Financial Eligibility - PM web service
Avatar PM WEBSVC.FinancialEligibility web service
This web service has the following calls:
- AddFinancialElig
- EstimateLiability
- GetDictionaryItems
- GetFinancialEligibility
- UpdateFinancialElig
This web service has the following object classes:
- WEBSVC.ServiceCodeObject
- WEBSVC.ListOfGuarantorSelectionObjects
- WEBSVC.GuarantorSelectionObject
- WEBSVC.ListOfPolicyNumberOverrideObjects
- PolicyNumberOverrideObject
AddFinancialElig call
The following tables list the AddFinancialElig 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 |
|
|
EpisodeNumber |
N/A |
Episode Number |
|
|
CoverageComments |
N/A |
Free Text |
|
|
GUID |
N/A |
Globally Unique ID |
In the format xxxxxxxx-xxxx-xxxx-xxxx-xxxxxxxxxxxx (8-4-4-4-12). |
|
TimeStamp |
N/A |
Time Stamp |
In the format YYYY-MM-DD hh:mm:ss. |
Parameters with Properties
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
|
FEInfo |
ListOfGuarantorSelectionObjects |
WEBSVC.ListOfGuarantorSelectionObjects |
This parameter is itself a web service object -- see below for its properties |
EstimateLiability call
The following table lists the EstimateLiability 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 |
|
|
ServiceObject |
N/A |
WEBSVC.ServiceCodeObject |
|
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 |
GetFinancialEligibility call
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 |
|
|
EpisodeNumber |
N/A |
Episode Number |
|
UpdateFinancialElig call
The following tables list the UpdateFinancialElig 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 |
|
|
EpisodeNumber |
N/A |
Episode Number |
|
|
CoverageComments |
N/A |
Free Text |
|
|
GUID |
N/A |
Globally Unique ID |
In the format xxxxxxxx-xxxx-xxxx-xxxx-xxxxxxxxxxxx (8-4-4-4-12). |
|
TimeStamp |
N/A |
Time Stamp |
In the format YYYY-MM-DD hh:mm:ss. |
Parameters with Properties
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
|
FEInfo |
ListOfGuarantorSelectionObjects |
WEBSVC.ListOfGuarantorSelectionObjects |
This parameter is itself a web service object -- see below for its properties |
Object class: ServiceCodeObject
Parameters with no Properties
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
| ClientID | N/A | Avatar Client ID | |
| DateOfService | N/A | Date | |
| Duration | N/A | Number | |
| Episode | N/A | Episode Number | |
| FeeOverride | N/A | ||
| Location | N/A | Dictionary Code | From Client file, data element 10006 |
| Program | N/A | Avatar Program Code | |
| ServiceCode | N/A | Avatar Service Code |
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.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 |
|
|
|
GuarantorNumber |
Avatar Guarantor ID |
|
|
|
GuarantorOrderNumber |
Number |
|
|
|
GuarantorPlan |
Avatar Guarantor Plan ID |
|
|
|
GuarantorsAddress1 |
Free Text |
|
|
|
GuarantorsAddress2 |
Free Text |
|
|
|
GuarantorsAddressCity |
Free Text |
|
|
|
GuarantorsAddressState |
State |
The state (as in location) the accident occurred in. |
|
|
GuarantorsAddressZipcode |
Zip Code |
|
|
|
GuarantorsPhoneNumber |
Phone Number |
|
|
|
InhibitBillingByMail |
Dictionary Code |
From Client File, data element 190. |
|
|
InsPlanNameOrProgName |
Free Text |
|
|
|
InsuranceCodeMedicaidTape |
Free Text |
|
|
|
IsThisAManagedCareContract |
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 Finmancial Eligibility form. |
|
|
SubscriberAddIDQualifier |
Free Text |
Related to the 'Subscriber Additional Id Qualifier (270-2100C-REF-01)' field in the Cross Episode Finmancial 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. |
|
|
SubscriberEmployerCounty |
Dictionary Code |
From Client File, data element 93. |
|
|
SubscriberEmployerID |
Free Text |
|
|
|
SubscriberEmployerName |
Free Text |
|
|
|
SubscriberEmployerState |
State |
The state (as in location) the accident occurred in. |
|
|
SubscriberEmployerStreet |
Free Text |
|
|
|
SubscriberEmployerZip |
Zip Code |
|
|
|
SubscriberEmploymentID |
Free Text |
|
|
|
SubscriberGroupName |
Free Text |
|
|
|
SubscriberGroupNumber |
Free Text |
|
|
|
SubscriberMedicaidNumber |
Free Text |
|
|
|
SubscriberMedicareNumber |
Free Text |
|
|
|
SubscriberMilitaryStatus |
Dictionary Code |
From Client File, data element 268. |
|
|
SubscriberPhone |
Phone Number |
|
|
|
SubscriberPolicyNumber |
Free Text |
|
|
|
SubscriberPolicyOverride |
Free Text |
|
|
|
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 |
|
|
|
SubscriberState |
State |
The state (as in location) the accident occurred in. |
|
|
SubscriberTreatmentAuth |
Dictionary Code |
From Client File, data element 271. |
|
|
SubscriberWorkPhone |
Phone Number |
|
|
|
SubscriberZip |
Zip Code |
|
|
|
SubscribersBirthDate |
Date |
|
|
|
SubscribersCoveredDays |
Number |
|
|
|
SubscribersEmployment |
Dictionary Code |
From Client File, data element 256. |
|
|
SubscribersFirstName |
Free Text |
|
|
|
SubscribersLastName |
Free Text |
|
|
|
SubscribersMiddleName |
Free Text |
|
|
|
SubscribersName |
Name |
Last, First |
|
|
SubscribersPrefix |
Dictionary Code |
From Client File, data element 175. |
|
|
SubscribersSSNumber |
Social Security Number |
|
|
|
SubscribersSex |
Dictionary Code |
From Client File, data element 255. |
|
|
SubscribersSuffix |
Dictionary Code |
From Client File, data element 174. |
|
|
TitleXXAreaAssigned |
Dictionary Code |
From Client File, data element 10215. |
|
|
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.ListOFPolicyNumberOverrideObjects
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
| ELEMENTTYPE | PolicyNumberOverrideObject | WEBSVC.PolicyNumberOverrideObject | This parameter is itself a web service object -- see below for its properties |
PolicyNumberOverrideObject
| Parameter |
Property |
Value Accepted |
Notes |
|---|---|---|---|
| EndDate | Date | ||
| PolicyNumber | Free Text | ||
| StartDate | Date |