POST
/
api
/
eligibility
/
cob
/
v1
cURL
curl --request POST \
  --url https://forecaster.cairhealth.com/api/eligibility/cob/v1 \
  --header 'Authorization: Bearer <token>' \
  --header 'Content-Type: application/json' \
  --data '{
  "patientFirstName": "John",
  "patientLastName": "Doe",
  "patientDOB": "01-01-1991",
  "patientMemberId": "U1234567",
  "dateOfCoverage": "03-24-2025",
  "payerId": "HGJLR",
  "providerId": "0195b964-5b2c-7bb3-875a-276ad770dc66"
}'
{
  "cobCode": "CobInstanceExistsPrimacyDetermined",
  "requestedPlanBenefits": [
    {
      "payerName": "Blue Cross",
      "serviceTypeCodes": [
        {
          "code": "30",
          "name": "Health Benefit Plan Coverage"
        }
      ],
      "benefitDate": {
        "planStartDate": "2024-01-01"
      }
    }
  ],
  "additionalPlanBenefitInfo": [
    {
      "payerName": "Aetna",
      "payerPrimacy": "SecondaryPayer",
      "serviceTypeCodes": [
        {
          "code": "30",
          "name": "Health Benefit Plan Coverage"
        }
      ],
      "benefitDate": {
        "overlapBeginDate": "2024-01-01",
        "overlapEndDate": "2024-12-31",
        "planStartDate": "2024-01-01",
        "planEndDate": "2024-12-31",
        "coordinationOfBenefits": "2024-01-01"
      },
      "subscriber": {
        "firstName": "John",
        "lastName": "Doe",
        "dateOfBirth": "1990-01-01",
        "memberId": "W9876543"
      }
    }
  ]
}
The following endpoint requires provider enrollment through our platform. Refer to the platform help guides or contact Cair Support with any questions.
Use this endpoint to search for health benefit coverage information in the case that a patient has more than one insurance plan. This check can also be performed as part of an eligibility check automatically by setting the runCobCheck flag to true.

​
Possible COB codes

CodeDescription
MemberFoundNoCOBNo coordination of benefits found for this member
CoverageOverlapNoBenefitOverlapMultiple coverages found but no overlap in benefits
CoverageOverlapExistsNotSubjectToCobCoverage overlap exists but is not subject to COB
CobInstanceExistsPrimacyUndeterminedCOB exists but primary/secondary status is undetermined. Likely requires a phone call to verify
CobInstanceExistsPrimacyDeterminedCOB exists with determined primacy for payer

Authorizations

​
Authorization
string
header
required

Bearer authentication header of the form Bearer <token>, where <token> is your auth token.

Body

application/json

Patient and coverage information for COB check

​
patientFirstName
string
required

Patient first name

​
patientLastName
string
required

Patient last name

​
dateOfCoverage
string
required

Date to request coverage information. Formatted as MM-DD-YYYY

​
payerId
string
required

Payer ID. Can be found under the enrollments page in the platform, or the Fetch Enrollments API

​
providerId
string
required

Provider ID. Can be found by copying the enrollment ID in the enrollments page in the platform, or the Fetch Enrollments API

​
patientDOB
string

Patient Date of Birth, formatted as MM-DD-YYYY

​
patientMemberId
string

Member ID of patient's insurance policy. For a successful check, you MUST provide either the member ID or the SSN.

​
patientSSN
string

Patient's Social Security Number. For a successful check, you MUST provide either the member ID or the SSN.

​
dependentFirstName
string

Dependent's first name if checking coverage for a dependent

​
dependentLastName
string

Dependent's last name if checking coverage for a dependent

​
dependentDOB
string

Dependent's Date of Birth, formatted as MM-DD-YYYY

​
serviceTypeCodes
string[]

Service type codes to request coverage information for

Response

COB check successful

​
cobCode
string

Code indicating the type of coordination of benefits

​
requestedPlanBenefits
object[]

Information about the requested plan benefits

​
additionalPlanBenefitInfo
object[]

Additional information about plan benefits