GenHealth integration

Check Eligibility

Perform Check Eligibility through GenHealth.

View as Markdown

genhealth_check_eligibility

write

Inputs

preferred_portal
selectdynamic options
Preferred Portal
Optional selected identifier or value. Retrieve allowed values from the dynamic options endpoint.
Default: "auto"
jurisdiction
expression
Jurisdiction
Optional literal value or workflow expression.
Default: "C"
insurance_policy_id
expression
Insurance Policy Id
Optional literal value or workflow expression.
document_id
expression
Document Id
Optional literal value or workflow expression.
carrier_id
expression
Carrier Id
Optional literal value or workflow expression.
patient_first_name
expression
Patient First Name
Optional literal value or workflow expression.
patient_last_name
expression
Patient Last Name
Optional literal value or workflow expression.
patient_birth_date
date
Patient Birth Date
Optional date in YYYY-MM-DD format.
patient_state
expression
Patient State
Optional literal value or workflow expression.
patient_address
expression
Patient Address
Optional literal value or workflow expression.
medicare_id
expression
Medicare Id
Optional literal value or workflow expression.
member_id
expression
Member Id
Optional literal value or workflow expression.
group_id
expression
Group Id
Optional literal value or workflow expression.
provider_npi
expression
Provider Npi
Optional literal value or workflow expression.
provider_last_name
expression
Provider Last Name
Optional literal value or workflow expression.
provider_type
expression
Provider Type
Optional literal value or workflow expression.
place_of_service
expression
Place Of Service
Optional literal value or workflow expression.
as_of_date
date
As Of Date
Optional date in YYYY-MM-DD format.
source_service_date
date
Source Service Date
Optional date in YYYY-MM-DD format.
require_source_service_month_current
boolean
Require Source Service Month Current
Optional true-or-false value.
Default: false
source_service_month_timezone
text
Source Service Month Timezone
Optional text value.
service_types
expression
Service Types
Optional literal value or workflow expression.
service_type_mode
select
Service Type Mode
Optional selected identifier or value.
Options: Use carrier mapping/default (""), Explicit service types ("explicit"), All service types ("all")
include_availity_coverage_details
boolean
Include Availity Coverage Details
Optional true-or-false value.
Default: true
password_expiration_slack_channel
text
Password Expiration Slack Channel
Optional text value.
Default: "#feed-alerts"
service_type_descriptions
expression
Service Type Descriptions
Optional literal value or workflow expression.
coverage_basis
select
Coverage Basis
Optional selected identifier or value.
Default: "any"
Options: Any active coverage (default) ("any"), Medicare Part B only ("part_b")
fast_http_determination
boolean
Fast Http Determination
Optional true-or-false value.
Default: false
enabled
boolean
Enabled
Optional true-or-false value.
Default: true
skip_reason
expression
Skip Reason
Optional literal value or workflow expression.
generate_pdf
boolean
Generate Pdf
Optional true-or-false value.
Default: false
persist_generated_pdf
boolean
Persist Generated Pdf
Optional true-or-false value.
Default: false
show_generated_document_in_inbox
boolean
Show Generated Document In Inbox
Optional true-or-false value.
Default: false
generated_pdf_filename
expression
Generated Pdf Filename
Optional literal value or workflow expression.
generated_pdf_source
text
Generated Pdf Source
Optional text value.
Default: "eligibility"
generated_pdf_dedupe_key
expression
Generated Pdf Dedupe Key
Optional literal value or workflow expression.

Outputs

successSuccess
input_modeInput Mode
statusStatus
skippedSkipped
is_eligibleIs Eligible
transaction_completeTransaction Complete
requested_service_typesRequested Service Types
service_type_outcomeService Type Outcome
portalPortal
document_idDocument Id
insurance_policy_idInsurance Policy Id
carrier_idCarrier Id
coverage_idCoverage Id
pdf_pathPdf Path
coverage_detailsCoverage Details
normalized_coverage_detailsNormalized Coverage Details
coverage_start_dateCoverage Start Date
coverage_end_dateCoverage End Date
is_medicare_advantageIs Medicare Advantage
has_mspHas Msp
other_payersOther Payers
coordination_of_benefitsCoordination Of Benefits
settings_urlSettings Url
eligibility_responseEligibility Response
generated_pdf_successGenerated Pdf Success
generated_pdf_statusGenerated Pdf Status
generated_pdf_document_idGenerated Pdf Document Id
generated_pdf_titleGenerated Pdf Title
generated_pdf_document_typeGenerated Pdf Document Type
generated_pdf_s3_keyGenerated Pdf S3 Key
generated_pdf_s3_uriGenerated Pdf S3 Uri
generated_pdf_sha256Generated Pdf Sha256
generated_pdf_sizeGenerated Pdf Size
generated_pdf_filenameGenerated Pdf Filename
generated_pdf_sourceGenerated Pdf Source
generated_pdf_content_typeGenerated Pdf Content Type
generated_pdf_external_idGenerated Pdf External Id
generated_pdf_was_existingGenerated Pdf Was Existing
generated_pdf_errorGenerated Pdf Error
generated_pdf_error_messageGenerated Pdf Error Message
error_messageError Message
errorError

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",
  "properties": {
    "enabled": {
      "type": "boolean",
      "default": true,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "group_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "member_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"
    },
    "carrier_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "document_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "medicare_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "skip_reason": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "generate_pdf": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "jurisdiction": {
      "default": "C",
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "provider_npi": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "patient_state": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "provider_type": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_types": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "coverage_basis": {
      "enum": [
        "any",
        "part_b"
      ],
      "type": "string",
      "default": "any",
      "description": "Optional selected identifier or value.",
      "x-workflow-field-type": "select"
    },
    "patient_address": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "place_of_service": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "preferred_portal": {
      "type": "string",
      "default": "auto",
      "description": "Optional selected identifier or value. Retrieve allowed values from the dynamic options endpoint.",
      "x-dynamic-options": true,
      "x-workflow-field-type": "select"
    },
    "patient_last_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_type_mode": {
      "enum": [
        "",
        "explicit",
        "all"
      ],
      "type": "string",
      "description": "Optional selected identifier or value.",
      "x-workflow-field-type": "select"
    },
    "patient_birth_date": {
      "type": "string",
      "format": "date",
      "description": "Optional date in YYYY-MM-DD format.",
      "x-workflow-field-type": "date"
    },
    "patient_first_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "provider_last_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "insurance_policy_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "source_service_date": {
      "type": "string",
      "format": "date",
      "description": "Optional date in YYYY-MM-DD format.",
      "x-workflow-field-type": "date"
    },
    "generated_pdf_source": {
      "type": "string",
      "default": "eligibility",
      "description": "Optional text value.",
      "x-workflow-field-type": "text"
    },
    "persist_generated_pdf": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "generated_pdf_filename": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "fast_http_determination": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "generated_pdf_dedupe_key": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_type_descriptions": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "source_service_month_timezone": {
      "type": "string",
      "description": "Optional text value.",
      "x-workflow-field-type": "text"
    },
    "show_generated_document_in_inbox": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "include_availity_coverage_details": {
      "type": "boolean",
      "default": true,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "password_expiration_slack_channel": {
      "type": "string",
      "default": "#feed-alerts",
      "description": "Optional text value.",
      "x-workflow-field-type": "text"
    },
    "require_source_service_month_current": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    }
  },
  "additionalProperties": false
}

Output schema

{
  "type": "object",
  "properties": {
    "error": {},
    "portal": {},
    "status": {},
    "has_msp": {},
    "skipped": {},
    "success": {},
    "pdf_path": {},
    "carrier_id": {},
    "input_mode": {},
    "coverage_id": {},
    "document_id": {},
    "is_eligible": {},
    "other_payers": {},
    "settings_url": {},
    "error_message": {},
    "coverage_details": {},
    "coverage_end_date": {},
    "generated_pdf_size": {},
    "coverage_start_date": {},
    "generated_pdf_error": {},
    "generated_pdf_title": {},
    "insurance_policy_id": {},
    "eligibility_response": {},
    "generated_pdf_s3_key": {},
    "generated_pdf_s3_uri": {},
    "generated_pdf_sha256": {},
    "generated_pdf_source": {},
    "generated_pdf_status": {},
    "service_type_outcome": {},
    "transaction_complete": {},
    "generated_pdf_success": {},
    "is_medicare_advantage": {},
    "generated_pdf_filename": {},
    "requested_service_types": {},
    "coordination_of_benefits": {},
    "generated_pdf_document_id": {},
    "generated_pdf_external_id": {},
    "generated_pdf_content_type": {},
    "generated_pdf_was_existing": {},
    "generated_pdf_document_type": {},
    "generated_pdf_error_message": {},
    "normalized_coverage_details": {}
  },
  "additionalProperties": true
}

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