Vyne Dental

Vyne Dental Eligibility and Benefits API (Onederful)

Real-time and asynchronous dental eligibility and benefits checks (JSON, HTML and EDI 271 responses), enhanced/ClearCoverage eligibility, async status and response retrieval, and OAuth2 token issuance. 17 paths published by Vyne Dental at production.onederful.co/swagger.json.

GitHub OpenAPI

Operations 1

POST /eligibility Create eligibility #

Documentation

📖
Documentation
https://developers.onederful.co/documentation/
📖
APIReference
https://production.onederful.co/api-docs/

Specifications

⚙
OpenAPI
https://artifacts.apis.io/vynedental/openapi/vynedental-eligibility-api-openapi.yml
⚙
OpenAPI
https://production.onederful.co/swagger.json

Schemas & Data

📊
JSONSchema
https://artifacts.apis.io/vynedental/json-schema/vynedental-partial-benefit-type-schema.json
📊
JSONSchema
https://artifacts.apis.io/vynedental/json-schema/vynedental-benefit-type-schema.json
📊
JSONSchema
https://artifacts.apis.io/vynedental/json-schema/vynedental-ebgeneric-benefit-type-schema.json
📊
JSONSchema
https://artifacts.apis.io/vynedental/json-schema/vynedental-rules-type-schema.json
📊
JSONSchema
https://artifacts.apis.io/vynedental/json-schema/vynedental-plan-type-schema.json
📊
JSONSchema
https://artifacts.apis.io/vynedental/json-schema/vynedental-patient-type-schema.json

Other Resources

🔗
APIsJSON
https://artifacts.apis.io/vynedental/apis.yml

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OpenAPI Specification

vynedental-eligibility-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Documentation Eligibility API
  version: 1.0.0
servers: []
tags:
- name: Eligibility
paths:
  /eligibility:
    post:
      requestBody:
        content:
          application/json:
            schema:
              anyOf:
              - type: object
                properties:
                  provider:
                    type: object
                    properties:
                      npi:
                        type: string
                        minLength: 10
                        maxLength: 10
                      tax_id:
                        type: string
                        minLength: 9
                        maxLength: 9
                      network:
                        type: string
                      payer_specific_description:
                        type: string
                      gender:
                        type: string
                        enum:
                        - M
                        - F
                        - U
                      first_name:
                        type: string
                      last_name:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                    required:
                    - npi
                  payer:
                    type: object
                    properties:
                      id:
                        type: string
                      name:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                    required:
                    - id
                  procedure_codes:
                    type: array
                    items:
                      type: string
                  version:
                    type: string
                  location_id:
                    type: string
                  options:
                    type: object
                    properties:
                      status_classifier:
                        type: boolean
                    required:
                    - status_classifier
                  response_structure:
                    allOf:
                    - $ref: '#/components/schemas/ClearCoverageStructureEnumInput'
                  subscriber:
                    type: object
                    properties:
                      first_name:
                        type: string
                      last_name:
                        type: string
                      gender:
                        allOf:
                        - $ref: '#/components/schemas/GenderEnumInput'
                      group_number:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                      dob:
                        type: string
                      member_id:
                        type: string
                        minLength: 2
                    required:
                    - dob
                  dependent:
                    type:
                    - string
                    - 'null'
                    enum:
                    - null
                required:
                - provider
                - payer
                - subscriber
              - type: object
                properties:
                  provider:
                    type: object
                    properties:
                      npi:
                        type: string
                        minLength: 10
                        maxLength: 10
                      tax_id:
                        type: string
                        minLength: 9
                        maxLength: 9
                      network:
                        type: string
                      payer_specific_description:
                        type: string
                      gender:
                        type: string
                        enum:
                        - M
                        - F
                        - U
                      first_name:
                        type: string
                      last_name:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                    required:
                    - npi
                  payer:
                    type: object
                    properties:
                      id:
                        type: string
                      name:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                    required:
                    - id
                  procedure_codes:
                    type: array
                    items:
                      type: string
                  version:
                    type: string
                  location_id:
                    type: string
                  options:
                    type: object
                    properties:
                      status_classifier:
                        type: boolean
                    required:
                    - status_classifier
                  response_structure:
                    allOf:
                    - $ref: '#/components/schemas/ClearCoverageStructureEnumInput'
                  subscriber:
                    type:
                    - object
                    - 'null'
                    properties:
                      first_name:
                        type: string
                      last_name:
                        type: string
                      gender:
                        allOf:
                        - $ref: '#/components/schemas/GenderEnumInput'
                      group_number:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                      dob:
                        type: string
                      member_id:
                        type: string
                        minLength: 2
                  dependent:
                    type: object
                    properties:
                      first_name:
                        type: string
                      last_name:
                        type: string
                      gender:
                        allOf:
                        - $ref: '#/components/schemas/GenderEnumInput'
                      group_number:
                        type: string
                      address_line_one:
                        type: string
                      address_line_two:
                        type:
                        - string
                        - 'null'
                      city:
                        type: string
                      state:
                        type: string
                      zip_code:
                        type: string
                      dob:
                        type: string
                      member_id:
                        type: string
                        minLength: 2
                      relationship_to_insured:
                        type: string
                    required:
                    - dob
                required:
                - provider
                - payer
                - dependent
      security:
      - BearerAuth: []
      responses:
        '200':
          description: Default Response
          content:
            application/json:
              schema:
                type: object
                properties:
                  active_coverage:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  benefit_computed:
                    allOf:
                    - $ref: '#/components/schemas/EBBenefitComputedType'
                  coinsurance:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  coinsurance_computed:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  copayment:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  coverage:
                    allOf:
                    - $ref: '#/components/schemas/EBCoverageType'
                  deductible:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  deductible_computed:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBBenefitAmountRemaining'
                  dependents:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBPatientType'
                  disclaimers:
                    type: array
                    items:
                      type: string
                  effective_dates:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBEffectivePeriod'
                  limitations:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  maximum_computed:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBBenefitAmountRemaining'
                  maximums:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  metadata:
                    allOf:
                    - $ref: '#/components/schemas/EBMetadataType'
                  network_options_computed:
                    type: array
                    items:
                      type: string
                  not_covered:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  onederfulId:
                    type: string
                  out_of_pocket:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  patient:
                    allOf:
                    - $ref: '#/components/schemas/EBPatientType'
                  patient_computed:
                    allOf:
                    - $ref: '#/components/schemas/EBPatientType'
                  payer:
                    allOf:
                    - $ref: '#/components/schemas/EBPayerType'
                  payer_specific_info:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  payer_uuid:
                    type: string
                  plan:
                    allOf:
                    - $ref: '#/components/schemas/EBPlanType'
                  procedure_code_computed:
                    allOf:
                    - $ref: '#/components/schemas/EBProcedureCodeComputedType'
                  procedure_code_list_computed:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBProcedureCodeComputedType'
                  provider:
                    allOf:
                    - $ref: '#/components/schemas/EBProviderType'
                  subscriber:
                    allOf:
                    - $ref: '#/components/schemas/EBPatientType'
                  waiting_period:
                    type: array
                    items:
                      $ref: '#/components/schemas/EBGenericBenefitType'
                  status_code:
                    type:
                    - string
                    - 'null'
                  status_description:
                    type:
                    - string
                    - 'null'
                additionalProperties: false
        '400':
          description: Default Response
          content:
            application/json:
              schema:
                type: object
                properties:
                  onederfulId:
                    type: string
                    format: uuid
                    pattern: ^([0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[1-8][0-9a-fA-F]{3}-[89abAB][0-9a-fA-F]{3}-[0-9a-fA-F]{12}|00000000-0000-0000-0000-000000000000|ffffffff-ffff-ffff-ffff-ffffffffffff)$
                  code:
                    type: string
                  message:
                    type: string
                  primaryReason:
                    type: string
                  errors:
                    type: array
                    items:
                      type: object
                      properties: {}
                      additionalProperties: false
                  status_code:
                    type:
                    - string
                    - 'null'
                  status_description:
                    type:
                    - string
                    - 'null'
                required:
                - onederfulId
                - code
                - message
                - primaryReason
                - errors
                additionalProperties: false
      tags:
      - Eligibility
      summary: Create eligibility
      x-summary-source: derived
      operationId: postEligibility
      x-operation-id-source: derived
components:
  schemas:
    EBAgeLimit:
      type: object
      properties:
        age_high_value:
          type: string
        age_low_value:
          type: string
      additionalProperties: false
    EBProcedureCodeComputedType:
      type: object
      properties:
        category:
          type: string
        category_service:
          type: string
        disclaimers:
          type: array
          items:
            type: string
        disclaimers_string:
          type: string
        eligibility_details:
          type: array
          items:
            $ref: '#/components/schemas/EBEligibilityDetails'
        is_covered:
          type: boolean
        limitation:
          type: string
        limitation_applies_to:
          type: array
          items:
            type: string
        limitation_applies_to_string:
          type: string
        percent_computed:
          type: string
        searched_procedure_code:
          type: string
        service_dates:
          type: array
          items:
            $ref: '#/components/schemas/EBServiceHistoryType'
        service_dates_string:
          type: string
        service_type:
          type: string
        services_remaining:
          type: number
      additionalProperties: false
    ClearCoverageStructureEnumInput:
      type: string
      enum:
      - CLEAR_COVERAGE_V1
      - CLEAR_COVERAGE_V2
    EBBenefitAmountRemaining:
      type: object
      properties:
        amount:
          type: string
        category:
          type: string
        coverage_level:
          allOf:
          - $ref: '#/components/schemas/EBCoverageLevelEnum'
        key:
          type: string
        network:
          type: string
        plan_period:
          allOf:
          - $ref: '#/components/schemas/EBPlanPeriodEnum'
        remaining:
          type: string
        service_type:
          type: string
        used:
          type: string
      additionalProperties: false
    EBEffectivePeriod:
      type: object
      properties:
        category:
          type: string
        effective_date:
          type: string
        is_a_waiting_period:
          type: boolean
        network:
          type: string
        service_type:
          type: string
      additionalProperties: false
    GenderEnumInput:
      type: string
      enum:
      - FEMALE
      - MALE
      - UNKNOWN
    EBMetadataType:
      type: object
      properties:
        dependent_age_limit:
          type: string
        student_age_limit:
          type: string
      additionalProperties: false
    EBEligibilityDetails:
      type: object
      properties:
        date:
          type: string
        eligibility:
          type: string
        location:
          type: string
      additionalProperties: false
    EBPlanType:
      type: object
      properties:
        group_name:
          type: string
        group_number:
          type: string
        metadata:
          type: array
          items:
            $ref: '#/components/schemas/EBPlanMetadataType'
        name:
          type: string
        number:
          type: string
        period:
          type: string
        state:
          type: string
        type:
          type: string
        payer_plan_name:
          type: string
        payer_plan_identifier:
          type: string
        insurance_type:
          type: string
      additionalProperties: false
    EBPatientTypeMetadata:
      type: object
      properties:
        type:
          type: string
        value:
          type: string
      additionalProperties: false
    EBGenericBenefitType:
      type: object
      properties:
        age_limit:
          allOf:
          - $ref: '#/components/schemas/EBAgeLimit'
        amount:
          type: string
        applies_to_deductible:
          type: boolean
        category:
          type: string
        coverage_level:
          allOf:
          - $ref: '#/components/schemas/EBCoverageLevelEnum'
        disclaimers:
          type: array
          items:
            type: string
        does_deductible_apply_to_basic:
          type: boolean
        does_deductible_apply_to_preventive:
          type: boolean
        eligibility_details:
          type: array
          items:
            $ref: '#/components/schemas/EBEligibilityDetails'
        health_service_descriptions:
          type: array
          items:
            $ref: '#/components/schemas/EBGenericHSDType'
        insurance_type:
          type: string
        limitation:
          type: string
        limitation_applies_to:
          type: array
          items:
            type: string
        metadata:
          type: array
          items:
            $ref: '#/components/schemas/EBPlanMetadataType'
        network:
          type: string
        payer_specific_description:
          type: string
        percent:
          type: string
        plan_period:
          allOf:
          - $ref: '#/components/schemas/EBPlanPeriodEnum'
        procedure_code:
          type: string
        quantity:
          type: string
        quantity_qualifier:
          type: string
        references:
          type: array
          items:
            $ref: '#/components/schemas/EBReferenceType'
        service_dates:
          type: array
          items:
            $ref: '#/components/schemas/EBServiceHistoryType'
        service_type:
          type: string
        services_remaining:
          type: number
        supported_procedure_codes:
          type: array
          items:
            type: string
      additionalProperties: false
    EBPayerType:
      type: object
      properties:
        claim_address:
          allOf:
          - $ref: '#/components/schemas/EBAddressType'
        id:
          type: string
        name:
          type: string
        phone:
          type: string
      additionalProperties: false
    EBProviderType:
      type: object
      properties:
        first_name:
          type: string
        last_name:
          type: string
        npi:
          type: string
        organization_name:
          type: string
        tax_id:
          type: string
      additionalProperties: false
    EBReferenceType:
      type: object
      properties:
        description:
          type: string
        reference_qualifier:
          type: string
        reference_value:
          type: string
      additionalProperties: false
    EBPlanPeriodEnum:
      type: string
      enum:
      - calendar
      - contract
      - lifetime
      - lifetime_remaining
      - lifetime_used
      - plan
      - policy
      - remaining
      - service
      - unknown
      - used
      - year_to_date
    EBCoverageLevelEnum:
      type: string
      enum:
      - children_only
      - dependents_only
      - employee_and_children
      - employee_and_spouse
      - employee_only
      - family
      - individual
      - spouse_and_children
      - spouse_only
      - unknown
    EBServiceHistoryType:
      type: object
      properties:
        category:
          type: string
        procedure_code:
          type: string
        service_date:
          type: string
        service_type:
          type: string
        tooth_code:
          type: string
        tooth_range:
          type: string
        tooth_surfaces:
          type: string
        type:
          type: string
        value:
          type: string
      additionalProperties: false
    EBGenericHSDType:
      type: object
      properties:
        delivery_frequency:
          type: string
        delivery_pattern_time:
          type: string
        quantity:
          type: string
        quantity_qualifier:
          type: string
        time_period_qualifier:
          type: string
        time_period_value:
          type: string
        unit:
          type: string
        unit_qualifier:
          type: string
      additionalProperties: false
    EBPlanMetadataType:
      type: object
      properties:
        description:
          type: string
        qualifier:
          type: string
        value:
          type: string
      additionalProperties: false
    EBCoverageType:
      type: object
      properties:
        effective_date:
          type: string
        end_date:
          type: string
        start_date:
          type: string
        status:
          type: string
          enum:
          - active
          - inactive
          - terminated
          - unknown
      additionalProperties: false
    EBAddressType:
      type: object
      properties:
        city:
          type: string
        state:
          type: string
        street1:
          type: string
        street2:
          type: string
        zip:
          type: string
      additionalProperties: false
    EBPatientType:
      type: object
      properties:
        address:
          allOf:
          - $ref: '#/components/schemas/EBAddressType'
        age:
          type: string
        coverage:
          allOf:
          - $ref: '#/components/schemas/EBCoverageType'
        dob:
          type: string
        first_name:
          type: string
        gender:
          type: string
        is_subscriber:
          type: boolean
        last_name:
          type: string
        member_id:
          type: string
        metadata:
          type: array
          items:
            $ref: '#/components/schemas/EBPatientTypeMetadata'
        middle_name:
          type: string
        name:
          type: string
        relationship:
          type: string
      additionalProperties: false
    EBBenefitComputedType:
      type: object
      properties:
        amount:
          type: string
        percent:
          type: string
      additionalProperties: false
  securitySchemes:
    BearerAuth:
      type: http
      scheme: bearer
      bearerFormat: JWT
x-provenance:
  method: harvested
  publisher: Vyne Dental
  source: https://production.onederful.co/swagger.json
  note: split by refine-openapis from the provider's own published document, verified by fetch (openapi/_original/*.fetch.json);
    stamped by stamp-openapi-provenance.py (roadmap#793)