Candid Health

Candid Health Payers API

The Payers API from Candid Health — 4 operation(s) for payers.

GitHub OpenAPI

Operations 4

GET /api/payers/v3/{payer_uuid} Get payer #
GET /api/payers/v3 Get all payers #
GET /api/payers/v4/{payer_uuid} Get payer #
GET /api/payers/v4 Get all payers #

Documentation

📖
Documentation
https://docs.joincandidhealth.com/api-reference/eligibility/v-2
📖
Documentation
https://docs.joincandidhealth.com/api-reference/encounters/v-4
📖
Documentation
https://docs.joincandidhealth.com/api-reference/encounters/v-4/get-all
📖
APIReference
https://docs.joincandidhealth.com/api-reference/encounters/v-4/create
📖
Documentation
https://docs.joincandidhealth.com/api-reference/eligibility/v-2/submit-eligibility-check
📖
APIReference
https://docs.joincandidhealth.com/api-reference/pre-encounter/coverages/v-1/check-eligibility
📖
Documentation
https://docs.joincandidhealth.com/api-reference/charge-capture/v-1/create
📖
Documentation
https://docs.joincandidhealth.com/api-reference/payers/v-3/get
📖
APIReference
https://docs.joincandidhealth.com/api-reference/fee-schedules/v-3/get-match
📖
Documentation
https://docs.joincandidhealth.com/api-reference/insurance-adjudications/v-1/get
📖
Documentation
https://docs.joincandidhealth.com/api-reference/events/v-1/get

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/candid-health/refs/heads/main/openapi/candid-health-payers-api-openapi.yml

Other Resources

🔗
PostmanCollection
https://raw.githubusercontent.com/api-evangelist/candid-health/refs/heads/main/collections/candidhealth.postman_collection.json
🔗
OpenCollection
https://raw.githubusercontent.com/api-evangelist/candid-health/refs/heads/main/collections/candidhealth.opencollection.json

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OpenAPI Specification

candid-health-payers-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Reference Payers API
  version: 1.0.0
servers:
- url: https://pre-api.joincandidhealth.com
  description: Production
- url: https://pre-api-staging.joincandidhealth.com
  description: Staging
- url: https://sandbox-pre-api.joincandidhealth.com
  description: CandidSandbox
- url: https://staging-pre-api.joincandidhealth.com
  description: CandidStaging
- url: http://localhost:4000
  description: Local
- url: https://api.joincandidhealth.com
  description: Production
- url: https://api-staging.joincandidhealth.com
  description: Staging
- url: https://sandbox-api.joincandidhealth.com
  description: CandidSandbox
- url: https://staging-api.joincandidhealth.com
  description: CandidStaging
- url: http://localhost:5050
  description: Local
tags:
- name: Payers
paths:
  /api/payers/v3/{payer_uuid}:
    get:
      operationId: get
      summary: Get payer
      tags:
      - Payers
      parameters:
      - name: payer_uuid
        in: path
        required: true
        schema:
          $ref: '#/components/schemas/type_payers_v3_PayerUuid'
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_payers_v3_Payer'
  /api/payers/v3:
    get:
      operationId: getAll
      summary: Get all payers
      tags:
      - Payers
      parameters:
      - name: limit
        in: query
        description: Maximum number of entities per page, defaults to 100.
        required: false
        schema:
          type: integer
      - name: search_term
        in: query
        required: false
        schema:
          type: string
      - name: page_token
        in: query
        required: false
        schema:
          $ref: '#/components/schemas/type_commons_PageToken'
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_payers_v3_PayerPage'
  /api/payers/v4/{payer_uuid}:
    get:
      operationId: getApiPayersV4ByPayerUuid
      summary: Get payer
      tags:
      - Payers
      parameters:
      - name: payer_uuid
        in: path
        required: true
        schema:
          $ref: '#/components/schemas/type_payers_v4_PayerUuid'
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_payers_v4_Payer'
      x-operation-id-source: normalized
      x-operation-id-original: get
  /api/payers/v4:
    get:
      operationId: getApiPayersV4
      summary: Get all payers
      tags:
      - Payers
      parameters:
      - name: limit
        in: query
        description: Maximum number of entities per page, defaults to 100.
        required: false
        schema:
          type: integer
      - name: search_term
        in: query
        required: false
        schema:
          type: string
      - name: page_token
        in: query
        required: false
        schema:
          $ref: '#/components/schemas/type_commons_PageToken'
      - name: Authorization
        in: header
        description: OAuth authentication
        required: true
        schema:
          type: string
      responses:
        '200':
          description: Response with status 200
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/type_payers_v4_PayerPage'
      x-operation-id-source: normalized
      x-operation-id-original: getAll
components:
  schemas:
    type_commons_PageToken:
      type: string
      title: PageToken
    type_payers_v4_PrimaryPayerIds:
      type: object
      properties:
        claims_payer_id:
          type: string
          description: The payer ID for claim submission
        eligibility_payer_id:
          type: string
          description: The payer ID for eligibility
        remittance_payer_id:
          type: string
          description: The payer ID for remittance
      required:
      - claims_payer_id
      title: PrimaryPayerIds
    type_payers_v4_PayerIds:
      type: object
      properties:
        claims_payer_id:
          type: string
          description: The payer ID for claim submission
        eligibility_payer_id:
          type: string
          description: The payer ID for eligibility
        remittance_payer_id:
          type: string
          description: The payer ID for remittance
      title: PayerIds
    type_payers_v4_SupportState:
      type: string
      enum:
      - NOT_SUPPORTED
      - SUPPORTED_ENROLLMENT_NOT_REQUIRED
      - SUPPORTED_ENROLLMENT_REQUIRED
      title: SupportState
    type_payers_v3_PayerPage:
      type: object
      properties:
        prev_page_token:
          $ref: '#/components/schemas/type_commons_PageToken'
        next_page_token:
          $ref: '#/components/schemas/type_commons_PageToken'
        items:
          type: array
          items:
            $ref: '#/components/schemas/type_payers_v3_Payer'
      required:
      - items
      title: PayerPage
    type_commons_StreetAddressLongZip:
      type: object
      properties:
        address1:
          type: string
        address2:
          type: string
        city:
          type: string
        state:
          $ref: '#/components/schemas/type_commons_State'
        zip_code:
          type: string
          description: 5-digit zip code
        zip_plus_four_code:
          type: string
          description: 4-digit zip add-on code https://en.wikipedia.org/wiki/ZIP_Code#ZIP+4
      required:
      - address1
      - city
      - state
      - zip_code
      - zip_plus_four_code
      title: StreetAddressLongZip
    type_payers_v4_Payer:
      type: object
      properties:
        payer_uuid:
          $ref: '#/components/schemas/type_payers_v4_PayerUuid'
          description: Auto-generated ID set on creation.
        payer_ids:
          $ref: '#/components/schemas/type_payers_v4_PrimaryPayerIds'
          description: The primary national payer IDs of the payer.
        payer_name:
          type: string
          description: The primary display name of the payer.
        payer_category:
          $ref: '#/components/schemas/type_payers_v4_PayerCategory'
          description: The category of the payer.
        alternate_payer_names:
          type: array
          items:
            type: string
          description: The alternate display names of the payer.
        clearinghouse_payer_info:
          type: object
          additionalProperties:
            $ref: '#/components/schemas/type_payers_v4_ClearinghousePayerInfo'
        street_address:
          $ref: '#/components/schemas/type_commons_StreetAddressLongZip'
        alternate_payer_addresses:
          type: array
          items:
            $ref: '#/components/schemas/type_commons_StreetAddressLongZip'
      required:
      - payer_uuid
      - payer_ids
      - payer_name
      - alternate_payer_names
      - clearinghouse_payer_info
      - alternate_payer_addresses
      title: Payer
    type_payers_v4_PayerUuid:
      type: string
      format: uuid
      title: PayerUuid
    type_payers_v3_Payer:
      type: object
      properties:
        payer_uuid:
          $ref: '#/components/schemas/type_payers_v3_PayerUuid'
          description: Auto-generated ID set on creation.
        payer_id:
          type: string
          description: The primary national payer ID of the payer.
        payer_name:
          type: string
          description: The primary display name of the payer.
        availity_payer_name:
          type: string
          description: The name of the payer as it appears in Availity.
        availity_claims_payer_id:
          type: string
          description: The ID of the payer as it appears in Availity.
        availity_eligibility_id:
          type: string
          description: The eligibility ID of the payer as it appears in Availity.
        availity_remittance_payer_id:
          type: string
          description: The remittance ID of the payer as it appears in Availity.
        street_address:
          $ref: '#/components/schemas/type_commons_StreetAddressLongZip'
      required:
      - payer_uuid
      - payer_id
      - payer_name
      title: Payer
    type_payers_v4_PayerPage:
      type: object
      properties:
        prev_page_token:
          $ref: '#/components/schemas/type_commons_PageToken'
        next_page_token:
          $ref: '#/components/schemas/type_commons_PageToken'
        items:
          type: array
          items:
            $ref: '#/components/schemas/type_payers_v4_Payer'
      required:
      - items
      title: PayerPage
    type_payers_v3_PayerUuid:
      type: string
      format: uuid
      title: PayerUuid
    type_commons_State:
      type: string
      enum:
      - AA
      - AE
      - AP
      - AL
      - AK
      - AS
      - AZ
      - AR
      - CA
      - CO
      - CT
      - DC
      - DE
      - FL
      - FM
      - GA
      - GU
      - HI
      - ID
      - IL
      - IN
      - IA
      - KS
      - KY
      - LA
      - ME
      - MD
      - MA
      - MH
      - MI
      - MN
      - MP
      - MS
      - MO
      - MT
      - NE
      - NV
      - NH
      - NJ
      - NM
      - NY
      - NC
      - ND
      - OH
      - OK
      - OR
      - PA
      - PR
      - PW
      - RI
      - SC
      - SD
      - TN
      - TX
      - UT
      - VI
      - VT
      - VA
      - WA
      - WV
      - WI
      - WY
      title: State
    type_payers_v4_ClearinghousePayerInfo:
      type: object
      properties:
        payer_name:
          type: string
          description: The clearinghouse display name of the payer.
        professional_payer_ids:
          $ref: '#/components/schemas/type_payers_v4_PayerIds'
          description: Payer IDs for professional claims
        institutional_payer_ids:
          $ref: '#/components/schemas/type_payers_v4_PayerIds'
          description: Payer IDs for institutional claims
        professional_claims_support:
          $ref: '#/components/schemas/type_payers_v4_SupportState'
          description: The support state for claims submission
        institutional_claims_support:
          $ref: '#/components/schemas/type_payers_v4_SupportState'
          description: The support state for institutional claims submission
        eligibility_support:
          $ref: '#/components/schemas/type_payers_v4_SupportState'
          description: The support state for eligibility
        remittance_support:
          $ref: '#/components/schemas/type_payers_v4_SupportState'
          description: The support state for remittance
        claim_attachment_support:
          $ref: '#/components/schemas/type_payers_v4_SupportState'
          description: The support state for claim attachment submission
      required:
      - payer_name
      - professional_payer_ids
      - institutional_payer_ids
      - professional_claims_support
      - institutional_claims_support
      - eligibility_support
      - remittance_support
      - claim_attachment_support
      title: ClearinghousePayerInfo
    type_payers_v4_PayerCategory:
      type: string
      enum:
      - BCBS
      - AETNA_AFFILIATED
      - CIGNA_AFFILIATED
      - UNITED_AFFILIATED
      - MEDICARE
      - NON_TRADITIONAL_MEDICARE
      - MEDICAID
      - HOSPICE
      - SNF
      - TRICARE
      - WORKERS_COMP
      - OTHER_GOVERNMENT
      - AUTO_TPL
      - LIEN
      - HUMANA
      - MOLINA
      - OTHER_FACILITY
      title: PayerCategory
  securitySchemes:
    OAuthScheme:
      type: http
      scheme: bearer
      description: OAuth 2.0 authentication