API Reference

POSTGET

/api/eligibility/check/mock

Integration-test endpoint. Same authentication as the live check — but the payer network is never called and the transaction is not billed. Use this in CI, development, automated tests, and voice/CRM integrations.

Not billed. Mock requests are logged in your workspace with a mock tag but do not deduct from your wallet.

POST

JSON body (recommended)

Send a JSON body — same fields as POST /api/eligibility/check plus mockFixture:

FieldTypeRequiredDescription
payerNamestringPayer name (matched against catalog)
memberIdstringInsurance member ID
patientFirstNamestringPatient first name
patientLastNamestringPatient last name
mockFixturestringFixture slug to return. See table below.
patientDateOfBirthstringISO 8601 date (e.g. 1990-04-15)

Headers

HeaderRequiredDescription
AuthorizationBearer YOUR_API_KEY
X-Client-IdUUID of the clinic client
Content-Typeapplication/json
Idempotency-KeyUUID for idempotent retries
curl -X POST https://eligibility.dev/api/eligibility/check/mock \
  -H "Authorization: Bearer YOUR_API_KEY" \
  -H "X-Client-Id: YOUR_CLIENT_ID" \
  -H "Content-Type: application/json" \
  -d '{
    "payerName": "Aetna",
    "memberId": "W123456789",
    "patientFirstName": "Jane",
    "patientLastName": "Smith",
    "mockFixture": "aetna-dependent1"
  }'

GET

Query-string (voice AI / no-body integrations)

Identical behavior to POST, but all parameters are passed as URL query strings. Designed for tools that can only make GET requests — for example GHL Voice AI webhooks. No Content-Type header needed.

ParameterRequiredDescription
payerNamePayer name (matched against catalog)
memberIdInsurance member ID
patientFirstNamePatient first name
patientLastNamePatient last name
mockFixtureFixture slug to return. See table below.
patientDateOfBirthISO 8601 date (e.g. 1990-04-15)
idempotencyKeyUUID for idempotent retries (alternative to Idempotency-Key header)

Headers

HeaderRequiredDescription
AuthorizationBearer YOUR_API_KEY
X-Client-IdUUID of the clinic client
curl "https://eligibility.dev/api/eligibility/check/mock?payerName=Aetna&memberId=W123456789&patientFirstName=Jane&patientLastName=Smith&mockFixture=aetna-dependent1" \
  -H "Authorization: Bearer YOUR_API_KEY" \
  -H "X-Client-Id: YOUR_CLIENT_ID"

Available fixtures

mockFixtureScenario
aetna-dependent1Active coverage, dependent member (Aetna)
cigna-subscriber-onlyActive coverage, subscriber only (Cigna)
dentalDental benefit check
medical-inactiveInactive medical coverage
mbi-lookup-ssnMBI / SSN lookup
75-subscriber-not-foundUpstream error: subscriber not found
42-payer-unable-to-respondUpstream error: payer unable to respond
43-invalid-missing-provider-infoUpstream error: missing provider info
72-invalid-missing-subscriber-idUpstream error: missing subscriber ID
73-invalid-missing-subscriber-nameUpstream error: missing subscriber name
79-invalid-participant-infoUpstream error: invalid participant info

Response

Identical shape to POST /api/eligibility/check. The success and benefitSummary fields reflect the fixture, not a live payer call.