GenHealth - Eligibility integration

Prepare Reviewed VOB Benefits

Perform Prepare Reviewed VOB Benefits through GenHealth - Eligibility.

View as Markdown

eligibility_prepare_reviewed_vob_benefits

write

Inputs

record_id
expression
Record Id
Optional literal value or workflow expression.
record_link_id
expression
Record Link Id
Optional literal value or workflow expression.
payer_id
expression
Payer Id
Optional literal value or workflow expression.
payer_name
expression
Payer Name
Optional literal value or workflow expression.
member_id
expressionrequired
Member Id
Required literal value or workflow expression.
patient_first_name
expressionrequired
Patient First Name
Required literal value or workflow expression.
patient_middle_name
expression
Patient Middle Name
Optional literal value or workflow expression.
patient_last_name
expressionrequired
Patient Last Name
Required literal value or workflow expression.
patient_birth_date
expressionrequired
Patient Birth Date
Required literal value or workflow expression.
subscriber_relationship
expression
Subscriber Relationship
Optional literal value or workflow expression.
general_coverage_id
expressionrequired
General Coverage Id
Required literal value or workflow expression.
pre_test_coverage_id
expression
Pre Test Coverage Id
Optional literal value or workflow expression.
sleep_coverage_id
expression
Sleep Coverage Id
Optional literal value or workflow expression.
post_test_coverage_id
expression
Post Test Coverage Id
Optional literal value or workflow expression.
as_of_date
date
As Of Date
Optional date in YYYY-MM-DD format.
rates
json
Rates
Optional JSON value.
reviewed_document_rules
json
Reviewed Document Rules
Optional JSON value.
reviewed_cost_share_rules
json
Reviewed Cost Share Rules
Optional JSON value.
card
json
Card
Optional JSON value.
automatic_write_enabled
boolean
Automatic Write Enabled
Optional true-or-false value.
Default: false

Outputs

successSuccess
errorError
failure_categoryFailure Category
statusStatus
write_evidenceWrite Evidence
reasonReason
field_valuesField Values
allowed_field_link_namesAllowed Field Link Names
withheld_field_link_namesWithheld Field Link Names
fallback_servicesFallback Services
model_callsModel Calls
source_hashesSource Hashes
request_sha256Request Sha256
preparation_sha256Preparation Sha256
estimate_sha256Estimate Sha256
note_sha256Note Sha256
report_titleReport Title

Output schema completeness: best_effort_declared

Safety

External effect: write
Confirmation recommended: No
Retry safe: No
Dry run supported: No

Schemas

These schemas are first-pass authoring guidance. Runtime validation remains authoritative.

Input schema

{
  "type": "object",
  "required": [
    "member_id",
    "patient_first_name",
    "patient_last_name",
    "patient_birth_date",
    "general_coverage_id"
  ],
  "properties": {
    "card": {
      "description": "Optional JSON value.",
      "x-workflow-field-type": "json"
    },
    "rates": {
      "description": "Optional JSON value.",
      "x-workflow-field-type": "json"
    },
    "payer_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "member_id": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "record_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "as_of_date": {
      "type": "string",
      "format": "date",
      "description": "Optional date in YYYY-MM-DD format.",
      "x-workflow-field-type": "date"
    },
    "payer_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "record_link_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "patient_last_name": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "sleep_coverage_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "patient_birth_date": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "patient_first_name": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "general_coverage_id": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "patient_middle_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "pre_test_coverage_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "post_test_coverage_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "automatic_write_enabled": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "reviewed_document_rules": {
      "description": "Optional JSON value.",
      "x-workflow-field-type": "json"
    },
    "subscriber_relationship": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "reviewed_cost_share_rules": {
      "description": "Optional JSON value.",
      "x-workflow-field-type": "json"
    }
  },
  "additionalProperties": false
}

Output schema

{
  "type": "object",
  "properties": {
    "error": {},
    "reason": {},
    "status": {},
    "success": {},
    "model_calls": {},
    "note_sha256": {},
    "field_values": {},
    "report_title": {},
    "source_hashes": {},
    "request_sha256": {},
    "write_evidence": {},
    "estimate_sha256": {},
    "failure_category": {},
    "fallback_services": {},
    "preparation_sha256": {},
    "allowed_field_link_names": {},
    "withheld_field_link_names": {}
  },
  "additionalProperties": true
}

View all GenHealth - Eligibility actions