Retrieve a patient’s insurance coverage

Care coordination

If you want to access a patient’s insurance coverage—as recorded by a specific organization—you can use this API action to retrieve insurance data.

Typically, you can use this for:

  • identifying the insurance plan information for billing purposes; or
  • finding out whether a patient is registered for SelfPay (e.g., for worker’s compensation or uninsured patients).

Action Steps

  • 1 Retrieve a patient's insurance coverage Required

Refer to the resource schema for more details.

View resource schema

Query Parameter Required Notes
beneficiary You must include at least one identifier for the patient that's used by the EHR system you're querying. If you don't have a patient identifier, you can find one by Search for a patient with demographics.

Explore Use Cases

Care coordination

Ensure the patient record is comprehensive, and care handoffs are effective.

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