# GenHealth - Eligibility integration

> Build workflow automations with 27 public GenHealth - Eligibility actions.

Source: [https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility)

## Available actions

27 actions. Connection types: None required.

### [Admit VOB Retry Candidates](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_admit_vob_retry_candidates.md)

- Handler: `eligibility_admit_vob_retry_candidates`

- External effect: `write`
- Inputs: `candidates`, `enforce_backoff`, `max_retry_attempts`, `backoff_minutes`
- Outputs: `success`, `status`, `candidates`, `processing_candidate_count`, `retry_deferred_count`, `retry_exhausted_count`, `terminal_unchanged_count`, `sheet_handoff_resume_count`, `retry_history`, `deferred_items`, `exhausted_items`, `exhausted_handoff`, `terminal_unchanged_items`, `error`

Perform Admit VOB Retry Candidates through GenHealth - Eligibility.

### [Aggregate VOB Benefits](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_aggregate_vob_benefits.md)

- Handler: `eligibility_aggregate_vob_benefits`

- External effect: `write`
- Inputs: `primary_summary`, `dme_purchase_submission`, `dme_purchase_summary`, `dme_purchase_service_type`, `dme_rental_submission`, `dme_rental_summary`, `dme_rental_service_type`, `office_visit_submission`, `office_visit_summary`, `office_visit_service_type`, `sleep_study_submission`, `sleep_study_summary`, `sleep_study_service_type`
- Outputs: `success`, `coverage_summary`, `vob_fields`, `vob_field_sources`, `vob_field_provenance`, `service_probe_summaries`, `probe_reference_numbers`, `manual_review_required`, `manual_review_reason`, `field_conflicts`, `error`

Perform Aggregate VOB Benefits through GenHealth - Eligibility.

### [Evaluate DME Eligibility Policy](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_evaluate_dme_policy.md)

- Handler: `eligibility_evaluate_dme_policy`

- External effect: `write`
- Inputs: `phase`, `niko_patient_id`, `niko_order_id`, `niko_order_display_id`, `source_types`, `service_type`, `patient_insurance`, `order_insurance`, `insurance_id`, `niko_insurance_status`, `patient`, `patient_insurances`, `payer_key`, `benefit_summary`, `niko_eligibility`, `patient_notes`, `current_order`, `current_order_items`, `patient_orders`, `dry_run`
- Outputs: `success`, `phase`, `status`, `reason`, `case_key`, `service_type`, `payer_key`, `patient_insurance`, `order_insurance`, `insurance_id`, `requires_eligibility_check`, `dry_run`, `side_effects_enabled`, `side_effects_ready`, `niko_eligibility_request`, `benefit_summary_ready`, `benefit_summary`, `upfront_fee`, `installment_details`, `final_summary_text`, `self_pay_note_text`, `network_status`, `network_status_detail`, `patient_note_request`, `task_request`, `patient_tag_request`, `order_tag_request`, `required_side_effects`, `missing_side_effect_settings`, `diagnostics`, `error`, `error_message`

Perform Evaluate DME Eligibility Policy through GenHealth - Eligibility.

### [Evaluate Sleep VOB Evidence](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_evaluate_sleep_vob_evidence.md)

- Handler: `eligibility_evaluate_sleep_vob_evidence`

- External effect: `write`
- Inputs: `general_check`, `sleep_check`, `general_summary`, `sleep_summary`
- Outputs: `success`, `error`, `failure_category`, `write_evidence`, `reason`, `coverage_status`, `manual_review_required`, `manual_review_reasons`, `field_values`, `allowed_field_link_names`, `withheld_field_link_names`, `report_title`

Perform Evaluate Sleep VOB Evidence through GenHealth - Eligibility.

### [Evaluate VOB Outcome](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_evaluate_vob_outcome.md)

- Handler: `eligibility_evaluate_vob_outcome`

- External effect: `write`
- Inputs: `primary_outcome`, `fallback_outcome`, `portal_outcome`, `fallback_guard`, `portal_context`, `candidate`, `patient_resolution_failed`
- Outputs: `success`, `status`, `category`, `resolution`, `public_conclusion`, `terminal`, `retry`, `documentable`, `submitted`, `report_available`, `reason`, `source`, `insurance_source`, `attempt_history`, `fallback_attempted`, `payer_conflict`, `member_id_conflict`, `insurance_discrepancy`, `discrepancy_message`, `report_document_id`, `report_s3_path`, `report_pdf_path`, `error`, `error_message`

Perform Evaluate VOB Outcome through GenHealth - Eligibility.

### [Guard athenahealth VOB Reconciliation](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_guard_athena_vob_reconciliation.md)

- Handler: `eligibility_guard_athena_vob_reconciliation`

- External effect: `write`
- Inputs: `candidate`, `read_enabled`
- Outputs: `success`, `should_read`, `status`, `reasons`, `candidate_athena_id`, `patient_id`, `chart_id`, `source`, `error`

Perform Guard athenahealth VOB Reconciliation through GenHealth - Eligibility.

### [Guard athenahealth VOB Writeback](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_guard_athena_vob_writeback.md)

- Handler: `eligibility_guard_athena_vob_writeback`

- External effect: `write`
- Inputs: `candidate`, `outcome`, `note`, `athena_reconciliation`, `external_writes_enabled`, `writeback_enabled`, `signature`
- Outputs: `success`, `should_write`, `should_upload_documents`, `write_kind`, `append_signature`, `status`, `reasons`, `patient_id`, `chart_id`, `note_text`, `subject`, `source`, `error`

Perform Guard athenahealth VOB Writeback through GenHealth - Eligibility.

### [Guard Availity VOB Submission](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_guard_availity_vob_submission.md)

- Handler: `eligibility_guard_availity_vob_submission`

- External effect: `write`
- Inputs: `candidate`, `athena_payer_reconciliation`, `loop_index`, `submit_enabled`, `max_live_transactions`, `max_live_submissions`, `primary_transactions_per_candidate`, `max_transactions_per_candidate`, `allowed_row_numbers`, `require_row_allowlist`, `require_athena_payer_match`
- Outputs: `success`, `should_submit`, `status`, `reasons`, `source`, `transaction_budget_required`, `availity_params`, `attempt`, `error`

Perform Guard Availity VOB Submission through GenHealth - Eligibility.

### [Guard Fallback VOB Submission](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_guard_vob_fallback_submission.md)

- Handler: `eligibility_guard_vob_fallback_submission`

- External effect: `write`
- Inputs: `candidate`, `athena_payer_reconciliation`, `primary_guard`, `primary_outcome`, `loop_index`, `submit_enabled`, `max_live_transactions`, `max_live_submissions`, `max_transactions_per_candidate`, `allowed_row_numbers`, `require_row_allowlist`
- Outputs: `success`, `should_submit`, `status`, `reasons`, `source`, `transaction_budget_required`, `availity_params`, `probe_plan`, `attempt`, `payer_conflict`, `member_id_conflict`, `error`

Perform Guard Fallback VOB Submission through GenHealth - Eligibility.

### [Guard Primary VOB Submission](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_guard_vob_primary_submission.md)

- Handler: `eligibility_guard_vob_primary_submission`

- External effect: `write`
- Inputs: `candidate`, `loop_index`, `submit_enabled`, `max_live_transactions`, `max_live_submissions`, `primary_transactions_per_candidate`, `max_transactions_per_candidate`, `allowed_row_numbers`, `require_row_allowlist`, `uhc_submit_enabled`
- Outputs: `success`, `should_submit`, `status`, `reasons`, `source`, `transaction_budget_required`, `portal`, `availity_params`, `uhc_params`, `probe_plan`, `attempt`, `error`

Perform Guard Primary VOB Submission through GenHealth - Eligibility.

### [Guard VOB Sheet Fallback](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_guard_vob_sheet_fallback.md)

- Handler: `eligibility_guard_vob_sheet_fallback`

- External effect: `write`
- Inputs: `candidate`, `primary_guard`, `primary_outcome`, `loop_index`, `submit_enabled`, `max_live_transactions`, `max_live_submissions`, `max_transactions_per_candidate`, `allowed_row_numbers`, `require_row_allowlist`
- Outputs: `success`, `should_submit`, `status`, `reasons`, `source`, `transaction_budget_required`, `availity_params`, `attempt`, `payer_conflict`, `member_id_conflict`, `error`

Perform Guard VOB Sheet Fallback through GenHealth - Eligibility.

### [Normalize DME Benefit Summary](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_normalize_dme_benefits.md)

- Handler: `eligibility_normalize_dme_benefits`

- External effect: `write`
- Inputs: `eligibility_result`, `service_type`, `target_fields`, `use_prompt`
- Outputs: `success`, `benefit_summary_ready`, `benefit_summary`, `missing_fields`, `diagnostics`, `error`, `error_message`

Perform Normalize DME Benefit Summary through GenHealth - Eligibility.

### [Normalize VOB Attempt](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_normalize_vob_attempt.md)

- Handler: `eligibility_normalize_vob_attempt`

- External effect: `write`
- Inputs: `candidate`, `not_submitted`, `submission_failure`, `submission`, `eligibility_summary`, `report`, `report_failure`, `service_probe_failures`, `attempt`
- Outputs: `success`, `status`, `category`, `submitted`, `terminal`, `retry`, `vob_fields`, `report_document_id`, `error`

Perform Normalize VOB Attempt through GenHealth - Eligibility.

### [Prepare Eligibility Delivery Digest](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/prepare_eligibility_delivery_digest.md)

- Handler: `prepare_eligibility_delivery_digest`

- External effect: `write`
- Inputs: `source_workflow_definition_id`, `report_day`, `timezone`, `auto_rollover_hour`, `require_terminal_source_population`
- Outputs: `success`, `error`, `failure_category`, `preconditions_ok`, `delivery_cutover_proven`, `delivery_start_day`, `source_workflow_definition_id`, `collector_scope_proven`, `calculation_integrity_ok`, `source_population_terminal_required`, `source_population_terminal`, `source_window_closed`, `report_day`, `report_day_us`, `processed_count`, `successful_report_count`, `active_count`, `inactive_count`, `no_definitive_answer_count`, `candidate_count`, `status_19_candidate_count`, `status_19_subscriber_insured_not_found_count`, `status_19_invalid_missing_subscriber_insured_name_count`, `status_19_invalid_missing_subscriber_insured_id_count`, `definitive_missing_pdf_count`, `identity_conflict_count`, `active_inactive_conflict_count`, `document_identity_conflict_count`, `manual_evidence_error_count`, `manual_review_missing_order_number_count`, `status_19_missing_order_number_count`, `status_19_multi_category_count`, `status_19_qualifier_evidence_error_count`, `failure_reasons`, `review_reasons`, `review_excluded_count`, `report_day_candidate_count`, `report_day_status_19_candidate_count`, `already_delivered_count`, `status_19_already_delivered_count`, `delivery_unresolved_count`, `email_items`, `status_19_email_items`

Perform Prepare Eligibility Delivery Digest through GenHealth - Eligibility.

### [Prepare VOB Note](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_prepare_vob_note.md)

- Handler: `eligibility_prepare_vob_note`

- External effect: `write`
- Inputs: `candidate`, `outcome`, `subject`
- Outputs: `success`, `status`, `reason`, `note_kind`, `subject`, `note_text`, `source`, `athena`, `error`, `error_message`

Perform Prepare VOB Note through GenHealth - Eligibility.

### [Prepare VOB Review Payload](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_prepare_vob_review_payload.md)

- Handler: `eligibility_prepare_vob_review_payload`

- External effect: `write`
- Inputs: `candidate`
- Outputs: `success`, `status`, `reason`, `source`, `routing`, `payer_resolution`, `redacted_availity_params`, `error`, `error_message`

Perform Prepare VOB Review Payload through GenHealth - Eligibility.

### [Prepare VOB Sheet Writeback](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_prepare_vob_sheet_writeback.md)

- Handler: `eligibility_prepare_vob_sheet_writeback`

- External effect: `write`
- Inputs: `candidate`, `outcome`, `patient_resolution_failure`, `athena_case`, `athena_attachment`, `external_writes_enabled`, `writeback_enabled`, `completed_team_assignment`
- Outputs: `success`, `should_write`, `status`, `primary_reason`, `reasons`, `source`, `spreadsheet_id`, `status_note`, `expected_data`, `data`, `error`, `error_message`

Perform Prepare VOB Sheet Writeback through GenHealth - Eligibility.

### [Prepare Zoho VOB Scalar Guard](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_prepare_zoho_vob_scalar_guard.md)

- Handler: `eligibility_prepare_zoho_vob_scalar_guard`

- External effect: `write`
- Inputs: `expected_field_values`, `uploaded_field_link_name`, `uploaded_file_name`
- Outputs: `success`, `error`, `failure_category`, `expected_field_values`

Perform Prepare Zoho VOB Scalar Guard through GenHealth - Eligibility.

### [Prepare Zoho VOB Subject](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_prepare_zoho_vob_subject.md)

- Handler: `eligibility_prepare_zoho_vob_subject`

- External effect: `write`
- Inputs: `record_id`, `record_link_id`, `values`
- Outputs: `success`, `error`, `failure_category`, `can_submit`, `reason`, `record_id`, `record_link_id`, `payer_label`, `member_id`, `patient_first_name`, `patient_middle_name`, `patient_last_name`, `patient_birth_date`, `subscriber_relationship`, `expected_field_values`

Perform Prepare Zoho VOB Subject through GenHealth - Eligibility.

### [Reconcile athenahealth VOB Payer](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_reconcile_athena_vob_payer.md)

- Handler: `eligibility_reconcile_athena_vob_payer`

- External effect: `write`
- Inputs: `candidate`, `athena_reconciliation`, `selected_policy`, `athena_payer_resolution`, `require_match`, `manual_review_payer_terms`
- Outputs: `success`, `status`, `should_allow_availity`, `payer_match`, `reasons`, `selected_policy`, `resolved_availity_payer`, `source`, `error`

Perform Reconcile athenahealth VOB Payer through GenHealth - Eligibility.

### [Resolve Portal Payer](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_resolve_portal_payer.md)

- Handler: `eligibility_resolve_portal_payer`

- External effect: `read`
- Inputs: `portal`, `source_payer_label`, `source_payer_id`
- Outputs: `success`, `status`, `can_submit`, `portal`, `source_label`, `normalized_label`, `source_payer_id`, `payer_id`, `payer_name`, `payer_aliases`, `supported_service_types`, `reason`, `error`, `error_message`

Perform Resolve Portal Payer through GenHealth - Eligibility.

### [Resolve VOB Run Controls](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_resolve_vob_run_controls.md)

- Handler: `eligibility_resolve_vob_run_controls`

- External effect: `read`
- Inputs: `trigger`, `automatic_processing_enabled`, `default_spreadsheet_id`, `default_max_candidates`, `default_vob_assignment_value`, `default_team_assignment_values`, `default_max_retry_attempts`, `default_retry_backoff_minutes`, `default_uhc_automatic_processing_enabled`
- Outputs: `success`, `status`, `run_mode`, `automatic_processing_enabled`, `automatic_run`, `spreadsheet_id`, `max_candidates`, `candidate_row_numbers`, `vob_assignment_value`, `team_assignment_values`, `allow_unassigned_vob_rows_for_allowlist`, `athena_reconciliation_enabled`, `availity_submit_enabled`, `uhc_submit_enabled`, `enabled_eligibility_portals`, `max_live_availity_submissions`, `candidate_processing_enabled`, `max_live_availity_candidates`, `max_live_availity_transactions`, `availity_primary_transactions_per_candidate`, `availity_max_transactions_per_candidate`, `allowed_availity_row_numbers`, `require_availity_row_allowlist`, `require_athena_payer_match`, `athena_writeback_enabled`, `google_sheets_writeback_enabled`, `external_writes_enabled`, `writes_locked`, `max_retry_attempts`, `retry_backoff_minutes`, `retry_backoff_enforced`, `retry_backoff_overridden`, `error`

Perform Resolve VOB Run Controls through GenHealth - Eligibility.

### [Select athenahealth VOB Policy](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_select_athena_vob_policy.md)

- Handler: `eligibility_select_athena_vob_policy`

- External effect: `write`
- Inputs: `candidate`, `athena_insurance`
- Outputs: `success`, `selected_policy`, `selection_reason`, `top_priority_policy_count`, `sheet_disambiguated`, `patient_id`, `chart_id`, `athena`, `error`

Perform Select athenahealth VOB Policy through GenHealth - Eligibility.

### [Select DME VOB Candidates](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_select_dme_vob_candidates.md)

- Handler: `eligibility_select_dme_vob_candidates`

- External effect: `write`
- Inputs: `value_ranges`, `spreadsheet_id`, `as_of_date`, `vob_assignment_value`, `team_assignment_values`, `max_candidates`, `candidate_row_numbers`, `allow_unassigned_vob_rows_for_allowlist`, `additional_assignment_scopes`, `enabled_eligibility_portals`
- Outputs: `success`, `candidates`, `candidate_count`, `manual_review_rows`, `manual_review_count`, `manual_review_handoff`, `portal_held_rows`, `portal_held_count`, `skipped_rows`, `skipped_count`, `diagnostics`, `error`, `error_message`

Perform Select DME VOB Candidates through GenHealth - Eligibility.

### [Select VOB Processing Candidates](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_select_vob_processing_candidates.md)

- Handler: `eligibility_select_vob_processing_candidates`

- External effect: `write`
- Inputs: `candidates`, `processing_enabled`, `availity_submit_enabled`, `max_live_availity_candidates`, `enabled_eligibility_portals`
- Outputs: `success`, `status`, `processing_candidate_count`, `portal_held_candidate_count`, `budget_limited_candidate_count`, `candidates`, `error`

Perform Select VOB Processing Candidates through GenHealth - Eligibility.

### [Select Zoho VOB Candidates](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_select_zoho_vob_candidates.md)

- Handler: `eligibility_select_zoho_vob_candidates`

- External effect: `write`
- Inputs: `records`, `max_candidates`, `record_link_ids`
- Outputs: `success`, `error`, `failure_category`, `candidates`, `decisions`, `candidate_count`, `review_count`, `skipped_count`, `truncated_count`

Perform Select Zoho VOB Candidates through GenHealth - Eligibility.

### [Summarize VOB Batch](https://genhealth.ai/docs/workflows/integrations/gen-health-eligibility/eligibility_summarize_vob_batch.md)

- Handler: `eligibility_summarize_vob_batch`

- External effect: `write`
- Inputs: `loop_results`, `candidate_count`, `processing_status`, `processing_candidate_count`, `manual_review_count`, `skipped_count`, `portal_held_count`, `selector_diagnostics`, `availity_transaction_budget`, `retry_deferred_count`, `retry_exhausted_count`, `terminal_unchanged_count`, `retry_history`, `max_retry_attempts`
- Outputs: `success`, `status`, `candidate_count`, `processing_candidate_count`, `manual_review_count`, `portal_held_count`, `reportable_activity_count`, `should_report_activity`, `failed_review_payload_count`, `recovered_branch_failure_count`, `recovered_fallback_outcome_count`, `availity_submission_count`, `availity_submission_failed_count`, `availity_recovered_submission_count`, `availity_transaction_attempt_count`, `eligibility_transaction_attempt_count`, `uhc_transaction_attempt_count`, `uhc_submission_count`, `uhc_submission_failed_count`, `uhc_report_count`, `availity_transaction_budget_remaining`, `retry_deferred_count`, `retry_exhausted_count`, `terminal_unchanged_count`, `retry_newly_exhausted_count`, `retry_newly_exhausted_items`, `retry_newly_exhausted_handoff`, `error_message`, `verified_availity_outcome_count`, `retry_availity_outcome_count`, `terminal_failure_availity_outcome_count`, `athena_writeback_count`, `google_sheets_writeback_count`

Perform Summarize VOB Batch through GenHealth - Eligibility.