Automatically assigns a Primary care Physician to Members based on the Criteria found in the EnrollmentPCPAutoAssign entity passed in the body.
required | object (OptionCriteria) |
required | Array of objects (GroupCriteria) |
required | Array of objects (NetworkCriteria) |
Array of objects or null (SpecialtyCriteria) | |
Array of objects or null (PracticeTypeCriteria) | |
Array of objects or null (IDCodeCriteria) |
Success
Unauthorized
{- "options": {
- "run_Date": "2019-08-24T14:15:22Z",
- "capitation_Category": "string",
- "reason_ID": 0,
- "assignment_Rule1": "string",
- "assignment_Rule2": "string",
- "assignment_Rule3": "string",
- "assignment_Rule4": "string",
- "max_Radius": 0
}, - "groupCriterias": [
- {
- "group_ID": "string",
- "division_ID": "string"
}
], - "networkCriterias": [
- {
- "network_ID": "string"
}
], - "specialtyCriterias": [
- {
- "specialty_Code": "string",
- "sequence": 0,
- "age_From": 0,
- "age_Thru": 0,
- "sex": "string"
}
], - "practiceTypeCriterias": [
- {
- "practice_Type": "string"
}
], - "idCodeCriterias": [
- {
- "iD_Code": "string",
- "type": "string",
- "iD_Code_Data": "string",
- "iD_Code_Data_Date": "2019-08-24T14:15:22Z",
- "iD_Code_Data_Number": 0,
- "iD_Code_Data_Decimal": 0.1,
- "iD_Code_Data_Option": true
}
]
}
Get a list of Members that will be automatically assigned a Primary care Physician.
Success
Unauthorized
Get a list of Providers that are eligible for PCP Auto-Assign for the given Networks and Provider Types.
Success
Unauthorized
Creates a new Members
Success
Unauthorized
{- "subscriber_ID": "string",
- "member_Seq": "st",
- "access_Code": "string",
- "adult_Child": "s",
- "adult_Dependent": true,
- "adult_Dependent_End": "2019-08-24T14:15:22Z",
- "alternate_ID": "string",
- "birth_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage": true,
- "continue_Coverage_End_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage_Ex_Code": "string",
- "coverage_Type": "string",
- "credible_Coverage": 0,
- "creditable_Coverage_End": "2019-08-24T14:15:22Z",
- "creditable_Coverage_Start": "2019-08-24T14:15:22Z",
- "date_Enrolled": "2019-08-24T14:15:22Z",
- "date_Of_Death": "2019-08-24T14:15:22Z",
- "disenroll_Date": "2019-08-24T14:15:22Z",
- "ethnicity_Code": "s",
- "first_Name": "string",
- "height": 0,
- "initial_Volume": 0.1,
- "initial_Volume_Salary_Pct": true,
- "last_Name": "string",
- "marital_Status": "s",
- "middle_Name": "string",
- "name_Suffix": "string",
- "notes": "string",
- "other_Insurance": true,
- "other_Name": "string",
- "pend_Ex_Code": "string",
- "pend_Flag": "s",
- "plan_Year_Frequency": 0,
- "plan_Year_Frequency_Type": "s",
- "pre_Exist": "s",
- "pre_Exist_End": "2019-08-24T14:15:22Z",
- "pre_Exist_Ex_Code": "string",
- "relationship": "string",
- "ssn": "string",
- "salutation": "string",
- "sex": "s",
- "smoker": true,
- "student": "s",
- "student_End": "2019-08-24T14:15:22Z",
- "unique_ID": "string",
- "use_Member_Plan_Year": true,
- "viP_Flag": "s",
- "weight": 0
}
{- "data": {
- "subscriber_ID": "string",
- "member_Seq": "st",
- "access_Code": "string",
- "adult_Child": "s",
- "adult_Dependent": true,
- "adult_Dependent_End": "2019-08-24T14:15:22Z",
- "alternate_ID": "string",
- "birth_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage": true,
- "continue_Coverage_End_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage_Ex_Code": "string",
- "coverage_Type": "string",
- "credible_Coverage": 0,
- "creditable_Coverage_End": "2019-08-24T14:15:22Z",
- "creditable_Coverage_Start": "2019-08-24T14:15:22Z",
- "date_Enrolled": "2019-08-24T14:15:22Z",
- "date_Of_Death": "2019-08-24T14:15:22Z",
- "disenroll_Date": "2019-08-24T14:15:22Z",
- "ethnicity_Code": "s",
- "first_Name": "string",
- "height": 0,
- "initial_Volume": 0.1,
- "initial_Volume_Salary_Pct": true,
- "last_Name": "string",
- "marital_Status": "s",
- "middle_Name": "string",
- "name_Suffix": "string",
- "notes": "string",
- "other_Insurance": true,
- "other_Name": "string",
- "pend_Ex_Code": "string",
- "pend_Flag": "s",
- "plan_Year_Frequency": 0,
- "plan_Year_Frequency_Type": "s",
- "pre_Exist": "s",
- "pre_Exist_End": "2019-08-24T14:15:22Z",
- "pre_Exist_Ex_Code": "string",
- "relationship": "string",
- "ssn": "string",
- "salutation": "string",
- "sex": "s",
- "smoker": true,
- "student": "s",
- "student_End": "2019-08-24T14:15:22Z",
- "unique_ID": "string",
- "use_Member_Plan_Year": true,
- "viP_Flag": "s",
- "weight": 0
}, - "error": {
- "detail": "string",
- "instance": "string",
- "status": 0,
- "title": "string",
- "type": "string"
}, - "debug": {
- "activityID": "string"
}
}
Lists all Members for the given subscriberID
Success
Unauthorized
Updates a specific Members.
Success
Unauthorized
{- "subscriber_ID": "string",
- "member_Seq": "st",
- "access_Code": "string",
- "adult_Child": "s",
- "adult_Dependent": true,
- "adult_Dependent_End": "2019-08-24T14:15:22Z",
- "alternate_ID": "string",
- "birth_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage": true,
- "continue_Coverage_End_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage_Ex_Code": "string",
- "coverage_Type": "string",
- "credible_Coverage": 0,
- "creditable_Coverage_End": "2019-08-24T14:15:22Z",
- "creditable_Coverage_Start": "2019-08-24T14:15:22Z",
- "date_Enrolled": "2019-08-24T14:15:22Z",
- "date_Of_Death": "2019-08-24T14:15:22Z",
- "disenroll_Date": "2019-08-24T14:15:22Z",
- "ethnicity_Code": "s",
- "first_Name": "string",
- "height": 0,
- "initial_Volume": 0.1,
- "initial_Volume_Salary_Pct": true,
- "last_Name": "string",
- "marital_Status": "s",
- "middle_Name": "string",
- "name_Suffix": "string",
- "notes": "string",
- "other_Insurance": true,
- "other_Name": "string",
- "pend_Ex_Code": "string",
- "pend_Flag": "s",
- "plan_Year_Frequency": 0,
- "plan_Year_Frequency_Type": "s",
- "pre_Exist": "s",
- "pre_Exist_End": "2019-08-24T14:15:22Z",
- "pre_Exist_Ex_Code": "string",
- "relationship": "string",
- "ssn": "string",
- "salutation": "string",
- "sex": "s",
- "smoker": true,
- "student": "s",
- "student_End": "2019-08-24T14:15:22Z",
- "unique_ID": "string",
- "use_Member_Plan_Year": true,
- "viP_Flag": "s",
- "weight": 0
}
{- "data": {
- "subscriber_ID": "string",
- "member_Seq": "st",
- "access_Code": "string",
- "adult_Child": "s",
- "adult_Dependent": true,
- "adult_Dependent_End": "2019-08-24T14:15:22Z",
- "alternate_ID": "string",
- "birth_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage": true,
- "continue_Coverage_End_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage_Ex_Code": "string",
- "coverage_Type": "string",
- "credible_Coverage": 0,
- "creditable_Coverage_End": "2019-08-24T14:15:22Z",
- "creditable_Coverage_Start": "2019-08-24T14:15:22Z",
- "date_Enrolled": "2019-08-24T14:15:22Z",
- "date_Of_Death": "2019-08-24T14:15:22Z",
- "disenroll_Date": "2019-08-24T14:15:22Z",
- "ethnicity_Code": "s",
- "first_Name": "string",
- "height": 0,
- "initial_Volume": 0.1,
- "initial_Volume_Salary_Pct": true,
- "last_Name": "string",
- "marital_Status": "s",
- "middle_Name": "string",
- "name_Suffix": "string",
- "notes": "string",
- "other_Insurance": true,
- "other_Name": "string",
- "pend_Ex_Code": "string",
- "pend_Flag": "s",
- "plan_Year_Frequency": 0,
- "plan_Year_Frequency_Type": "s",
- "pre_Exist": "s",
- "pre_Exist_End": "2019-08-24T14:15:22Z",
- "pre_Exist_Ex_Code": "string",
- "relationship": "string",
- "ssn": "string",
- "salutation": "string",
- "sex": "s",
- "smoker": true,
- "student": "s",
- "student_End": "2019-08-24T14:15:22Z",
- "unique_ID": "string",
- "use_Member_Plan_Year": true,
- "viP_Flag": "s",
- "weight": 0
}, - "error": {
- "detail": "string",
- "instance": "string",
- "status": 0,
- "title": "string",
- "type": "string"
}, - "debug": {
- "activityID": "string"
}
}
Create or Update multiple Members at once. If the entity exists, it will be updated. If the entity does not exist, it will be created.
Success
Unauthorized
[- {
- "subscriber_ID": "string",
- "member_Seq": "st",
- "access_Code": "string",
- "adult_Child": "s",
- "adult_Dependent": true,
- "adult_Dependent_End": "2019-08-24T14:15:22Z",
- "alternate_ID": "string",
- "birth_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage": true,
- "continue_Coverage_End_Date": "2019-08-24T14:15:22Z",
- "continue_Coverage_Ex_Code": "string",
- "coverage_Type": "string",
- "credible_Coverage": 0,
- "creditable_Coverage_End": "2019-08-24T14:15:22Z",
- "creditable_Coverage_Start": "2019-08-24T14:15:22Z",
- "date_Enrolled": "2019-08-24T14:15:22Z",
- "date_Of_Death": "2019-08-24T14:15:22Z",
- "disenroll_Date": "2019-08-24T14:15:22Z",
- "ethnicity_Code": "s",
- "first_Name": "string",
- "height": 0,
- "initial_Volume": 0.1,
- "initial_Volume_Salary_Pct": true,
- "last_Name": "string",
- "marital_Status": "s",
- "middle_Name": "string",
- "name_Suffix": "string",
- "notes": "string",
- "other_Insurance": true,
- "other_Name": "string",
- "pend_Ex_Code": "string",
- "pend_Flag": "s",
- "plan_Year_Frequency": 0,
- "plan_Year_Frequency_Type": "s",
- "pre_Exist": "s",
- "pre_Exist_End": "2019-08-24T14:15:22Z",
- "pre_Exist_Ex_Code": "string",
- "relationship": "string",
- "ssn": "string",
- "salutation": "string",
- "sex": "s",
- "smoker": true,
- "student": "s",
- "student_End": "2019-08-24T14:15:22Z",
- "unique_ID": "string",
- "use_Member_Plan_Year": true,
- "viP_Flag": "s",
- "weight": 0
}
]
{- "data": [
- {
- "id": [
- {
- "key": "string",
- "value": "string"
}
], - "status": 0,
- "body": "string"
}
], - "error": {
- "detail": "string",
- "instance": "string",
- "status": 0,
- "title": "string",
- "type": "string"
}, - "debug": {
- "activityID": "string"
}
}
Retrieve the MembersDisabilityTaxSummary for the given year
Success
Unauthorized