UnitedHealthcare · Schema

UnitedHealthcare Benefit Check Request

Request for patient-specific benefit and cost-sharing check

Health InsuranceHealthcareFHIRClaimsEligibility

Properties

Name Type Description
memberId string Member ID
dateOfBirth string Date of birth
serviceCode string CPT/HCPCS service code
dateOfService string Date of service
npi string Provider NPI
providerTaxId string Provider tax ID
placeOfService string Place of service code
View JSON Schema on GitHub

JSON Schema

provider-benefit-check-request-schema.json Raw ↑
{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-benefit-check-request-schema.json",
  "title": "UnitedHealthcare Benefit Check Request",
  "description": "Request for patient-specific benefit and cost-sharing check",
  "type": "object",
  "required": [
    "memberId",
    "dateOfBirth",
    "serviceCode",
    "dateOfService"
  ],
  "properties": {
    "memberId": {
      "type": "string",
      "description": "Member ID"
    },
    "dateOfBirth": {
      "type": "string",
      "format": "date",
      "description": "Date of birth"
    },
    "serviceCode": {
      "type": "string",
      "description": "CPT/HCPCS service code"
    },
    "dateOfService": {
      "type": "string",
      "format": "date",
      "description": "Date of service"
    },
    "npi": {
      "type": "string",
      "description": "Provider NPI"
    },
    "providerTaxId": {
      "type": "string",
      "description": "Provider tax ID"
    },
    "placeOfService": {
      "type": "string",
      "description": "Place of service code"
    }
  }
}

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