Eligible Payment Estimation API

The Payment Estimation API calculates expected patient out-of-pocket amounts for a service before it is rendered, combining benefit details from a coverage check with provider contracted rates and accumulators. The API helps providers offer transparent cost estimates and collect patient responsibility at the point of service.

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API entry from apis.yml

apis.yml Raw ↑
aid: eligible:payment-estimation
name: Eligible Payment Estimation API
description: The Payment Estimation API calculates expected patient out-of-pocket amounts for a service
  before it is rendered, combining benefit details from a coverage check with provider contracted rates
  and accumulators. The API helps providers offer transparent cost estimates and collect patient responsibility
  at the point of service.
humanURL: https://eligible.com/
baseURL: https://gds.eligibleapi.com/v1.5
tags:
- Payment Estimation
- Cost Transparency
- Healthcare
- Billing
properties:
- type: Documentation
  url: https://eligible.com/docs