UnitedHealthcare Eligibility Request

Request parameters for real-time eligibility and benefit verification

Health InsuranceHealthcareFHIRClaimsEligibility

Properties

Name	Type	Description
memberId	string	UnitedHealthcare member ID
dateOfBirth	string	Member date of birth
serviceType	string	X12 service type code
dateOfService	string	Requested date of service
npi	string	Rendering provider NPI
groupNumber	string	Insurance group number

View JSON Schema on GitHub

JSON Schema

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-eligibility-request-schema.json",
  "title": "UnitedHealthcare Eligibility Request",
  "description": "Request parameters for real-time eligibility and benefit verification",
  "type": "object",
  "required": [
    "memberId",
    "dateOfBirth",
    "serviceType",
    "dateOfService"
  ],
  "properties": {
    "memberId": {
      "type": "string",
      "description": "UnitedHealthcare member ID"
    },
    "dateOfBirth": {
      "type": "string",
      "format": "date",
      "description": "Member date of birth"
    },
    "serviceType": {
      "type": "string",
      "description": "X12 service type code"
    },
    "dateOfService": {
      "type": "string",
      "format": "date",
      "description": "Requested date of service"
    },
    "npi": {
      "type": "string",
      "description": "Rendering provider NPI"
    },
    "groupNumber": {
      "type": "string",
      "description": "Insurance group number"
    }
  }
}