Real Time Coordination of Benefits Check

POST

api

eligibility

cob

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"
}
'

import requests

url = "https://forecaster.cairhealth.com/api/eligibility/cob/v1"

payload = {
    "patientFirstName": "John",
    "patientLastName": "Doe",
    "patientDOB": "01-01-1991",
    "patientMemberId": "U1234567",
    "dateOfCoverage": "03-24-2025",
    "payerId": "HGJLR",
    "providerId": "0195b964-5b2c-7bb3-875a-276ad770dc66"
}
headers = {
    "Authorization": "Bearer <token>",
    "Content-Type": "application/json"
}

response = requests.post(url, json=payload, headers=headers)

print(response.text)

const options = {
  method: 'POST',
  headers: {Authorization: 'Bearer <token>', 'Content-Type': 'application/json'},
  body: JSON.stringify({
    patientFirstName: 'John',
    patientLastName: 'Doe',
    patientDOB: '01-01-1991',
    patientMemberId: 'U1234567',
    dateOfCoverage: '03-24-2025',
    payerId: 'HGJLR',
    providerId: '0195b964-5b2c-7bb3-875a-276ad770dc66'
  })
};

fetch('https://forecaster.cairhealth.com/api/eligibility/cob/v1', options)
  .then(res => res.json())
  .then(res => console.log(res))
  .catch(err => console.error(err));

<?php

$curl = curl_init();

curl_setopt_array($curl, [
  CURLOPT_URL => "https://forecaster.cairhealth.com/api/eligibility/cob/v1",
  CURLOPT_RETURNTRANSFER => true,
  CURLOPT_ENCODING => "",
  CURLOPT_MAXREDIRS => 10,
  CURLOPT_TIMEOUT => 30,
  CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
  CURLOPT_CUSTOMREQUEST => "POST",
  CURLOPT_POSTFIELDS => json_encode([
    'patientFirstName' => 'John',
    'patientLastName' => 'Doe',
    'patientDOB' => '01-01-1991',
    'patientMemberId' => 'U1234567',
    'dateOfCoverage' => '03-24-2025',
    'payerId' => 'HGJLR',
    'providerId' => '0195b964-5b2c-7bb3-875a-276ad770dc66'
  ]),
  CURLOPT_HTTPHEADER => [
    "Authorization: Bearer <token>",
    "Content-Type: application/json"
  ],
]);

$response = curl_exec($curl);
$err = curl_error($curl);

curl_close($curl);

if ($err) {
  echo "cURL Error #:" . $err;
} else {
  echo $response;
}

package main

import (
	"fmt"
	"strings"
	"net/http"
	"io"
)

func main() {

	url := "https://forecaster.cairhealth.com/api/eligibility/cob/v1"

	payload := strings.NewReader("{\n  \"patientFirstName\": \"John\",\n  \"patientLastName\": \"Doe\",\n  \"patientDOB\": \"01-01-1991\",\n  \"patientMemberId\": \"U1234567\",\n  \"dateOfCoverage\": \"03-24-2025\",\n  \"payerId\": \"HGJLR\",\n  \"providerId\": \"0195b964-5b2c-7bb3-875a-276ad770dc66\"\n}")

	req, _ := http.NewRequest("POST", url, payload)

	req.Header.Add("Authorization", "Bearer <token>")
	req.Header.Add("Content-Type", "application/json")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(string(body))

}

HttpResponse<String> response = Unirest.post("https://forecaster.cairhealth.com/api/eligibility/cob/v1")
  .header("Authorization", "Bearer <token>")
  .header("Content-Type", "application/json")
  .body("{\n  \"patientFirstName\": \"John\",\n  \"patientLastName\": \"Doe\",\n  \"patientDOB\": \"01-01-1991\",\n  \"patientMemberId\": \"U1234567\",\n  \"dateOfCoverage\": \"03-24-2025\",\n  \"payerId\": \"HGJLR\",\n  \"providerId\": \"0195b964-5b2c-7bb3-875a-276ad770dc66\"\n}")
  .asString();

require 'uri'
require 'net/http'

url = URI("https://forecaster.cairhealth.com/api/eligibility/cob/v1")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Post.new(url)
request["Authorization"] = 'Bearer <token>'
request["Content-Type"] = 'application/json'
request.body = "{\n  \"patientFirstName\": \"John\",\n  \"patientLastName\": \"Doe\",\n  \"patientDOB\": \"01-01-1991\",\n  \"patientMemberId\": \"U1234567\",\n  \"dateOfCoverage\": \"03-24-2025\",\n  \"payerId\": \"HGJLR\",\n  \"providerId\": \"0195b964-5b2c-7bb3-875a-276ad770dc66\"\n}"

response = http.request(request)
puts response.read_body

{
  "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"
      }
    }
  ]
}

{
  "message": "<string>"
}

{
  "message": "<string>"
}

{
  "message": "<string>"
}

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

Code	Description
`MemberFoundNoCOB`	No coordination of benefits found for this member
`CoverageOverlapNoBenefitOverlap`	Multiple coverages found but no overlap in benefits
`CoverageOverlapExistsNotSubjectToCob`	Coverage overlap exists but is not subject to COB
`CobInstanceExistsPrimacyUndetermined`	COB exists but primary/secondary status is undetermined. Likely requires a phone call to verify
`CobInstanceExistsPrimacyDetermined`	COB 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

Show child attributes

additionalPlanBenefitInfo

object[]

Additional information about plan benefits

Show child attributes

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"
}
'

import requests

url = "https://forecaster.cairhealth.com/api/eligibility/cob/v1"

payload = {
    "patientFirstName": "John",
    "patientLastName": "Doe",
    "patientDOB": "01-01-1991",
    "patientMemberId": "U1234567",
    "dateOfCoverage": "03-24-2025",
    "payerId": "HGJLR",
    "providerId": "0195b964-5b2c-7bb3-875a-276ad770dc66"
}
headers = {
    "Authorization": "Bearer <token>",
    "Content-Type": "application/json"
}

response = requests.post(url, json=payload, headers=headers)

print(response.text)

const options = {
  method: 'POST',
  headers: {Authorization: 'Bearer <token>', 'Content-Type': 'application/json'},
  body: JSON.stringify({
    patientFirstName: 'John',
    patientLastName: 'Doe',
    patientDOB: '01-01-1991',
    patientMemberId: 'U1234567',
    dateOfCoverage: '03-24-2025',
    payerId: 'HGJLR',
    providerId: '0195b964-5b2c-7bb3-875a-276ad770dc66'
  })
};

fetch('https://forecaster.cairhealth.com/api/eligibility/cob/v1', options)
  .then(res => res.json())
  .then(res => console.log(res))
  .catch(err => console.error(err));

<?php

$curl = curl_init();

curl_setopt_array($curl, [
  CURLOPT_URL => "https://forecaster.cairhealth.com/api/eligibility/cob/v1",
  CURLOPT_RETURNTRANSFER => true,
  CURLOPT_ENCODING => "",
  CURLOPT_MAXREDIRS => 10,
  CURLOPT_TIMEOUT => 30,
  CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
  CURLOPT_CUSTOMREQUEST => "POST",
  CURLOPT_POSTFIELDS => json_encode([
    'patientFirstName' => 'John',
    'patientLastName' => 'Doe',
    'patientDOB' => '01-01-1991',
    'patientMemberId' => 'U1234567',
    'dateOfCoverage' => '03-24-2025',
    'payerId' => 'HGJLR',
    'providerId' => '0195b964-5b2c-7bb3-875a-276ad770dc66'
  ]),
  CURLOPT_HTTPHEADER => [
    "Authorization: Bearer <token>",
    "Content-Type: application/json"
  ],
]);

$response = curl_exec($curl);
$err = curl_error($curl);

curl_close($curl);

if ($err) {
  echo "cURL Error #:" . $err;
} else {
  echo $response;
}

package main

import (
	"fmt"
	"strings"
	"net/http"
	"io"
)

func main() {

	url := "https://forecaster.cairhealth.com/api/eligibility/cob/v1"

	payload := strings.NewReader("{\n  \"patientFirstName\": \"John\",\n  \"patientLastName\": \"Doe\",\n  \"patientDOB\": \"01-01-1991\",\n  \"patientMemberId\": \"U1234567\",\n  \"dateOfCoverage\": \"03-24-2025\",\n  \"payerId\": \"HGJLR\",\n  \"providerId\": \"0195b964-5b2c-7bb3-875a-276ad770dc66\"\n}")

	req, _ := http.NewRequest("POST", url, payload)

	req.Header.Add("Authorization", "Bearer <token>")
	req.Header.Add("Content-Type", "application/json")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(string(body))

}

HttpResponse<String> response = Unirest.post("https://forecaster.cairhealth.com/api/eligibility/cob/v1")
  .header("Authorization", "Bearer <token>")
  .header("Content-Type", "application/json")
  .body("{\n  \"patientFirstName\": \"John\",\n  \"patientLastName\": \"Doe\",\n  \"patientDOB\": \"01-01-1991\",\n  \"patientMemberId\": \"U1234567\",\n  \"dateOfCoverage\": \"03-24-2025\",\n  \"payerId\": \"HGJLR\",\n  \"providerId\": \"0195b964-5b2c-7bb3-875a-276ad770dc66\"\n}")
  .asString();

require 'uri'
require 'net/http'

url = URI("https://forecaster.cairhealth.com/api/eligibility/cob/v1")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Post.new(url)
request["Authorization"] = 'Bearer <token>'
request["Content-Type"] = 'application/json'
request.body = "{\n  \"patientFirstName\": \"John\",\n  \"patientLastName\": \"Doe\",\n  \"patientDOB\": \"01-01-1991\",\n  \"patientMemberId\": \"U1234567\",\n  \"dateOfCoverage\": \"03-24-2025\",\n  \"payerId\": \"HGJLR\",\n  \"providerId\": \"0195b964-5b2c-7bb3-875a-276ad770dc66\"\n}"

response = http.request(request)
puts response.read_body

{
  "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"
      }
    }
  ]
}

{
  "message": "<string>"
}

{
  "message": "<string>"
}

{
  "message": "<string>"
}

Overview

API Authentication

Eligibility

Enrollments/Providers

Claims

Claim AI Actions

Patient Chart Analysis

Patient Payments

Webhooks

AI Phone Calls

Real Time Coordination of Benefits Check

Possible COB codes

Authorizations

Body

Response

​Possible COB codes

Authorizations

Body

Response

Possible COB codes