Response Overview
Both the search and check endpoints should return the same response payload, and should be structured as JSON objects containing the following three core properties:
matchFound
The matchFound property should return a true/false value indicating if a patient match was found, and whether that patient is eligible for 98point6 services. If a non-eligible patient was found, this value should be returned as false and the members property should return an empty array.
canDisambiguate
The canDisambiguate property should return a true/false value indicating whether multiple matches were found that be used to narrow down additional information such as:
if value is
true, no member information should be returned.if there are one or more matches:
a result of
trueshould indicate that we could further reduce or confirm those matches by providing an additional piece of disambiguating information (email,last4Ssn, etc).a result of
falseshould indicate that even though there are multiple potential matches, there is no further information that could be provided to further narrow the results. No data should be returned in themembersproperty.
If there is exactly one match, a result of
falseindicates that results have been found and should be returned in themembersproperty.
Scenarios
Scenario | matchFound | canDisambiguate | members |
|---|---|---|---|
initial search call, single match | true | true | return members property upon secondary search call |
initial search call, no match | false | false | do not return members property |
initial search call, multiple matches | true | true | return members property upon secondary search call |
initial search call, multiple matches, cannot narrow | true | false | do not return members property |
Members
The members property should return an array containing a matched patient and all associated dependents. The preferred shape of the objects contained inside of this array is as described below:
If a call was made to the API providing only
firstName,lastName, andbirthDate, this array should be empty, even if matches were found. This array should only be populated with results when a definitive match has been found using the appropriate disambiguating fieldemail,last4Ssn, etc.This array should include entries for the primary member’s coverage and all dependents (both adult and minor), for whom the matched patient has medical access. Note that the service implementing this API will determine which primaries can access specific, minor dependents.
If the matched patient is an adult dependent of another member, this array should have entries for that member and any minor dependents they have access to. It should not contain an entry for the primary member.
In the event that a patient has coverage from multiple sources (e.g. from both their own employer and a spouse’s employer), the rank property on the member info field must be filled out according to the priority of coverage. For instance, the lower the number, the higher the priority.