrected_value
      title: RequestCorrection
    type_pre-encounter_coverages_v1_CoverageValue:
      type: object
      properties:
        family:
          type: number
          format: double
        individual:
          type: number
          format: double
        employeeAndSpouse:
          type: number
          format: double
        employeeAndChildren:
          type: number
          format: double
      title: CoverageValue
    type_pre-encounter_coverages_v1_ExpandedMemberInfo:
      type: object
      properties:
        member_id:
          type: string
        group_number:
          type: string
        first_name:
          type: string
        middle_name:
          type: string
        last_name:
          type: string
        date_of_birth:
          type: string
        gender:
          type: string
        address:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_Address'
      title: ExpandedMemberInfo
    type_pre-encounter_coverages_v1_NonCoveredDetail:
      type: object
      properties:
        type:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_BenefitType'
        coverageLevel:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageLevel'
        unit:
          $ref: '#/components/schemas/type_pre-encounter_coverages_v1_CoverageValueUnit'
        value:
          type: number
          format: double
        additional_notes:
          type: string
        service_type_codes:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_coverages_v1_ServiceTypeCode'
      required:
      - type
      - coverageLevel
      - unit
      - value
      title: NonCoveredDetail
    type_pre-encounter_eligibilityChecks_v1_CoordinationOfBenefitsResponse:
      type: object
      properties:
        provider:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobResponseProvider'
          description: Information about the provider who submitted the COB request.
        subscriber:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobResponseSubscriber'
          description: Information about the primary policyholder.
        dependent:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobResponseDependent'
          description: Information about the dependent listed in the COB request.
        payer:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobPayer'
          description: Information about the payer listed in the COB request.
        plan_date_information:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_CobPlanDateInformation'
          description: Date information for the plan.
        benefits_information:
          type: array
          items:
            description: Any type
          description: Raw passthrough of Stedi's benefits information (coverage, service types, related entities, etc.).
        errors:
          type: array
          items:
            $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_EligibilityCheckErrorDetails'
        coordination_of_benefits:
          $ref: '#/components/schemas/type_pre-encounter_eligibilityChecks_v1_Cob'
          description: Overview of the COB response including whether coverage overlap exists and payer primacy.
      description: An object representing the data for a coordination of benefits response.
      title: CoordinationOfBenefitsResponse
    type_pre-encounter_eligibilityChecks_v1_MedicareAdvantageRecommendationPayload:
      type: object
      properties:
        ma_benefit:
          description: Any type
        payer_id:
          type: string
        payer_name:
          type: string
        member_id:
          type: string
      description: An object representing the payload for a Medicare Advantage recommendation.
      title: MedicareAdvantageRecommendationPayload
  securitySchemes:
    OAuthScheme:
      type: http
      scheme: bearer
      description: OAuth 2.0 authentication