Create Medical Inquiries

ExternalInquiryType

ExternalMedicalEligibilitySearchQuery

Any additional information about the inquiry that is not covered by the other fields. This can be used to pass in any additional information for the request. Please check with the Health Harbor team before using this field as it may not be incorporated into the inquiry unless we are already aware of it.

Additional Info

Codes processed for a CODE_LOOKUP_BENEFITS or a CODE_LOOKUP_PRIOR_AUTH benefits inquiry.

Benefits Codes

The name of a custom form for your providers. Contact alan@healthharbor.co for details.

Benefits Form Name

The specific set of benefits to query. These are customized for each customer. Contact alan@healthharbor.co for details.

The billed amount for the claim. Value should be a float with 2 decimal places. Only used for claims inquiries.

Billed Amount

The claim number for the inquiry if provided by the user. Only used for claims inquiries.

Claim Number

The date of service for the claim in MM-DD-YYYY format. Only used for claims inquiries.

Claims Date Of Service

The requested completion date of the inquiry in MM-DD-YYYY format. Calls will typically be completed by the morning of the requested completion date, but in some cases may be completed earlier.

Desired Completion Date

Any diagnosis codes for the patient. If omitted, a general diagnosis code will be used.

Diagnosis Codes

date of birth of the patient in MM-DD-YYYY format

An identifier which you can define and pass in with your creation request. This is useful for tracking a specific subgroup of inquiries. For instance, you can assign a unique external id to all inquiries for a specific provider on your platform.

External Id

Group Id

Insurance

whether or not the provider is in-network. If it is not known, leave this field blank and it will be determined.

Insurance In Network

The payor id for the insurance. Usually five characters. For example, one payor id for Aetna is 60054.

Insurance Payor Id

The phone number used for identifying the insurance

Insurance Phone Number

The type of provider making the inquiry. If the provider is a specialist, set this to True. If the provider is a general PCP, set this to False.

Is Specialist

Member Id

Patient Name

Where the service will be performed. This is typically one of a few places: the doctors office or telehealth See this page for the full list: https://www.cms.gov/medicare/coding-billing/place-of-service-codes/code-sets 

Place Of Service

The billing address of the practice. If omitted, the address will be determined from the NPI.

Practice Billing Address

API Documentation

Dental

Mental Health

Medical

Create Medical Inquiries

Authorizations

Body

Response