Verify a member’s eligibility and retrieve their coverage details before submitting a prior authorization. Returns the member’s plan information, coverage status, and group number.
payer_id for the payer you intend to submit the prior auth to.Simplex API Key
The name of the stored credential to authenticate with the portal.
The payer to verify against (e.g. "bcbs_tx", "anthem_bcbs").
The member's insurance ID number.
Patient first name.
Patient last name.
Patient date of birth in YYYY-MM-DD format.
Verify member response
Whether the verification was successful.
Confirmed member ID.
Patient first name as registered with the payer.
Patient last name as registered with the payer.
Full payer name (e.g. "Blue Cross Blue Shield of Texas").
Current coverage status.
active, inactive, terminated Patient date of birth.
Insurance plan name.
Insurance group number.
Coverage effective date (YYYY-MM-DD).
Coverage termination date, if applicable (YYYY-MM-DD).