Plan Benefit Rates

Create PlanBenefitRate

Creates a new PlanBenefitRate

SecurityapiKeyAuth and bearerAuth
Request
path Parameters
planID
required
string

Plan ID

benefitCode
required
string

Benefit Code

header Parameters
vbasoftware-database
required
string

Target database

Request Body schema:
required
planBenefitRate_Key
required
integer <int32>

Unique idenfiter assigned to the Plan Benefit Rate. Note: The database will apply a default value of 0 for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of 0 to meet the API requirements and ensure that the functionality occurs as expected.

benefit_Code
required
string [ 1 .. 10 ] characters

References the PlanBenefits.Benefit_Code value in parent table.

effective_Date
required
string <date-time>

Date when the Rate becomes effective.

entry_Date
string <date-time>

Date when the record was added to the system.

entry_User
string or null <= 20 characters

User that first added the record to the system.

ex_Code
string or null <= 6 characters

This code is applied to any claim that utilizes the benefit rate.

network_ID
string or null <= 10 characters

Network ID associated with the Plan Benefit Rate

plan_ID
required
string [ 1 .. 20 ] characters

References the PlanBenefits.Plan_ID value in parent table.

rate
required
number <double>

This area will allow for a limit (dollar or percentage) of how much of the allowed amount can be paid out, per claim detail line, by the specific plan benefit. Note: The database will apply a default value of 0 for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of 0 to meet the API requirements and ensure that the functionality occurs as expected.

rate_Max
number or null <double>

Max rate that can be paid out.

rate_Max_Type
string or null <= 6 characters

Type of Benefit Level Maximum: Per Calendar Year - January 1st through December 31st. Per Plan Year - per plan year as defined by the Group.

rate_Pct
required
boolean

Indicates whether the Rate will be a percentage or fixed amount. Note: The database will apply a default value of False for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of False to meet the API requirements and ensure that the functionality occurs as expected.

rate_Type
required
string [ 1 .. 6 ] characters

Type of Benefit Rate: Per Service Line - rate is applied to each service line. Per Day - rate is applied per service date. Per Visit - rate is applied per service date per Provider.

term_Date
string or null <date-time>

Date when the Rate expires.

update_Date
string <date-time>

Date when the record was last updated in the system.

update_User
string or null <= 20 characters

User that last updated the record in the system.

Responses
200

Success

401

Unauthorized

post/plans/{planID}/benefits/{benefitCode}/rates
Request samples
{
  • "planBenefitRate_Key": 0,
  • "benefit_Code": "string",
  • "effective_Date": "2019-08-24T14:15:22Z",
  • "entry_Date": "2019-08-24T14:15:22Z",
  • "entry_User": "string",
  • "ex_Code": "string",
  • "network_ID": "string",
  • "plan_ID": "string",
  • "rate": 0.1,
  • "rate_Max": 0.1,
  • "rate_Max_Type": "string",
  • "rate_Pct": true,
  • "rate_Type": "string",
  • "term_Date": "2019-08-24T14:15:22Z",
  • "update_Date": "2019-08-24T14:15:22Z",
  • "update_User": "string"
}
Response samples
{
  • "data": {
    },
  • "error": {
    },
  • "debug": {
    }
}

List PlanBenefitRate

Lists all PlanBenefitRate for the given planID and benefitCode

SecurityapiKeyAuth and bearerAuth
Request
path Parameters
planID
required
string

Plan ID

benefitCode
required
string

Benefit Code

header Parameters
vbasoftware-database
required
string

Target database

Responses
200

Success

401

Unauthorized

get/plans/{planID}/benefits/{benefitCode}/rates
Request samples 
Response samples 
No sample
Get PlanBenefitRate
Gets PlanBenefitRate


SecurityapiKeyAuth and bearerAuth 
Request 
path Parameters
planID
required
string
Plan ID


 
benefitCode
required
string
Benefit Code


 
planBenefitRateKey
required
integer <int32> 
PlanBenefitRate Key


 
header Parameters
vbasoftware-database
required
string
Target database


 
Responses 
200
Success


401
Unauthorized


get/plans/{planID}/benefits/{benefitCode}/rates/{planBenefitRateKey}
Request samples 
Response samples 
No sample
Update PlanBenefitRate
Updates a specific PlanBenefitRate.


SecurityapiKeyAuth and bearerAuth 
Request 
path Parameters
planID
required
string
Plan ID


 
benefitCode
required
string
Benefit Code


 
planBenefitRateKey
required
integer <int32> 
PlanBenefitRate Key


 
header Parameters
vbasoftware-database
required
string
Target database


 
Request Body schema: 
required
planBenefitRate_Key
required
integer <int32> 
Unique idenfiter assigned to the Plan Benefit Rate.  Note: The database will apply a default value of 0 for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of 0 to meet the API requirements and ensure that the functionality occurs as expected.


 
benefit_Code
required
string  [ 1 .. 10 ] characters 
References the PlanBenefits.Benefit_Code value in parent table.


 
effective_Date
required
string <date-time> 
Date when the Rate becomes effective.


 
entry_Date
string <date-time> 
Date when the record was added to the system.


 
entry_User
string or null  <= 20 characters 
User that first added the record to the system.


 
ex_Code
string or null  <= 6 characters 
This code is applied to any claim that utilizes the benefit rate.


 
network_ID
string or null  <= 10 characters 
Network ID associated with the Plan Benefit Rate


 
plan_ID
required
string  [ 1 .. 20 ] characters 
References the PlanBenefits.Plan_ID value in parent table.


 
rate
required
number <double> 
This area will allow for a limit (dollar or percentage) of how much of the allowed amount can be paid out, per claim detail line, by the specific plan benefit.  Note: The database will apply a default value of 0 for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of 0 to meet the API requirements and ensure that the functionality occurs as expected.


 
rate_Max
number or null <double> 
Max rate that can be paid out.


 
rate_Max_Type
string or null  <= 6 characters 
Type of Benefit Level Maximum: Per Calendar Year - January 1st through December 31st. Per Plan Year - per plan year as defined by the Group.


 
rate_Pct
required
boolean
Indicates whether the Rate will be a percentage or fixed amount.  Note: The database will apply a default value of False for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of False to meet the API requirements and ensure that the functionality occurs as expected.


 
rate_Type
required
string  [ 1 .. 6 ] characters 
Type of Benefit Rate: Per Service Line - rate is applied to each service line. Per Day - rate is applied per service date. Per Visit - rate is applied per service date per Provider.


 
term_Date
string or null <date-time> 
Date when the Rate expires.


 
update_Date
string <date-time> 
Date when the record was last updated in the system.


 
update_User
string or null  <= 20 characters 
User that last updated the record in the system.


 
Responses 
200
Success


401
Unauthorized


put/plans/{planID}/benefits/{benefitCode}/rates/{planBenefitRateKey}
Request samples 
{
  • "planBenefitRate_Key": 0,
  • "benefit_Code": "string",
  • "effective_Date": "2019-08-24T14:15:22Z",
  • "entry_Date": "2019-08-24T14:15:22Z",
  • "entry_User": "string",
  • "ex_Code": "string",
  • "network_ID": "string",
  • "plan_ID": "string",
  • "rate": 0.1,
  • "rate_Max": 0.1,
  • "rate_Max_Type": "string",
  • "rate_Pct": true,
  • "rate_Type": "string",
  • "term_Date": "2019-08-24T14:15:22Z",
  • "update_Date": "2019-08-24T14:15:22Z",
  • "update_User": "string"
}
Response samples 
{
  • "data": {
    },
  • "error": {
    },
  • "debug": {
    }
}
Delete PlanBenefitRate
Deletes an PlanBenefitRate


SecurityapiKeyAuth and bearerAuth 
Request 
path Parameters
planID
required
string
Plan ID


 
benefitCode
required
string
Benefit Code


 
planBenefitRateKey
required
integer <int32> 
PlanBenefitRate Key


 
header Parameters
vbasoftware-database
required
string
Target database


 
Responses 
204
Success


401
Unauthorized


delete/plans/{planID}/benefits/{benefitCode}/rates/{planBenefitRateKey}
Request samples 
Create or Update Batch PlanBenefitRate
Create or Update multiple PlanBenefitRate at once.  If the entity exists, it will be updated.  If the entity does not exist, it will be created.


SecurityapiKeyAuth and bearerAuth 
Request 
path Parameters
planID
required
string
Plan ID


 
benefitCode
required
string
Benefit Code


 
header Parameters
vbasoftware-database
required
string
Target database


 
Request Body schema: 
required
 Array 
planBenefitRate_Key
required
integer <int32> 
Unique idenfiter assigned to the Plan Benefit Rate.  Note: The database will apply a default value of 0 for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of 0 to meet the API requirements and ensure that the functionality occurs as expected.


 
benefit_Code
required
string  [ 1 .. 10 ] characters 
References the PlanBenefits.Benefit_Code value in parent table.


 
effective_Date
required
string <date-time> 
Date when the Rate becomes effective.


 
entry_Date
string <date-time> 
Date when the record was added to the system.


 
entry_User
string or null  <= 20 characters 
User that first added the record to the system.


 
ex_Code
string or null  <= 6 characters 
This code is applied to any claim that utilizes the benefit rate.


 
network_ID
string or null  <= 10 characters 
Network ID associated with the Plan Benefit Rate


 
plan_ID
required
string  [ 1 .. 20 ] characters 
References the PlanBenefits.Plan_ID value in parent table.


 
rate
required
number <double> 
This area will allow for a limit (dollar or percentage) of how much of the allowed amount can be paid out, per claim detail line, by the specific plan benefit.  Note: The database will apply a default value of 0 for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of 0 to meet the API requirements and ensure that the functionality occurs as expected.


 
rate_Max
number or null <double> 
Max rate that can be paid out.


 
rate_Max_Type
string or null  <= 6 characters 
Type of Benefit Level Maximum: Per Calendar Year - January 1st through December 31st. Per Plan Year - per plan year as defined by the Group.


 
rate_Pct
required
boolean
Indicates whether the Rate will be a percentage or fixed amount.  Note: The database will apply a default value of False for this field if a value is not provided.  This field is also marked as NOT NULL in the database and therefore required by the API.  If you do not have a value for this field, supply the database default value of False to meet the API requirements and ensure that the functionality occurs as expected.


 
rate_Type
required
string  [ 1 .. 6 ] characters 
Type of Benefit Rate: Per Service Line - rate is applied to each service line. Per Day - rate is applied per service date. Per Visit - rate is applied per service date per Provider.


 
term_Date
string or null <date-time> 
Date when the Rate expires.


 
update_Date
string <date-time> 
Date when the record was last updated in the system.


 
update_User
string or null  <= 20 characters 
User that last updated the record in the system.


 
Responses 
207
Success


401
Unauthorized


put/plans/{planID}/benefits/{benefitCode}/rates-batch
Request samples 
[
  • {
    }
]
Response samples 
{
  • "data": [
    ],
  • "error": {
    },
  • "debug": {
    }
}