Provider Eligibility Response Structure

{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-structure/provider-eligibility-response-structure.json",
  "name": "UnitedHealthcare Eligibility Response",
  "type": "object",
  "description": "Real-time eligibility verification response with coverage details",
  "fields": [
    {
      "name": "memberId",
      "type": "string",
      "description": "UnitedHealthcare member ID"
    },
    {
      "name": "memberName",
      "type": "string",
      "description": "Member full name"
    },
    {
      "name": "coverageStatus",
      "type": "string",
      "description": "Coverage status",
      "enum": [
        "ACTIVE",
        "INACTIVE",
        "TERMED"
      ]
    },
    {
      "name": "planName",
      "type": "string",
      "description": "Insurance plan name"
    },
    {
      "name": "groupNumber",
      "type": "string",
      "description": "Group number"
    },
    {
      "name": "effectiveDate",
      "type": "date",
      "description": "Coverage effective date"
    },
    {
      "name": "terminationDate",
      "type": "date",
      "description": "Coverage termination date"
    },
    {
      "name": "deductible",
      "type": "decimal",
      "description": "Annual deductible amount"
    },
    {
      "name": "deductibleMet",
      "type": "decimal",
      "description": "YTD deductible met"
    },
    {
      "name": "outOfPocketMax",
      "type": "decimal",
      "description": "Annual out-of-pocket maximum"
    },
    {
      "name": "outOfPocketMet",
      "type": "decimal",
      "description": "YTD out-of-pocket met"
    },
    {
      "name": "copay",
      "type": "decimal",
      "description": "Copay amount"
    },
    {
      "name": "coinsurance",
      "type": "decimal",
      "description": "Coinsurance percentage"
    },
    {
      "name": "networkStatus",
      "type": "string",
      "description": "Network status",
      "enum": [
        "IN_NETWORK",
        "OUT_OF_NETWORK",
        "UNKNOWN"
      ]
    }
  ]
}