UnitedHealthcare · Schema

UnitedHealthcare Eligibility Request

Request parameters for real-time eligibility and benefit verification

Health InsuranceHealthcareFHIRClaimsEligibility

Properties

Name Type Description
memberId string UnitedHealthcare member ID
dateOfBirth string Member date of birth
serviceType string X12 service type code
dateOfService string Requested date of service
npi string Rendering provider NPI
groupNumber string Insurance group number
View JSON Schema on GitHub

JSON Schema

provider-eligibility-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-eligibility-request-schema.json",
  "title": "UnitedHealthcare Eligibility Request",
  "description": "Request parameters for real-time eligibility and benefit verification",
  "type": "object",
  "required": [
    "memberId",
    "dateOfBirth",
    "serviceType",
    "dateOfService"
  ],
  "properties": {
    "memberId": {
      "type": "string",
      "description": "UnitedHealthcare member ID"
    },
    "dateOfBirth": {
      "type": "string",
      "format": "date",
      "description": "Member date of birth"
    },
    "serviceType": {
      "type": "string",
      "description": "X12 service type code"
    },
    "dateOfService": {
      "type": "string",
      "format": "date",
      "description": "Requested date of service"
    },
    "npi": {
      "type": "string",
      "description": "Rendering provider NPI"
    },
    "groupNumber": {
      "type": "string",
      "description": "Insurance group number"
    }
  }
}

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