United Healthcare integration

Check Eligibility

Perform Check Eligibility through United Healthcare.

View as Markdown

uhc_check_eligibility

writeunited_healthcare_portal

Inputs

member_id
expressionrequired
Member Id
Required literal value or workflow expression.
date_of_birth
expressionrequired
Date Of Birth
Required literal value or workflow expression.
service_start_date
expression
Service Start Date
Optional literal value or workflow expression.
service_end_date
expression
Service End Date
Optional literal value or workflow expression.
payer_id
expressionrequired
Payer Id
Required literal value or workflow expression.
payer_name
expression
Payer Name
Optional literal value or workflow expression.
Default: "UnitedHealthcare"
include_dme
boolean
Include Dme
Optional true-or-false value.
Default: true
generate_pdf
boolean
Generate 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

Outputs

successSuccess
errorError
failure_categoryFailure Category
exception_typeException Type
safe_error_codesSafe Error Codes
customer_messageCustomer Message
payer_rejection_reasonPayer Rejection Reason
payer_rejection_categoryPayer Rejection Category
is_coverage_data_issueIs Coverage Data Issue
insurance_infoInsurance Info
prior_authPrior Auth
prior_auth_issuerPrior Auth Issuer
deductiblesDeductibles
out_of_pocketOut Of Pocket
dmeDme
transaction_idTransaction Id
policy_idPolicy Id
pdf_pathPdf Path
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_document_s3_uriGenerated Pdf Document 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

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",
    "date_of_birth",
    "payer_id"
  ],
  "properties": {
    "payer_id": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "member_id": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "payer_name": {
      "default": "UnitedHealthcare",
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "include_dme": {
      "type": "boolean",
      "default": true,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "generate_pdf": {
      "type": "boolean",
      "default": false,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "date_of_birth": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_end_date": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_start_date": {
      "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": {
    "dme": {},
    "error": {},
    "success": {},
    "pdf_path": {},
    "policy_id": {},
    "prior_auth": {},
    "deductibles": {},
    "out_of_pocket": {},
    "exception_type": {},
    "insurance_info": {},
    "transaction_id": {},
    "customer_message": {},
    "failure_category": {},
    "safe_error_codes": {},
    "prior_auth_issuer": {},
    "generated_pdf_size": {},
    "generated_pdf_error": {},
    "generated_pdf_title": {},
    "generated_pdf_s3_key": {},
    "generated_pdf_s3_uri": {},
    "generated_pdf_sha256": {},
    "generated_pdf_source": {},
    "generated_pdf_status": {},
    "generated_pdf_success": {},
    "generated_pdf_filename": {},
    "is_coverage_data_issue": {},
    "payer_rejection_reason": {},
    "payer_rejection_category": {},
    "generated_pdf_document_id": {},
    "generated_pdf_external_id": {},
    "generated_pdf_content_type": {},
    "generated_pdf_was_existing": {},
    "generated_pdf_document_type": {},
    "generated_pdf_error_message": {},
    "generated_pdf_document_s3_uri": {}
  },
  "additionalProperties": true
}

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