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A payer is the insurance organization responsible for adjudicating a patient’s benefits. In Sohar, payers are represented by a stable payerId and a human-friendly payerName. You can retrieve the payer list with Get Payers and look up a specific payer with Get Payer.

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Payer IDs and aliases

Payer IDs are the identifiers Sohar expects in API requests. If an input payer is incorrect, Sohar may resolve it to the correct payer and return the corrected payerId and payerName in the response. Some payers also have alias IDs and alias names; these are alternative identifiers and payer names used by other systems that map to the same payer in Sohar. The Get Payers and Get Payer APIs return these as aliasPayerIds and aliasPayerNames.

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Group Payers

Group Payers are a Sohar concept that roll up related payer IDs under a single parent grouping. This is useful when a payer operates multiple regional plans, product lines, or legacy brands that you want to manage together. Each Group Payer has a Group ID, listed in the Sohar dashboard in the Payers view. For example, the Group ID for Medicaid is SH03D959. Pass a Group ID as the payerId value when calling the Create Verification V2 API. Sohar uses the patient’s member ID and state to select a payer within the group. If the group cannot be resolved, the API returns 400 Bad Request for payerId.
  • Use Group Payers when the patient indicates a broad payer (for example “Medicaid”) but the regional payer is unclear.
  • When available, prefer a specific payerId for the patient’s coverage to avoid ambiguity.
If you need help mapping payer IDs to a Group Payer, reach out to Sohar support.