click-health-entity-example-succeeded
1ClickHealthEntity Example (succeeded)
{
"healthDataUuid": "9e12fe5b-5bb8-410a-ac6b-6e053e4c7e8d",
"externalReference": "appointment-1042",
"status": "SUCCEEDED",
"results": [
{
"memberId": "A484069",
"payer": {
"name": "Aetna",
"verifiedId": "V404110",
"ids": [
"60054", // ids[0] is considered primary
"HPQRS",
"Z95668",
"10004",
"953402799",
"6400",
"60054MA",
"4500",
"AETNA"
],
"logoUrl": "https://assets.verified.inc/1-click/health/payers/11145919-80e4-4cb0-8518-cffbf44ee9fb.png"
},
"verificationMethod": "clearinghouse",
"coverageTypes": ["medical"],
"serviceTypeCodes": ["30"],
"isMedicare": false,
"edi_271": ...,
"eligibility": {
"coverageStatus": "active",
"coverageType": ["medical"],
"serviceTypeCodes": ["30"],
"payer": {
"name": "Aetna",
},
"member": {
"memberId": "A484069",
"fullName": {
"firstName": "Richard",
"lastName": "Hendricks"
},
"birthDate": "1989-08-01",
"sex": "Male",
"address": {
"line1": "5320 Newell Rd",
"line2": "",
"city": "Palo Alto",
"state": "CA",
"zipCode": "94303"
}
},
"plan": {
"name": "Managed Choice Open Access",
"groupNumber": "123456-123-12345",
"groupName": "PiedPiper",
"insuranceTypeCodes": ["C1"],
"effectiveDate": "2026-01-01",
"terminationDate": "2026-12-31"
},
"benefits": [
{
"type": "deductible",
"serviceTypeCodes": ["30"],
"insuranceTypeCode": "C1",
"level": "individual",
"network": "in",
"amount": "1500.00",
"remaining": "750.00",
"percent": "0.20"
},
...
],
"contacts": [
{
"name": "Aetna Member Services",
"serviceTypeCodes": ["30"],
"phone": "8005550000",
"fax": "8005550001",
"email": "memberservices@aetna.com",
"url": "https://aetna.com/member-services"
},
...
]
},
"network": {
"status": "IN_NETWORK",
"rules": [
{
"uuid": "ab280ee0-5f66-4076-9d1b-255d5f0024e3",
"name": "Rule 1: Aetna | MA, NY, WA | PPO | Hooli Health | Pied Piper - INN",
"status": "IN_NETWORK",
"notes": "Requires manual review",
"metadata": {
"selfPay": false,
"priority": 1,
"packageId": "123456"
},
"startDate": "2026-10-01",
"endDate": "2027-10-01",
"conditions": [
{
"key": "payerId",
"operator": "EQUAL",
"values": ["V404110"]
},
{
"key": "payerName",
"operator": "INCLUDE",
"values": ["Aetna"]
},
{
"key": "state",
"operator": "EQUAL",
"values": ["MA", "NY", "WA"]
},
{
"key": "insuranceTypeCodes",
"operator": "INCLUDE",
"values": ["PR"]
},
{
"key": "planName",
"operator": "INCLUDE",
"values": ["PPO"]
},
{
"key": "relatedEntites",
"operator": "INCLUDE",
"values": ["Hooli Health"]
},
{
"key": "groupNumber",
"operator": "EQUAL",
"values": ["123456-123-12345"]
},
{
"key": "groupName",
"operator": "INCLUDE",
"values": ["Pied Piper"]
}
]
}
]
}
},
{
"memberId": "B231615071",
"payer": {
"name": "UnitedHealthcare",
"verifiedId": "V816685",
"ids": [
"87726", // ids[0] is considered primary
"KMQTZ",
"77082",
"J87726MA",
"10655",
"2721",
"87726MA",
"95123",
"11077",
"MDC01",
"10192",
"14339",
"3550",
"3429",
"UHC",
"10806",
"87726E",
"KPIC1",
"8455",
"4523",
"96107",
"NGHPRT",
"6442",
"WCHEA",
"10636",
"10002",
"72126",
"UHCMP",
"6847",
"JDHS"
],
"logoUrl": "https://assets.verified.inc/1-click/health/payers/ff5e124c-f19f-475c-9757-7fa011e5221a.png"
},
"verificationMethod": "clearinghouse",
"coverageTypes": ["medical"],
"serviceTypeCodes": ["30"],
"isMedicare": false,
"edi_271": ...,
"eligibility": {
"coverageStatus": "active",
"coverageType": ["medical"],
"serviceTypeCodes": ["30"],
"payer": {
"name": "UnitedHealthcare",
},
"member": {
"memberId": "B231615071",
"fullName": {
"firstName": "Richard",
"lastName": "Hendricks"
},
"birthDate": "1989-08-01",
"sex": "Male",
"address": {
"line1": "5320 Newell Rd",
"line2": "",
"city": "Palo Alto",
"state": "CA",
"zipCode": "94303"
}
},
"plan": {
"name": "Choice Plus",
"groupNumber": "1234567",
"groupName": "PiedPiper",
"insuranceTypeCodes": ["C1"],
"effectiveDate": "2026-01-01",
"terminationDate": "2026-12-31"
},
"benefits": [
{
"type": "deductible",
"serviceTypeCodes": ["30"],
"insuranceTypeCode": "C1",
"level": "individual",
"network": "in",
"amount": "1500.00",
"remaining": "750.00",
"percent": "0.20"
},
...
],
"contacts": [
{
"name": "UnitedHealthcare Member Services",
"serviceTypeCodes": ["30"],
"phone": "8005550002",
"fax": "8005550003",
"email": "memberservices@uhc.com",
"url": "https://uhc.com/member-services"
},
...
]
},
"network": {
"status": "OUT_OF_NETWORK",
"rules": [
{
"uuid": "ea703d40-a073-454e-ae3e-3931e8e2cf5a",
"name": "Rule 2: UnitedHealthcare | HMO | Hooli Health - OON",
"status": "OUT_OF_NETWORK",
"conditions": [
{
"key": "payerName",
"operator": "INCLUDE",
"values": ["UnitedHealthcare", "United Healthcare"]
},
{
"key": "insuranceTypeCodes",
"operator": "NOT_INCLUDE",
"values": ["HM"]
},
{
"key": "relatedEntites",
"operator": "INCLUDE",
"values": ["Hooli Health"]
}
]
}
]
}
}
]
}