> For clean Markdown of any page, append .md to the page URL.
> For a complete documentation index, see https://docs.usebridge.com/documentation/eligibility/conditional-patient-responsibility/llms.txt.
> For AI client integration (Claude Code, Cursor, etc.), connect to the MCP server at https://docs.usebridge.com/_mcp/server.

# Conditional Patient Responsibility

Certain services may offer better coverage based on the patient's clinical history, resulting in lower patient responsibilities. Policies may limit the number of times care can be provided within a period. Bridge's system can process clinical information during an eligibility request.

# Behavior

## Service Eligibility

When a [Service Eligibility request](/api/api-reference/service-eligibility/v-2/create-service-eligibility) is made, and `clinicalInfo` is included, Bridge will inspect the policy against payer support.

If there is potential support, the Service Eligibility will contain an array of `ConditionalPatientResponsibility` objects.
Each will describe *why* it was matched against the request, and an additional `PatientResponsibility` nested within.

The original, unmodified `PatientResponsibility` will still be present at the root of the object.

## Services

When [creating a Service](/api/api-reference/services/create-service), under the `serviceEligibility` field, provide either the `ServiceEligibility` ID that was used for the original check, or a copy of the `clinicalInfo`, to properly associate Conditional Patient Responsibility at the Service. Please note that even when providing an existing ServiceEligibility ID, a new ServiceEligibility resource will be created as a child of the Service.

# Limits

Limits include a `type`, `value`, `period`, and `metric`. Together, these can influence how you communicate eligibility to patients.

Bridge is *not* currently able to provide a value for the number of times a patient has claimed for a service in this period.

* Type `UNKNOWN`
  * It is not known whether there is a limit or not
* Type `UNLIMITED`
  * This plan is known to support an unlimited number of visits
* Type `LIMIT`, without a `value`
  * This plan is known to have a limit, but the actual limit value cannot be determined
* Type `LIMIT`, with a `value`
  * This plan has a limit, that value is known

## Period

The period value indicates the time period over which the limit applies.

* `ANNUAL`
* `BENEFIT_YEAR`
* `LIFETIME`

## Metric

The metric value indicates what the limit `value` represents over the `period`.

* `VISIT`
  * This plan allows `value` visits per `period`
* `UNITS`
  * This plan allows `value` billing units per `period`

#### [Testing Conditional Patient Responsibility](/api/resources/testing#conditional-patient-responsibility)