Noridian integration

Check Eligibility

Perform Check Eligibility through Noridian.

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noridian_check_eligibility

writenoridian

Inputs

jurisdiction
select
Jurisdiction
Optional selected identifier or value.
Default: "A"
Options: Jurisdiction A ("A"), Jurisdiction D ("D")
member_id
expressionrequired
Member Id
Required literal value or workflow expression.
patient_last_name
expressionrequired
Patient Last Name
Required literal value or workflow expression.
patient_first_name
expression
Patient First Name
Optional literal value or workflow expression.
patient_birth_date
daterequired
Patient Birth Date
Required date in YYYY-MM-DD format.
patient_address
expression
Patient Address
Optional literal value or workflow expression.
in_region_states
expression
In Region States
Optional literal value or workflow expression.
service_start_date
date
Service Start Date
Optional date in YYYY-MM-DD format.
service_end_date
date
Service End Date
Optional date in YYYY-MM-DD format.
coverage_basis
select
Coverage Basis
Optional selected identifier or value.
Default: "any"
Options: Part A + Part B (default) ("any"), Medicare Part B only ("part_b")
suppress_stale_snf_flags
boolean
Suppress Stale Snf Flags
Optional true-or-false value.
Default: false
check_consolidated_billing
boolean
Check Consolidated Billing
Optional true-or-false value.
Default: false
consolidated_billing_hcpcs_codes
expression
Consolidated Billing Hcpcs Codes
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: "noridian_eligibility"
generated_pdf_dedupe_key
expression
Generated Pdf Dedupe Key
Optional literal value or workflow expression.

Outputs

successSuccess
statusStatus
failure_categoryFailure Category
is_eligibleIs Eligible
inactive_reasonInactive Reason
is_deceasedIs Deceased
flagsFlags
snf_most_recent_statusSnf Most Recent Status
snf_most_recent_status_categorySnf Most Recent Status Category
jurisdictionJurisdiction
medicare_programMedicare Program
part_aPart A
part_bPart B
part_b_deductiblePart B Deductible
ineligible_periodIneligible Period
same_or_similarSame Or Similar
consolidated_billingConsolidated Billing
has_home_health_bundledHas Home Health Bundled
has_hospice_consolidatedHas Hospice Consolidated
insurance_infoInsurance Info
patient_addressPatient Address
pdf_pathPdf Path
portalPortal
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
errorError
error_messageError Message

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_last_name",
    "patient_birth_date"
  ],
  "properties": {
    "member_id": {
      "description": "Required 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": {
      "enum": [
        "A",
        "D"
      ],
      "type": "string",
      "default": "A",
      "description": "Optional selected identifier or value.",
      "x-workflow-field-type": "select"
    },
    "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"
    },
    "in_region_states": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_end_date": {
      "type": "string",
      "format": "date",
      "description": "Optional date in YYYY-MM-DD format.",
      "x-workflow-field-type": "date"
    },
    "patient_last_name": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "patient_birth_date": {
      "type": "string",
      "format": "date",
      "description": "Required 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"
    },
    "service_start_date": {
      "type": "string",
      "format": "date",
      "description": "Optional date in YYYY-MM-DD format.",
      "x-workflow-field-type": "date"
    },
    "generated_pdf_source": {
      "type": "string",
      "default": "noridian_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"
    },
    "generated_pdf_dedupe_key": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "suppress_stale_snf_flags": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "check_consolidated_billing": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "consolidated_billing_hcpcs_codes": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "show_generated_document_in_inbox": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    }
  },
  "additionalProperties": false
}

Output schema

{
  "type": "object",
  "properties": {
    "error": {},
    "flags": {},
    "part_a": {},
    "part_b": {},
    "portal": {},
    "status": {},
    "success": {},
    "pdf_path": {},
    "is_deceased": {},
    "is_eligible": {},
    "jurisdiction": {},
    "error_message": {},
    "insurance_info": {},
    "inactive_reason": {},
    "patient_address": {},
    "same_or_similar": {},
    "failure_category": {},
    "medicare_program": {},
    "ineligible_period": {},
    "part_b_deductible": {},
    "generated_pdf_size": {},
    "generated_pdf_error": {},
    "generated_pdf_title": {},
    "consolidated_billing": {},
    "generated_pdf_s3_key": {},
    "generated_pdf_s3_uri": {},
    "generated_pdf_sha256": {},
    "generated_pdf_source": {},
    "generated_pdf_status": {},
    "generated_pdf_success": {},
    "generated_pdf_filename": {},
    "snf_most_recent_status": {},
    "has_home_health_bundled": {},
    "has_hospice_consolidated": {},
    "generated_pdf_document_id": {},
    "generated_pdf_external_id": {},
    "generated_pdf_content_type": {},
    "generated_pdf_was_existing": {},
    "generated_pdf_document_type": {},
    "generated_pdf_error_message": {},
    "snf_most_recent_status_category": {}
  },
  "additionalProperties": true
}

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