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GET
List eligibility checks
Each eligibility check is one 270/271 verification: a request sent to a payer and the benefits response that came back. This endpoint returns the check headers, each with a benefits_summary (the headline deductible and out-of-pocket numbers) and a benefit_count. To read the full per-benefit detail for a check, use its id with Get Eligibility Benefits. Filter by service-date range, patient_mrn, or coverage_status. A check whose coverage_status is error is one the payer could not process (for example a missing provider NPI); the reason is in status_message.

Example Request

Example Response

Query Parameters

  • start_date / end_date: Filter by service date (YYYY-MM-DD).
  • patient_mrn: Filter to a single patient by medical record number.
  • coverage_status: Filter by active, inactive, error, or unknown.
  • page: Page number (default 1).
  • page_size: Results per page (default 100, max 500).

Response Parameters

  • id: Cobalt’s eligibility check identifier. Use this in the benefits endpoint path.
  • emr_id: The eligibility request identifier as it appears in the EMR.
  • emr_patient_id / patient_name / patient_dob: The patient the check was run for.
  • emr_encounter_id: The encounter/visit the check is tied to.
  • provider_name / payer_name: Rendering provider and the payer that responded.
  • subscriber_name / subscriber_member_id / patient_relationship: Subscriber details; patient_relationship is self or dependent.
  • plan_name: Plan description from the 271.
  • coverage_status: active, inactive, error (payer could not process the request), or unknown.
  • status_message: Payer reject reason when coverage_status is error.
  • service_date / response_at: Date of service and when the payer response was received.
  • plan_begin_date / plan_end_date: The plan’s effective date range (either may be null).
  • benefits_summary: Headline EOB rollup. deductible and out_of_pocket are each split by individual / family into total and remaining amounts.
  • benefit_count: Number of benefit lines parsed from the 271.
  • pagination: page, page_size, total_records, total_pages.

Authorizations

client_id
string
header
required
client_secret
string
header
required
access_token
string
header
required

Query Parameters

start_date
string<date>

Filter to checks with a service date on or after this date (YYYY-MM-DD).

end_date
string<date>

Filter to checks with a service date on or before this date (YYYY-MM-DD).

patient_mrn
string

Filter to a single patient by medical record number.

coverage_status
enum<string>

Filter by coverage status.

Available options:
active,
inactive,
error,
unknown
page
integer
default:1

Page number (default 1).

page_size
integer
default:100

Results per page (default 100, max 500).

Required range: x <= 500

Response

Successful response

success
boolean
eligibility_checks
object[]
pagination
object