The most common use case for the Sohar Health API is to determine the eligibility status and healthcare benefits for a patient. In this tutorial we will create a verification request in your sandbox environment.

The easiest way to get started is to make a request to the Create Verifications API. The sandbox environment has a number of input values to generate pre-defined responses. We will make a sandbox request to Aetna using payer ID 60054.

1

Credentials

Locate your sandbox API key from the Sohar Health dashboard.

2

Request

Execute the request below, replacing <authorization> with your sandbox API key and {npi} with a valid NPI.

curl --request POST \
	--url https://api.soharhealth.com/v1/verifications/batch \
	--header 'Authorization: <authorization>' \
	--header 'Content-Type: application/json' \
	--data '{
		"verifications": [
			{
				"firstName": "John",
				"lastName": "Doe",
				"dateOfBirth": "09/20/2006",
				"state": "CA",
				"memberId": "00000000",
				"payerId": "60054",
				"id": "12345",
				"npi": {npi}
			}
		]
	}'
3

Response

The API response contains the IDs for the patient resource and verification resource that were created.

{
	"results":
	[
		{
			"patientId": "579d8605-7596-45e3-bc1e-3db2a8669116",
			"verificationId": "b213a377-744c-4c8b-b5db-be8955c187c0",
			"id": "12345",
			"status": 201
		}
	]
}
4

Webhooks

Our system processes requests asynchronously, and results are delivered via webhook. Once the verification request has completed, the sandbox.verification.updated webhook event will be sent with the following payload:

{
	"patientId": "579d8605-7596-45e3-bc1e-3db2a8669116",
	"verificationId": "b213a377-744c-4c8b-b5db-be8955c187c0",
	"id": "12345",
	"status": "complete.eligible",
	...
}
5

Get Verification

Call the Get Verification API, replacing <authorization> with your sandbox API key and {verificationId} with the verificationId from the webhook event payload.

curl --request GET \
	--url https://api.soharhealth.com/v1/verifications/{verificationId} \
	--header 'Authorization: <authorization>'
6

Benefits

The Get Verification API will return a response similar to the response below:

{
	"timestamp": "2024-05-23T08:24:20.000Z",
	"verificationId": "b213a377-744c-4c8b-b5db-be8955c187c0",
	"patientId": "579d8605-7596-45e3-bc1e-3db2a8669116",
	"id": "12345",
	"status": "complete.eligible",
	"memberId": "00000000",
	"payerId": "60054",
	"payerName": "Aetna",
	"planName": "Open Access Aetna Select",
	"insuranceTypeCode": "HM",
	"groupNumber": "123456",
	"groupName": "Acme Corporation",
	"coverageStartDate": "01/01/2023",
	"coverageEndDate": "12/31/9999",
	"benefits": [
		{
			"copay": 0,
			"coinsurance": 0.2,
			"totalDeductible": 5000,
			"remainingDeductible": 5000,
			"outOfPocket": 20000,
			"outOfPocketRemaining": 12564.98,
			"networkStatus": "inn",
			"tier": 1,
			"coverageLevelCode": "IND"
		},
		{
			"copay": 0,
			"coinsurance": 0.4,
			"totalDeductible": 5000,
			"remainingDeductible": 5000,
			"outOfPocket": 20000,
			"outOfPocketRemaining": 12564.98,
			"networkStatus": "inn",
			"tier": 2,
			"coverageLevelCode": "IND"
		},
		{
			"copay": null,
			"coinsurance": 1,
			"totalDeductible": null,
			"remainingDeductible": null,
			"outOfPocket": null,
			"outOfPocketRemaining": null,
			"networkStatus": "oon",
			"tier": null,
			"coverageLevelCode": null
		}
	],
	"relatedEntities": [
		{
			"payerId": "01260",
			"payerName": "Magellan Healthcare",
			"memberId": "000000"
		}
	],
	"patient": {
		"firstName": "John",
		"lastName": "Doe",
		"dateOfBirth": "09/20/2006",
		"address": "1 STREET, PHOENIX, AZ 90210",
		"state": "AZ"
	},
	"subscriber": {
		"firstName": "John",
		"lastName": "Doe"
	}
}

You have successfully created your first verification!

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