Elation Health · Schema

InsuranceEligibilityFullReport

HealthcareUnited StatesElectronic Health RecordsFHIRHL7InteroperabilitySMART on FHIRPrimary CareValue-Based CareEligibilityClinical DataSchedulinge-PrescribingDigital HealthA2A

Properties

Name	Type	Description
benefits	object
eligibility_check_timestamp	string	Eligibility check timestamp in ISO format.
eligibility_provider	object
patient_id	integer	Patient's id in Elation system.
patient_insurance_id	integer	Patient's insurance id in Elation system.
plan_details	object
practice_id	integer	Practice's id in Elation system.
service_type_code	string
subscriber	object

View JSON Schema on GitHub

JSON Schema

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/elation-health/main/json-schema/elation-health-insurance-eligibility-full-report-schema.json",
  "title": "InsuranceEligibilityFullReport",
  "x-generated": "2026-10-12",
  "x-method": "derived",
  "x-generator": "derive-json-schema.py",
  "x-source": "openapi/elation-health-insurance-eligibility-api-openapi.yml#/components/schemas/InsuranceEligibilityFullReport",
  "properties": {
    "benefits": {
      "$ref": "#/$defs/EligibilityBenefits"
    },
    "eligibility_check_timestamp": {
      "description": "Eligibility check timestamp in ISO format.",
      "format": "date-time",
      "type": "string"
    },
    "eligibility_provider": {
      "$ref": "#/$defs/EligibilityProvider"
    },
    "patient_id": {
      "description": "Patient's id in Elation system.",
      "type": "integer"
    },
    "patient_insurance_id": {
      "description": "Patient's insurance id in Elation system.",
      "type": "integer"
    },
    "plan_details": {
      "$ref": "#/$defs/EligibilityPlanDetails"
    },
    "practice_id": {
      "description": "Practice's id in Elation system.",
      "type": "integer"
    },
    "service_type_code": {
      "type": "string"
    },
    "subscriber": {
      "$ref": "#/$defs/EligibilitySubscriber"
    }
  },
  "type": "object",
  "$defs": {
    "EligibilityAddress": {
      "properties": {
        "address_1": {
          "type": "string"
        },
        "address_2": {
          "type": "string"
        },
        "city": {
          "type": "string"
        },
        "postal_code": {
          "type": "string"
        },
        "state": {
          "type": "string"
        }
      },
      "type": "object"
    },
    "EligibilityBenefits": {
      "properties": {
        "coinsurance": {
          "items": {
            "additionalProperties": {},
            "type": "object"
          },
          "type": "array"
        },
        "copay": {
          "items": {
            "additionalProperties": {},
            "type": "object"
          },
          "type": "array"
        },
        "deductible": {
          "items": {
            "additionalProperties": {},
            "type": "object"
          },
          "type": "array"
        },
        "limitations": {
          "items": {
            "additionalProperties": {},
            "type": "object"
          },
          "type": "array"
        },
        "out_of_pocket": {
          "items": {
            "additionalProperties": {},
            "type": "object"
          },
          "type": "array"
        }
      },
      "type": "object"
    },
    "EligibilityPlanDetails": {
      "properties": {
        "carrier": {
          "type": "string"
        },
        "end_date": {
          "format": "date",
          "type": [
            "string",
            "null"
          ]
        },
        "group_name": {
          "type": "string"
        },
        "group_number": {
          "type": "string"
        },
        "insurance_type": {
          "type": [
            "string",
            "null"
          ]
        },
        "member_id": {
          "type": "string"
        },
        "plan_name": {
          "type": "string"
        },
        "plan_number": {
          "type": "string"
        },
        "policy_name": {
          "type": [
            "string",
            "null"
          ]
        },
        "policy_number": {
          "type": [
            "string",
            "null"
          ]
        },
        "provider": {
          "$ref": "#/$defs/EligibilityProvider"
        },
        "start_date": {
          "format": "date",
          "type": "string"
        }
      },
      "type": "object"
    },
    "EligibilityProvider": {
      "properties": {
        "first_name": {
          "type": "string"
        },
        "last_name": {
          "type": "string"
        },
        "npi": {
          "type": "string"
        },
        "organization_name": {
          "type": "string"
        }
      },
      "type": "object"
    },
    "EligibilitySubscriber": {
      "properties": {
        "address": {
          "$ref": "#/$defs/EligibilityAddress"
        },
        "first_name": {
          "type": "string"
        },
        "last_name": {
          "type": "string"
        },
        "member_id": {
          "type": "string"
        },
        "middle_name": {
          "type": "string"
        },
        "name": {
          "type": "string"
        },
        "sex_at_birth": {
          "type": "string"
        }
      },
      "type": "object"
    }
  }
}

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