Patients

Patients represent individual people who hold insurance policies.

The Patient resource has optional externalId and metadata fields, which may be used to map keys/values back into your system. Uniqueness is not enforced on these values. The value in externalId will be returned in payout/billing reports.

The coverage field references the Patient’s active insurance. Expect a single entry, associating secondary insurance is not yet supported.

New Patient Workflow

Typically, new user hard eligibility checks are executed without an associated Patient. This is because new resources are created while retrying due to user input or payer issues.

When a confirmed Policy is found, it can be associated either when creating the Patient or by updating the Patient - setting the coverage value to the Policy ID.