Opkit Eligibility Inquiries API

openapi: 3.0.1
info:
  title: Opkit Benefits Eligibility Inquiries API
  description: 'REST API for Opkit, an automated health insurance verification platform for telehealth companies and virtual medical practices. The API exposes eligibility inquiries, benefits, payers, patients, and webhooks. Requests are authenticated with a Bearer API key and all payloads are JSON over HTTPS.


    Provenance note: Opkit''s platform appears to have been decommissioned after the company was acqui-hired by 11x in late 2024, and the live documentation at docs.opkit.co and the API host api.opkit.co are no longer reachable. This specification is reconstructed from Opkit''s publicly described resource model (eligibility inquiries, benefits, payers, patients, webhooks; Bearer-key auth; base URL https://api.opkit.co/v1). Endpoint paths and object fields that could not be verified against live documentation are modeled conservatively along standard RESTful conventions and should be reconciled against authoritative Opkit documentation if it becomes available. No values are presented as guaranteed-accurate beyond the verified auth scheme and base URL.'
  contact:
    name: Opkit
    url: https://www.opkit.co
  version: '1.0'
servers:
- url: https://api.opkit.co/v1
  description: Opkit API v1 production base URL (host no longer resolving as of catalog date).
security:
- bearerAuth: []
tags:
- name: Eligibility Inquiries
  description: Create and retrieve real-time insurance eligibility inquiries.
paths:
  /eligibility-inquiries:
    get:
      operationId: listEligibilityInquiries
      tags:
      - Eligibility Inquiries
      summary: List eligibility inquiries
      description: Returns a paginated list of eligibility inquiries on the account.
      parameters:
      - $ref: '#/components/parameters/Limit'
      - $ref: '#/components/parameters/StartingAfter'
      responses:
        '200':
          description: A list of eligibility inquiries.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/EligibilityInquiryList'
        '401':
          $ref: '#/components/responses/Unauthorized'
    post:
      operationId: createEligibilityInquiry
      tags:
      - Eligibility Inquiries
      summary: Create an eligibility inquiry
      description: Submits a real-time insurance eligibility inquiry for a patient against a payer. Inquiries are resolved asynchronously; poll the inquiry or subscribe to a webhook to receive the completed result and benefits.
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/EligibilityInquiryCreateRequest'
      responses:
        '201':
          description: The created eligibility inquiry.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/EligibilityInquiry'
        '400':
          $ref: '#/components/responses/BadRequest'
        '401':
          $ref: '#/components/responses/Unauthorized'
  /eligibility-inquiries/{id}:
    get:
      operationId: getEligibilityInquiry
      tags:
      - Eligibility Inquiries
      summary: Retrieve an eligibility inquiry
      description: Retrieves a single eligibility inquiry, including its status and benefits when complete.
      parameters:
      - $ref: '#/components/parameters/PathId'
      responses:
        '200':
          description: The requested eligibility inquiry.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/EligibilityInquiry'
        '401':
          $ref: '#/components/responses/Unauthorized'
        '404':
          $ref: '#/components/responses/NotFound'
components:
  parameters:
    Limit:
      name: limit
      in: query
      required: false
      description: Maximum number of records to return per page.
      schema:
        type: integer
        minimum: 1
        maximum: 100
        default: 20
    PathId:
      name: id
      in: path
      required: true
      description: The unique identifier of the resource.
      schema:
        type: string
    StartingAfter:
      name: starting_after
      in: query
      required: false
      description: Cursor for pagination; the id of the last object on the previous page.
      schema:
        type: string
  schemas:
    EligibilityInquiry:
      type: object
      properties:
        id:
          type: string
        object:
          type: string
          example: eligibility_inquiry
        status:
          type: string
          description: Lifecycle status of the inquiry.
          enum:
          - pending
          - processing
          - completed
          - error
        patient_id:
          type: string
        payer_id:
          type: string
        member_id:
          type: string
        benefits:
          type: array
          description: Structured benefits, populated once the inquiry completes.
          items:
            $ref: '#/components/schemas/Benefit'
        created_at:
          type: string
          format: date-time
        completed_at:
          type: string
          format: date-time
          nullable: true
        metadata:
          type: object
          additionalProperties: true
    EligibilityInquiryCreateRequest:
      type: object
      required:
      - patient_id
      - payer_id
      properties:
        patient_id:
          type: string
          description: The id of the patient to verify.
        payer_id:
          type: string
          description: The id of the payer to verify coverage against.
        member_id:
          type: string
          description: The patient's member or subscriber identifier on the payer.
        service_type:
          type: string
          description: The benefit/service type to check (e.g. health benefit plan coverage).
        metadata:
          type: object
          additionalProperties: true
          description: Arbitrary key/value metadata to associate with the inquiry.
    EligibilityInquiryList:
      type: object
      properties:
        object:
          type: string
          example: list
        data:
          type: array
          items:
            $ref: '#/components/schemas/EligibilityInquiry'
        has_more:
          type: boolean
    Error:
      type: object
      properties:
        error:
          type: object
          properties:
            type:
              type: string
              description: A machine-readable error type.
            message:
              type: string
              description: A human-readable description of the error.
    Benefit:
      type: object
      properties:
        id:
          type: string
        object:
          type: string
          example: benefit
        eligibility_inquiry_id:
          type: string
        coverage_status:
          type: string
          description: Whether the plan is active.
          enum:
          - active
          - inactive
          - unknown
        network_status:
          type: string
          description: Whether the patient is in- or out-of-network.
          enum:
          - in_network
          - out_of_network
          - unknown
        plan_name:
          type: string
        copay:
          type: number
          nullable: true
        coinsurance:
          type: number
          nullable: true
        deductible:
          type: number
          nullable: true
        deductible_remaining:
          type: number
          nullable: true
        out_of_pocket_max:
          type: number
          nullable: true
  responses:
    Unauthorized:
      description: Authentication failed or the API key is missing or invalid.
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
    BadRequest:
      description: The request was malformed or failed validation.
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
    NotFound:
      description: The requested resource was not found.
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
      description: 'Provide your Opkit API key as a Bearer token in the Authorization header: `Authorization: Bearer YOUR_API_KEY`.'