CrossEpisodeFinancialEligibility - PM web service
Avatar PM WEBSVC.CrossEpisodeFinancialEligibility web service
This web service has the following calls:
- AddCrossEpFinancialElig
- GetDictionaryItems
- UpdateCrossEpFinancialElig
This web service has the following object classes:
- WEBSVC.ListOfGuarantorSelectionObjects
- WEBSVC.ListOfCustomizePlanObjects
- WEBSVC.ListOfPolicyNumberOverrideObjects
- WEBSVC.GuarantorSelectionObject
- WEBSVC.CustomizePlanObject
- WEBSVC.PolicyNumberOverrideObject
AddCrossEpFinancialElig call
The following tables list the AddCrossEpFinancialElig parameters, properties, accepted values, and associated dictionaries.
Parameters with No Properties
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| SystemCode | N/A | Avatar System Code | examples: SAMPLE, LIVE, etc. |
| UserName | N/A | Avatar User ID | |
| Password | N/A | Avatar Password | |
| ClientID | N/A | Avatar Client ID |
Parameters with Properties
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| CEFEInfo | ListOfGuarantorSelectionObjects | WEBSVC.ListOfGuarantorSelectionObjects | This parameter is itself a web service object -- see below for its properties. |
GetDictionaryItems call
The following table lists the GetDictionaryItems parameters, properties, accepted values, and associated dictionaries.
Parameters with No Properties
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| SystemCode | N/A | Avatar System Code | examples: SAMPLE, LIVE, etc. |
| UserName | N/A | Avatar User ID | |
| Password | N/A | Avatar Password |
UpdateCrossEpFinancialElig call
The following tables list the UpdateCrossEpFinancialElig parameters, properties, accepted values, and associated dictionaries.
Parameters with No Properties
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| SystemCode | N/A | Avatar System Code | examples: SAMPLE, LIVE, etc. |
| UserName | N/A | Avatar User ID | |
| Password | N/A | Avatar Password | |
| ClientID | N/A | Avatar Client ID |
Parameters with Properties
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| CEFEInfo | ListOfGuarantorSelectionObjects | WEBSVC.ListOfGuarantorSelectionObjects | This parameter is itself a web service object -- see below for its properties. |
Object class: WEBSVC.ListOfGuarantorSelectionObjects
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| ELEMENTTYPE | GuarantorSelectionObject | WEBSVC.GuarantorSelectionObject | This parameter is itself a web service object -- see below for its properties. |
Object class: WEBSVC.ListOfCustomizePlanObjects
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| ELEMENTTYPE | ListOfCustomizePlanObjects | WEBSVC.CustomizePlanObject | This parameter is itself a web service object -- see below for its properties. |
Object class: WEBSVC.ListOfPolicyNumberOverrideObjects
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| ELEMENTTYPE | PolicyNumberOverrideObject | WEBSVC.PolicyNumberOverrideObject | This parameter is itself a web service object -- see below for its properties. |
Object class: WEBSVC.GuarantorSelectionObject
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
|
GuarantorSelectionObject |
CPList | WEBSVC.ListOfCustomizePlanObjects | This property of GuarantorSelectionObject is itself an object -- see below for its properties. |
|
|
ClientsRelationship | Dictionary Code | From Client file, data element 247 |
|
|
CoordinationOfBenefits | Dictionary Code | From Client file, data element 1058 |
|
|
CoverageEffectiveDate | Date | |
|
|
CoverageExpirationDate | Date | |
|
|
CustomizeGuarantorPlan | Dictionary code | From Client file, data element 50003 |
|
|
DateBenefitsDenied | Date | |
|
|
DateBenefitsTerminated | Date | |
|
|
DateOfAccident | Date | |
|
|
DenialCode | Dictionary Code | From Client file, data element 283 |
|
|
DoNotUseThroughDate | Date | |
|
|
EffectiveDateOfContract | Date | |
|
|
EligibilityVerified | Dictionary Code | From Client file, data element 1054 |
|
|
ExpirationDateOfContract | Date | |
|
|
GuarantorName | Avatar Guarantor name | |
|
|
GuarantorNumber | Avatar Guarantor ID | |
|
|
GuarantorOrderNumber | Number | |
|
|
GuarantorPlan | Avatar Guarantor Plan ID | |
|
|
GuarantorsAddress1 | Free text | |
|
|
GuarantorsAddress2 | Free text | |
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|
GuarantorsAddressCity | Free text | |
|
|
GuarantorsAddressState | State | The state (as in location) that the guarantor resides in. |
|
|
GuarantorsAddressZipcode | Zip Code | |
|
|
GuarantorsPhoneNumber | Phone number | |
|
|
InhibitBillingByMail | Dictionary code | From Client file, data element 190 |
|
|
InsPlanNameOrProgName | Free text | |
|
|
InsuranceCodeMedicaidTape | Free text | |
|
|
IsThisManagedCareContract | Free text | |
|
|
LifetimeReserveDays | Number | |
|
|
MaximumCoveredDollars | Amount | |
|
|
MedigapGuarantor | Avatar Guarantor ID | |
|
|
Notes | Free text | |
|
|
NumOfDaysInterimBilling | Number | |
|
|
PNOList | WEBSVC.ListOfPolicyNumberOverrideObjects | This property of GuarantorSelectionObject is itself an object -- see below for its properties. |
|
|
PatientSigSourceCode | Dictionary Code | From Client file, data element 290 |
|
|
SubscriberAddIDIdentifier | Free text | Related to the Subscriber Additional ID Qualifier (270-2100C-REF-02) field in the Cross Episode Financial Eligibility form. |
|
|
SubscriberAddIDQualifier | Free text | Related to the Subscriber Additional ID Qualifier (270-2100C-REF-01) field in the Cross Episode Financial Eligibility form |
|
|
SubscriberAddress1 | Free text | |
|
|
SubscriberAddress2 | Free text | |
|
|
SubscriberAssignOfBenefits | Dictionary Code | From Client file, data element 277 |
|
|
SubscriberBranchService | Dictionary Code | From Client file, data element 267 |
|
|
SubscriberCity | Free text | |
|
|
SubscriberCountry | Dictionary Code | From Client file, data element 99 |
|
|
SubscriberCounty | Dictionary Code | From Client file, data element 93 |
|
|
SubscriberEmployerCity | Free text | |
|
|
SubscriberEmployerCountry | Dictionary Code | From Client file, data element 99 |
|
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SubscriberEmployerCounty | Dictionary Coded | From Client file, data element 93 |
|
|
SubscriberEmployerID | Free text | |
|
|
SubscriberEmployerName | Free text | |
|
|
SubscriberEmployerState | State | The state (as in location) the accident occurred in. |
|
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SubscriberEmployerStreet | Free text | |
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SubscriberEmployerZip | Zip Code | |
|
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SubscriberEmploymentID | Free text | |
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SubscriberGroupName | Free text | |
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SubscriberGroupNumber | Free text | |
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|
SubscriberMedicaidNumber | Free text | |
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|
SubscriberMedicareNumber | Free text | |
|
|
SubscriberMilitaryStatus | Dictionary Code | From Client file, data element 268 |
|
|
SubscriberPhone | Phone number | |
|
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SubscriberPolicyNumber | Free text | |
|
|
SubscriberPolicyOverride | Free text | |
|
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SubscriberReleaseOfInfo | Dictionary Code | From Client file, data element 278 |
|
|
SubscriberSecIDQualifier | Dictionary Code | From Client file, data element 10220 |
| SubscriberSecIDQualifier2 | Dictionary Code | From Client file, data element 10220 | |
|
|
SubscriberSecIdentifier | Free text | |
|
|
SubscriberSecIdentifier2 | Free text | |
|
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SubscriberState | State | The state (as in location) the accident occurred in. |
|
|
SubscriberTreatmentAuth | Dictionary Code | From Client file, data element 271 |
|
|
SubscriberWorkPhone | Phone number | |
|
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SubscriberZip | Zip Code | |
|
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SubscribersBirthDate | Date | |
|
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SubscribersCoveredDays | Number | |
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SubscribersEmployment | Dictionary Code | From Client file, data element 256 |
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SubscribersFirstName | Free text | |
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SubscribersLastName | Free text | |
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SubscribersMiddleName | Free text | |
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SubscribersName | Name | |
|
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SubscribersPrefix | Dictionary Code | From Client file, data element 175 |
|
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SubscribersSSNumber | Social Security Number | |
|
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SubscribersSex | Dictionary Code | From Client file, data element 255 |
|
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SubscribersSuffix | Dictionary Code | From Client file, data element 174 |
|
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TitleXXAreaAssigned | Dictionary Code | From Client file, data element 10215 |
|
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TitleXXDateVerified | Date | |
|
|
TitleXXEligCriteria | Dictionary Code | From Client file, data element 10216 |
|
|
SubscriberIDCardIssueDate | Date | |
|
|
InsuranceTypeCode | Dictionary Code | From Payer file, data element 476 |
|
|
SubscriberPolicyNumSuffix | Free text |
Object class: WEBSVC.CustomizePlanObject
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
|
CustomizePlanObject |
CoveredChargeCategories | Dictionary Code | From Client file, data element 10021 |
|
|
DeductibleAmount | Amount | |
|
|
DeductibleType | Dictionary Code | From Family file, data element 1042 |
|
|
Description | Free text | |
|
|
DistPercentCovBasedOn | Dictionary Code | From Plan file, data element 900 |
|
|
InsDollarLimit | Amount | |
|
|
InsDollarLimitPerDay | Amount | |
|
|
InsDollarLimitRBPerDay | Amount | |
|
|
LevelEndDate | Date | |
|
|
LevelStartDate | Date | |
|
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MaxAmountPerService | Amount | |
|
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MaxCoveredAncillary | Amount | |
|
|
MaxCoveredDays | Number | |
|
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MaxCoveredPartialDays | Number | |
|
|
MaxCoveredVisits | Number | |
|
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MaxUnitsPerDay | Number | |
|
|
MonthlyMaxResponsibility | Amount | |
|
|
OtherSubscriberSecID | Free text | |
|
|
PerDiemPercentage | Free text | |
|
|
PerDiemPercentageAppliesTo | Free text | |
|
|
PerDiemRate | Amount | |
|
|
PercentageOfCoverage | Free text | |
|
|
PractitionerCategories | Dictionary Code | From Staff file, data element 70 |
|
|
SlidingFeeScale | Dictionary Code | From Client file, data element 681 |
|
|
VarLimit1Amount | Amount | |
|
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VarLimit1Checked | Dictionary Code | From Client file, data element 700 |
|
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VarLimit1Frequency | Number | |
|
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VarLimit1Type | Dictionary Code | From Client file, data element 699 |
|
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VarLimit2Amount | Amount | |
|
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VarLimit2Checked | Dictionary Code | From Client file, data element 704 |
|
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VarLimit2Frequency | Number | |
|
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VarLimit2Type | Dictionary Code | From Client file, data element 703 |
|
|
VarLimit3Amount | Amount | |
|
|
VarLimit3Checked | Dictionary Code | From Client file, data element 708 |
|
|
VarLimit3Frequency | Number | |
|
|
VarLimit3Type | Dictionary Code | From Client file, data element 707 |
Object class: PolicyNumberOverrideObject
| Parameter | Property | Value Accepted | Notes |
|---|---|---|---|
| PolicyNumberOverrideObject | EndDate | Date | |
| PolicyNumber | Free text | ||
| StartDate | Date |