POST
/
api
/
eligibility
/
v2
curl --request POST \
  --url https://forecaster.cairhealth.com/api/eligibility/v2 \
  --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",
  "serviceTypeCodes": [
    "30"
  ]
}'
{
  "30": {
    "inNetwork": {
      "individual": {
        "copay": "N/A",
        "deductible": {
          "total": "$2,000.00",
          "remaining": "$2,000.00"
        },
        "coinsurance": "N/A",
        "stopLoss": "$6,850.00"
      },
      "family": {
        "copay": "N/A",
        "deductible": {
          "total": "N/A",
          "remaining": "N/A"
        },
        "coinsurance": "N/A",
        "stopLoss": "N/A"
      }
    },
    "outNetwork": {
      "individual": {
        "copay": "N/A",
        "deductible": {
          "total": "$6,000.00",
          "remaining": "$6,000.00"
        },
        "coinsurance": "N/A",
        "stopLoss": "$14,000.00"
      },
      "family": {
        "copay": "N/A",
        "deductible": {
          "total": "N/A",
          "remaining": "N/A"
        },
        "coinsurance": "N/A",
        "stopLoss": "N/A"
      }
    },
    "message": "Eligibility check successful"
  }
}

The following endpoint requires provider enrollment through our platform. Refer to the platform help guides or contact Cair Support with any questions.

Mock Requests

To send a mock request without incurring charges, set the mockRequest parameter in the body to true. There are 4 scenarios you may test with. Refer to Mock Eligibility for the scenarios.

Data Richness

The response you receive will vary by payer. We parse the EDI response to the best of our ability, and the presence of an N/A in any field does not necessarily mean that the benefit is not present in the subscriber’s insurance plan.

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

The body is of type object.

Response

200
application/json
Eligibility check successful

The response is of type object.