UnitedHealthcare · JSON Structure

Provider Benefit Check Request Structure

Request for patient-specific benefit and cost-sharing check

Type: object Properties: 0
Health InsuranceHealthcareFHIRClaimsEligibility

UnitedHealthcare Benefit Check Request is a JSON Structure definition published by UnitedHealthcare. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Meta-schema: https://json-structure.org/meta/core/v0/#

JSON Structure

Raw ↑ 
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-structure/provider-benefit-check-request-structure.json",
  "name": "UnitedHealthcare Benefit Check Request",
  "type": "object",
  "description": "Request for patient-specific benefit and cost-sharing check",
  "fields": [
    {
      "name": "memberId",
      "type": "string",
      "description": "Member ID"
    },
    {
      "name": "dateOfBirth",
      "type": "date",
      "description": "Date of birth"
    },
    {
      "name": "serviceCode",
      "type": "string",
      "description": "CPT/HCPCS service code"
    },
    {
      "name": "dateOfService",
      "type": "date",
      "description": "Date of service"
    },
    {
      "name": "npi",
      "type": "string",
      "description": "Provider NPI"
    },
    {
      "name": "providerTaxId",
      "type": "string",
      "description": "Provider tax ID"
    },
    {
      "name": "placeOfService",
      "type": "string",
      "description": "Place of service code"
    }
  ]
}