vericredclient

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Published: Jan 26, 2017 License: Apache-2.0 Imports: 12 Imported by: 0

README

Go API client for vericredclient

Vericred's API allows you to search for Health Plans that a specific doctor accepts.

Getting Started

Visit our Developer Portal to create an account.

Once you have created an account, you can create one Application for Production and another for our Sandbox (select the appropriate Plan when you create the Application).

SDKs

Our API follows standard REST conventions, so you can use any HTTP client to integrate with us. You will likely find it easier to use one of our autogenerated SDKs, which we make available for several common programming languages.

Authentication

To authenticate, pass the API Key you created in the Developer Portal as a Vericred-Api-Key header.

curl -H 'Vericred-Api-Key: YOUR_KEY' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"

Versioning

Vericred's API default to the latest version. However, if you need a specific version, you can request it with an Accept-Version header.

The current version is v3. Previous versions are v1 and v2.

curl -H 'Vericred-Api-Key: YOUR_KEY' -H 'Accept-Version: v2' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"

Pagination

Endpoints that accept page and per_page parameters are paginated. They expose four additional fields that contain data about your position in the response, namely Total, Per-Page, Link, and Page as described in RFC-5988.

For example, to display 5 results per page and view the second page of a GET to /networks, your final request would be GET /networks?....page=2&per_page=5.

Sideloading

When we return multiple levels of an object graph (e.g. Providers and their States we sideload the associated data. In this example, we would provide an Array of States and a state_id for each provider. This is done primarily to reduce the payload size since many of the Providers will share a State

{
  providers: [{ id: 1, state_id: 1}, { id: 2, state_id: 1 }],
  states: [{ id: 1, code: 'NY' }]
}

If you need the second level of the object graph, you can just match the corresponding id.

Selecting specific data

All endpoints allow you to specify which fields you would like to return. This allows you to limit the response to contain only the data you need.

For example, let's take a request that returns the following JSON by default

{
  provider: {
    id: 1,
    name: 'John',
    phone: '1234567890',
    field_we_dont_care_about: 'value_we_dont_care_about'
  },
  states: [{
    id: 1,
    name: 'New York',
    code: 'NY',
    field_we_dont_care_about: 'value_we_dont_care_about'
  }]
}

To limit our results to only return the fields we care about, we specify the select query string parameter for the corresponding fields in the JSON document.

In this case, we want to select name and phone from the provider key, so we would add the parameters select=provider.name,provider.phone. We also want the name and code from the states key, so we would add the parameters select=states.name,staes.code. The id field of each document is always returned whether or not it is requested.

Our final request would be GET /providers/12345?select=provider.name,provider.phone,states.name,states.code

The response would be

{
  provider: {
    id: 1,
    name: 'John',
    phone: '1234567890'
  },
  states: [{
    id: 1,
    name: 'New York',
    code: 'NY'
  }]
}

Benefits summary format

Benefit cost-share strings are formatted to capture:

  • Network tiers
  • Compound or conditional cost-share
  • Limits on the cost-share
  • Benefit-specific maximum out-of-pocket costs

Example #1 As an example, we would represent this Summary of Benefits & Coverage as:

  • Hospital stay facility fees:

    • Network Provider: $400 copay/admit plus 20% coinsurance
    • Out-of-Network Provider: $1,500 copay/admit plus 50% coinsurance
    • Vericred's format for this benefit: In-Network: $400 before deductible then 20% after deductible / Out-of-Network: $1,500 before deductible then 50% after deductible
  • Rehabilitation services:

    • Network Provider: 20% coinsurance
    • Out-of-Network Provider: 50% coinsurance
    • Limitations & Exceptions: 35 visit maximum per benefit period combined with Chiropractic care.
    • Vericred's format for this benefit: In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period

Example #2 In this other Summary of Benefits & Coverage, the specialty_drugs cost-share has a maximum out-of-pocket for in-network pharmacies.

  • Specialty drugs:
    • Network Provider: 40% coinsurance up to a $500 maximum for up to a 30 day supply
    • Out-of-Network Provider Not covered
    • Vericred's format for this benefit: In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%

BNF

Here's a description of the benefits summary string, represented as a context-free grammar:

<cost-share>     ::= <tier> <opt-num-prefix> <value> <opt-per-unit> <deductible> <tier-limit> "/" <tier> <opt-num-prefix> <value> <opt-per-unit> <deductible> "|" <benefit-limit>
<tier>           ::= "In-Network:" | "In-Network-Tier-2:" | "Out-of-Network:"
<opt-num-prefix> ::= "first" <num> <unit> | ""
<unit>           ::= "day(s)" | "visit(s)" | "exam(s)" | "item(s)"
<value>          ::= <ddct_moop> | <copay> | <coinsurance> | <compound> | "unknown" | "Not Applicable"
<compound>       ::= <copay> <deductible> "then" <coinsurance> <deductible> | <copay> <deductible> "then" <copay> <deductible> | <coinsurance> <deductible> "then" <coinsurance> <deductible>
<copay>          ::= "$" <num>
<coinsurace>     ::= <num> "%"
<ddct_moop>      ::= <copay> | "Included in Medical" | "Unlimited"
<opt-per-unit>   ::= "per day" | "per visit" | "per stay" | ""
<deductible>     ::= "before deductible" | "after deductible" | ""
<tier-limit>     ::= ", " <limit> | ""
<benefit-limit>  ::= <limit> | ""

Overview

This API client was generated by the swagger-codegen project. By using the swagger-spec from a remote server, you can easily generate an API client.

  • API version: 1.0.0
  • Package version: 0.0.6
  • Build package: class io.swagger.codegen.languages.GoClientCodegen

Installation

Put the package under your project folder and add the following in import:

    "./vericredclient"

Documentation for API Endpoints

All URIs are relative to https://api.vericred.com/

Class Method HTTP request Description
DrugPackagesApi ShowFormularyDrugPackageCoverage Get /formularies/{formulary_id}/drug_packages/{ndc_package_code} Formulary Drug Package Search
DrugsApi GetDrugCoverages Get /drug_packages/{ndc_package_code}/coverages Search for DrugCoverages
DrugsApi ListDrugs Get /drugs Drug Search
NetworkSizesApi ListStateNetworkSizes Get /states/{state_id}/network_sizes State Network Sizes
NetworkSizesApi SearchNetworkSizes Post /network_sizes/search Network Sizes
NetworksApi ListNetworks Get /networks Networks
NetworksApi ShowNetwork Get /networks/{id} Network Details
PlansApi FindPlans Post /plans/search Find Plans
PlansApi ShowPlan Get /plans/{id} Show Plan
ProvidersApi GetProvider Get /providers/{npi} Find a Provider
ProvidersApi GetProviders Post /providers/search Find Providers
ProvidersApi GetProviders_0 Post /providers/search/geocode Find Providers
ZipCountiesApi GetZipCounties Get /zip_counties Search for Zip Counties

Documentation For Models

Documentation For Authorization

Vericred-Api-Key

  • Type: API key
  • API key parameter name: Vericred-Api-Key
  • Location: HTTP header

Author

Documentation

Index

Constants

This section is empty.

Variables

This section is empty.

Functions

This section is empty.

Types

type APIClient

type APIClient struct {
	// contains filtered or unexported fields
}

func (*APIClient) CallAPI

func (c *APIClient) CallAPI(path string, method string,
	postBody interface{},
	headerParams map[string]string,
	queryParams url.Values,
	formParams map[string]string,
	fileName string,
	fileBytes []byte) (*resty.Response, error)

func (*APIClient) ParameterToString

func (c *APIClient) ParameterToString(obj interface{}, collectionFormat string) string

func (*APIClient) SelectHeaderAccept

func (c *APIClient) SelectHeaderAccept(accepts []string) string

func (*APIClient) SelectHeaderContentType

func (c *APIClient) SelectHeaderContentType(contentTypes []string) string

type APIResponse

type APIResponse struct {
	*http.Response
	Message string `json:"message,omitempty"`
}

func NewAPIResponse

func NewAPIResponse(r *http.Response) *APIResponse

func NewAPIResponseWithError

func NewAPIResponseWithError(errorMessage string) *APIResponse

type Applicant

type Applicant struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Date of Birth
	Dob time.Time `json:"dob,omitempty"`

	// Member token
	MemberId string `json:"member_id,omitempty"`

	// Full name of the Applicant
	Name string `json:"name,omitempty"`

	// Relationship of the Applicant to the Member
	Relationship string `json:"relationship,omitempty"`

	// Does the Applicant smoke?
	Smoker bool `json:"smoker,omitempty"`

	// Applicant's Social Security Number
	Ssn string `json:"ssn,omitempty"`
}

type Base

type Base struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`
}

type Carrier

type Carrier struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Name of the Carrier
	Name string `json:"name,omitempty"`

	// URL for the Carrier's logo
	LogoPath string `json:"logo_path,omitempty"`
}

type CarrierSubsidiary

type CarrierSubsidiary struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Subsidiary name
	Name string `json:"name,omitempty"`

	// Parent Carrier Name
	AlternateName string `json:"alternate_name,omitempty"`
}

type Configuration

type Configuration struct {
	UserName      string            `json:"userName,omitempty"`
	Password      string            `json:"password,omitempty"`
	APIKeyPrefix  map[string]string `json:"APIKeyPrefix,omitempty"`
	APIKey        map[string]string `json:"APIKey,omitempty"`
	Debug         bool              `json:"debug,omitempty"`
	DebugFile     string            `json:"debugFile,omitempty"`
	OAuthToken    string            `json:"oAuthToken,omitempty"`
	BasePath      string            `json:"basePath,omitempty"`
	Host          string            `json:"host,omitempty"`
	Scheme        string            `json:"scheme,omitempty"`
	AccessToken   string            `json:"accessToken,omitempty"`
	DefaultHeader map[string]string `json:"defaultHeader,omitempty"`
	UserAgent     string            `json:"userAgent,omitempty"`
	APIClient     *APIClient
	Transport     *http.Transport
	Timeout       *time.Duration `json:"timeout,omitempty"`
}

func NewConfiguration

func NewConfiguration() *Configuration

func (*Configuration) AddDefaultHeader

func (c *Configuration) AddDefaultHeader(key string, value string)

func (*Configuration) GetAPIKeyWithPrefix

func (c *Configuration) GetAPIKeyWithPrefix(APIKeyIdentifier string) string

func (*Configuration) GetBasicAuthEncodedString

func (c *Configuration) GetBasicAuthEncodedString() string

type County

type County struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// State FIPS code
	FipsCode string `json:"fips_code,omitempty"`

	// Human-readable name
	Name string `json:"name,omitempty"`

	// Two-character state code
	StateCode string `json:"state_code,omitempty"`

	// state relationship
	StateId int32 `json:"state_id,omitempty"`

	// Is the state containing this county active for consumers?(deprecated in favor of last_date_for_individual)
	StateLive bool `json:"state_live,omitempty"`

	// Is the state containing this county active for business?(deprecated in favor of last_date_for_shop)
	StateLiveForBusiness bool `json:"state_live_for_business,omitempty"`
}

type CountyBulk

type CountyBulk struct {

	// FIPs code for the county
	Id string `json:"id,omitempty"`

	// Name of the county
	Name string `json:"name,omitempty"`

	// State code
	StateId string `json:"state_id,omitempty"`

	// Count of unique rating areas in the county
	RatingAreaCount string `json:"rating_area_count,omitempty"`

	// Count of unique service areas in the county
	ServiceAreaCount string `json:"service_area_count,omitempty"`
}

type Drug

type Drug struct {

	// National Drug Code ID
	Id string `json:"id,omitempty"`

	// Active Ingredient Strength information
	ActiveIngredientStrength string `json:"active_ingredient_strength,omitempty"`

	// Proprietary name of drug
	ProprietaryName string `json:"proprietary_name,omitempty"`

	// Non-proprietary name of drug
	NonProprietaryName string `json:"non_proprietary_name,omitempty"`

	// Array of drug package Ids
	DrugPackageIds []string `json:"drug_package_ids,omitempty"`
}

type DrugCoverage

type DrugCoverage struct {

	// Health Insurance Oversight System id
	PlanId string `json:"plan_id,omitempty"`

	// NDC package code
	DrugPackageId string `json:"drug_package_id,omitempty"`

	// Med ID
	MedId int32 `json:"med_id,omitempty"`

	// Quantity limit exists
	QuantityLimit bool `json:"quantity_limit,omitempty"`

	// Prior authorization required
	PriorAuthorization bool `json:"prior_authorization,omitempty"`

	// Step Treatment required
	StepTherapy bool `json:"step_therapy,omitempty"`

	// Tier Name
	Tier string `json:"tier,omitempty"`
}

type DrugCoverageResponse

type DrugCoverageResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// DrugCoverage search results
	DrugCoverages []DrugCoverage `json:"drug_coverages,omitempty"`

	// Drug
	Drugs []Drug `json:"drugs,omitempty"`

	// Drug Packages
	DrugPackages []DrugPackage `json:"drug_packages,omitempty"`
}

type DrugPackage

type DrugPackage struct {

	// National Drug Code ID (Package)
	Id string `json:"id,omitempty"`

	// Package description
	Description string `json:"description,omitempty"`

	// Med ID
	MedId int32 `json:"med_id,omitempty"`
}

type DrugPackagesApi

type DrugPackagesApi struct {
	Configuration *Configuration
}

func NewDrugPackagesApi

func NewDrugPackagesApi() *DrugPackagesApi

func NewDrugPackagesApiWithBasePath

func NewDrugPackagesApiWithBasePath(basePath string) *DrugPackagesApi

func (DrugPackagesApi) ShowFormularyDrugPackageCoverage

func (a DrugPackagesApi) ShowFormularyDrugPackageCoverage(formularyId string, ndcPackageCode string) (*FormularyDrugPackageResponse, *APIResponse, error)

*

  • Formulary Drug Package Search
  • Search for coverage by Formulary and DrugPackage ID *
  • @param formularyId ID of the Formulary in question
  • @param ndcPackageCode ID of the DrugPackage in question
  • @return *FormularyDrugPackageResponse

type DrugSearchResponse

type DrugSearchResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// Drugs found in query
	Drugs []Drug `json:"drugs,omitempty"`

	// DrugPackages
	DrugPackages []DrugPackage `json:"drug_packages,omitempty"`
}

type DrugsApi

type DrugsApi struct {
	Configuration *Configuration
}

func NewDrugsApi

func NewDrugsApi() *DrugsApi

func NewDrugsApiWithBasePath

func NewDrugsApiWithBasePath(basePath string) *DrugsApi

func (DrugsApi) GetDrugCoverages

func (a DrugsApi) GetDrugCoverages(ndcPackageCode string, audience string, stateCode string) (*DrugCoverageResponse, *APIResponse, error)

*

  • Search for DrugCoverages
  • Drug Coverages are the specific tier level, quantity limit, prior authorization and step therapy for a given Drug/Plan combination. This endpoint returns all DrugCoverages for a given Drug *
  • @param ndcPackageCode NDC package code
  • @param audience Plan Audience (individual or small_group)
  • @param stateCode Two-character state code
  • @return *DrugCoverageResponse

func (DrugsApi) ListDrugs

func (a DrugsApi) ListDrugs(searchTerm string) (*DrugSearchResponse, *APIResponse, error)

*

  • Drug Search
  • Search for drugs by proprietary name *
  • @param searchTerm Full or partial proprietary name of drug
  • @return *DrugSearchResponse

type Formulary

type Formulary struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Name of the Formulary
	Name string `json:"name,omitempty"`
}

type FormularyDrugPackageResponse

type FormularyDrugPackageResponse struct {

	// DrugCoverage
	Coverage DrugCoverage `json:"coverage,omitempty"`

	// DrugPackage
	DrugPackage DrugPackage `json:"drug_package,omitempty"`

	// Formulary
	Formulary Formulary `json:"formulary,omitempty"`
}

type FormularyResponse

type FormularyResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// List of formularies.
	Formularies []Formulary `json:"formularies,omitempty"`
}

type Meta

type Meta struct {

	// Number of entities returned
	Total int32 `json:"total,omitempty"`
}

type Network

type Network struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Name of the Network
	Name string `json:"name,omitempty"`
}

type NetworkDetails

type NetworkDetails struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Name of the Network
	Name string `json:"name,omitempty"`

	// List of issuer IDs
	HiosIssuerIds []int32 `json:"hios_issuer_ids,omitempty"`
}

type NetworkDetailsResponse

type NetworkDetailsResponse struct {

	// Network details
	Network NetworkDetails `json:"network,omitempty"`
}

type NetworkSearchResponse

type NetworkSearchResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// Networks that fit the requested criterion.
	Networks []Network `json:"networks,omitempty"`
}

type NetworkSize

type NetworkSize struct {

	// Foreign key to Network
	NetworkId int32 `json:"network_id,omitempty"`

	// Number of Providers in-network in this State
	Count int32 `json:"count,omitempty"`

	// Foreign key to State
	StateId string `json:"state_id,omitempty"`
}

type NetworkSizesApi

type NetworkSizesApi struct {
	Configuration *Configuration
}

func NewNetworkSizesApi

func NewNetworkSizesApi() *NetworkSizesApi

func NewNetworkSizesApiWithBasePath

func NewNetworkSizesApiWithBasePath(basePath string) *NetworkSizesApi

func (NetworkSizesApi) ListStateNetworkSizes

func (a NetworkSizesApi) ListStateNetworkSizes(stateId string, page int32, perPage int32) (*StateNetworkSizeResponse, *APIResponse, error)

*

  • State Network Sizes
  • The number of in-network Providers for each network in a given state. This data is recalculated nightly. The endpoint is paginated. *
  • @param stateId State code
  • @param page Page of paginated response
  • @param perPage Responses per page
  • @return *StateNetworkSizeResponse

func (NetworkSizesApi) SearchNetworkSizes

*

  • Network Sizes
  • The number of in-network Providers for each network/state combination provided. This data is recalculated nightly. *
  • @param body
  • @return *StateNetworkSizeResponse

type NetworksApi

type NetworksApi struct {
	Configuration *Configuration
}

func NewNetworksApi

func NewNetworksApi() *NetworksApi

func NewNetworksApiWithBasePath

func NewNetworksApiWithBasePath(basePath string) *NetworksApi

func (NetworksApi) ListNetworks

func (a NetworksApi) ListNetworks(carrierId string, page int32, perPage int32) (*NetworkSearchResponse, *APIResponse, error)

*

  • Networks
  • A network is a list of the doctors, other health care providers, and hospitals that a plan has contracted with to provide medical care to its members. This endpoint is paginated. *
  • @param carrierId Carrier HIOS Issuer ID
  • @param page Page of paginated response
  • @param perPage Responses per page
  • @return *NetworkSearchResponse

func (NetworksApi) ShowNetwork

func (a NetworksApi) ShowNetwork(id int32) (*NetworkDetailsResponse, *APIResponse, error)

*

  • Network Details
  • A network is a list of the doctors, other health care providers, and hospitals that a plan has contracted with to provide medical care to its members. *
  • @param id Primary key of the network
  • @return *NetworkDetailsResponse

type Plan

type Plan struct {

	// Does the plan provide dental coverage for adults?
	AdultDental bool `json:"adult_dental,omitempty"`

	// True if the plan allows dependents up to age 29
	Age29Rider bool `json:"age29_rider,omitempty"`

	// Benefits string for ambulance coverage
	Ambulance string `json:"ambulance,omitempty"`

	// Link to the summary of benefits and coverage (SBC) document.
	BenefitsSummaryUrl string `json:"benefits_summary_url,omitempty"`

	// Link to a location to purchase the plan.
	BuyLink string `json:"buy_link,omitempty"`

	// Name of the insurance carrier
	CarrierName string `json:"carrier_name,omitempty"`

	// Does the plan provide dental coverage for children?
	ChildDental bool `json:"child_dental,omitempty"`

	// Child eyewear benefits summary
	ChildEyewear string `json:"child_eyewear,omitempty"`

	// Child eye exam benefits summary
	ChildEyeExam string `json:"child_eye_exam,omitempty"`

	// Phone number to contact the insurance carrier
	CustomerServicePhoneNumber string `json:"customer_service_phone_number,omitempty"`

	// Benefits summary for durable medical equipment
	DurableMedicalEquipment string `json:"durable_medical_equipment,omitempty"`

	// Diagnostic tests benefit summary
	DiagnosticTest string `json:"diagnostic_test,omitempty"`

	// Alternate name for the Plan
	DisplayName string `json:"display_name,omitempty"`

	// True if plan does not cover domestic partners
	DpRider bool `json:"dp_rider,omitempty"`

	// Link to the summary of drug benefits for the plan
	DrugFormularyUrl string `json:"drug_formulary_url,omitempty"`

	// Effective date of coverage.
	EffectiveDate string `json:"effective_date,omitempty"`

	// Expiration date of coverage.
	ExpirationDate string `json:"expiration_date,omitempty"`

	// Description of costs when visiting the ER
	EmergencyRoom string `json:"emergency_room,omitempty"`

	// Deductible for drugs when a family is on the plan.
	FamilyDrugDeductible string `json:"family_drug_deductible,omitempty"`

	// Maximum out-of-pocket for drugs when a family is on the plan
	FamilyDrugMoop string `json:"family_drug_moop,omitempty"`

	// Deductible when a family is on the plan
	FamilyMedicalDeductible string `json:"family_medical_deductible,omitempty"`

	// Maximum out-of-pocket when a family is on the plan
	FamilyMedicalMoop string `json:"family_medical_moop,omitempty"`

	// True if plan does not cover family planning
	FpRider bool `json:"fp_rider,omitempty"`

	// Cost for generic drugs
	GenericDrugs string `json:"generic_drugs,omitempty"`

	// Habilitation services benefits summary
	HabilitationServices string `json:"habilitation_services,omitempty"`

	//
	HiosIssuerId string `json:"hios_issuer_id,omitempty"`

	// Home health care benefits summary
	HomeHealthCare string `json:"home_health_care,omitempty"`

	// Hospice service benefits summary
	HospiceService string `json:"hospice_service,omitempty"`

	// Is the plan HSA eligible?
	HsaEligible bool `json:"hsa_eligible,omitempty"`

	// Government-issued HIOS plan ID
	Id string `json:"id,omitempty"`

	// Benefits summary for imaging coverage
	Imaging string `json:"imaging,omitempty"`

	// List of NPI numbers for Providers passed in who accept this Plan
	InNetworkIds []int32 `json:"in_network_ids,omitempty"`

	// Deductible for drugs when an individual is on the plan
	IndividualDrugDeductible string `json:"individual_drug_deductible,omitempty"`

	// Maximum out-of-pocket for drugs when an individual is on the plan
	IndividualDrugMoop string `json:"individual_drug_moop,omitempty"`

	// Deductible when an individual is on the plan
	IndividualMedicalDeductible string `json:"individual_medical_deductible,omitempty"`

	// Maximum out-of-pocket when an individual is on the plan
	IndividualMedicalMoop string `json:"individual_medical_moop,omitempty"`

	// Inpatient birth benefits summary
	InpatientBirth string `json:"inpatient_birth,omitempty"`

	// Cost under the plan for an inpatient facility
	InpatientFacility string `json:"inpatient_facility,omitempty"`

	// Inpatient mental helath benefits summary
	InpatientMentalHealth string `json:"inpatient_mental_health,omitempty"`

	// Cost under the plan for an inpatient physician
	InpatientPhysician string `json:"inpatient_physician,omitempty"`

	// Inpatient substance abuse benefits summary
	InpatientSubstance string `json:"inpatient_substance,omitempty"`

	// Plan metal grouping (e.g. platinum, gold, silver, etc)
	Level string `json:"level,omitempty"`

	// Link to a copy of the insurance carrier's logo
	LogoUrl string `json:"logo_url,omitempty"`

	// Marketing name of the plan
	Name string `json:"name,omitempty"`

	// Total number of Providers in network
	NetworkSize int32 `json:"network_size,omitempty"`

	// Cost under the plan for non-preferred brand drugs
	NonPreferredBrandDrugs string `json:"non_preferred_brand_drugs,omitempty"`

	// Is the plan on-market?
	OnMarket bool `json:"on_market,omitempty"`

	// Is the plan off-market?
	OffMarket bool `json:"off_market,omitempty"`

	// Does this plan provide any out of network coverage?
	OutOfNetworkCoverage bool `json:"out_of_network_coverage,omitempty"`

	// List of NPI numbers for Providers passed in who do not accept this Plan
	OutOfNetworkIds []int32 `json:"out_of_network_ids,omitempty"`

	// Benefits summary for outpatient facility coverage
	OutpatientFacility string `json:"outpatient_facility,omitempty"`

	// Benefits summary for outpatient mental health coverage
	OutpatientMentalHealth string `json:"outpatient_mental_health,omitempty"`

	// Benefits summary for outpatient physician coverage
	OutpatientPhysician string `json:"outpatient_physician,omitempty"`

	// Outpatient substance abuse benefits summary
	OutpatientSubstance string `json:"outpatient_substance,omitempty"`

	// Market in which the plan is offered (on_marketplace, shop, etc)
	PlanMarket string `json:"plan_market,omitempty"`

	// Category of the plan (e.g. EPO, HMO, PPO, POS, Indemnity)
	PlanType string `json:"plan_type,omitempty"`

	// Cost under the plan for perferred brand drugs
	PreferredBrandDrugs string `json:"preferred_brand_drugs,omitempty"`

	// Inpatient substance abuse benefits summary
	PrenatalPostnatalCare string `json:"prenatal_postnatal_care,omitempty"`

	// Benefits summary for preventative care
	PreventativeCare string `json:"preventative_care,omitempty"`

	// Cumulative premium amount after subsidy
	PremiumSubsidized float32 `json:"premium_subsidized,omitempty"`

	// Cumulative premium amount
	Premium float32 `json:"premium,omitempty"`

	// Source of the base pricing data
	PremiumSource string `json:"premium_source,omitempty"`

	// Cost under the plan to visit a Primary Care Physician
	PrimaryCarePhysician string `json:"primary_care_physician,omitempty"`

	// Benefits summary for rehabilitation services
	RehabilitationServices string `json:"rehabilitation_services,omitempty"`

	// Foreign key for service area
	ServiceAreaId string `json:"service_area_id,omitempty"`

	// Benefits summary for skilled nursing services
	SkilledNursing string `json:"skilled_nursing,omitempty"`

	// Cost under the plan to visit a specialist
	Specialist string `json:"specialist,omitempty"`

	// Cost under the plan for specialty drugs
	SpecialtyDrugs string `json:"specialty_drugs,omitempty"`

	// Benefits summary for urgent care
	UrgentCare string `json:"urgent_care,omitempty"`
}

type PlanCounty

type PlanCounty struct {

	// Foreign key to plan
	PlanId int32 `json:"plan_id,omitempty"`

	// Foreign key to county
	CountyId int32 `json:"county_id,omitempty"`
}

type PlanCountyBulk

type PlanCountyBulk struct {

	// Foreign key to plan
	PlanId int32 `json:"plan_id,omitempty"`

	// Foreign key to county
	CountyId int32 `json:"county_id,omitempty"`
}

type PlanSearchResponse

type PlanSearchResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// Plan search results
	Plans []Plan `json:"plans,omitempty"`

	// Coverages associated with the plan.
	Coverages []DrugCoverage `json:"coverages,omitempty"`
}

type PlanSearchResponseMeta

type PlanSearchResponseMeta struct {

	// Number of entities returned
	Total int32 `json:"total,omitempty"`

	// Is this applicant potentially eligible for Chip or Medicaid?
	EligibleForChipMedicaid bool `json:"eligible_for_chip_medicaid,omitempty"`
}

type PlanSearchResult

type PlanSearchResult struct {

	// Does the plan provide dental coverage for adults?
	AdultDental bool `json:"adult_dental,omitempty"`

	// True if the plan allows dependents up to age 29
	Age29Rider bool `json:"age29_rider,omitempty"`

	// Benefits string for ambulance coverage
	Ambulance string `json:"ambulance,omitempty"`

	// Link to the summary of benefits and coverage (SBC) document.
	BenefitsSummaryUrl string `json:"benefits_summary_url,omitempty"`

	// Link to a location to purchase the plan.
	BuyLink string `json:"buy_link,omitempty"`

	// Name of the insurance carrier
	CarrierName string `json:"carrier_name,omitempty"`

	// Does the plan provide dental coverage for children?
	ChildDental bool `json:"child_dental,omitempty"`

	// Child eyewear benefits summary
	ChildEyewear string `json:"child_eyewear,omitempty"`

	// Child eye exam benefits summary
	ChildEyeExam string `json:"child_eye_exam,omitempty"`

	// Phone number to contact the insurance carrier
	CustomerServicePhoneNumber string `json:"customer_service_phone_number,omitempty"`

	// Benefits summary for durable medical equipment
	DurableMedicalEquipment string `json:"durable_medical_equipment,omitempty"`

	// Diagnostic tests benefit summary
	DiagnosticTest string `json:"diagnostic_test,omitempty"`

	// Alternate name for the Plan
	DisplayName string `json:"display_name,omitempty"`

	// True if plan does not cover domestic partners
	DpRider bool `json:"dp_rider,omitempty"`

	// Link to the summary of drug benefits for the plan
	DrugFormularyUrl string `json:"drug_formulary_url,omitempty"`

	// Effective date of coverage.
	EffectiveDate string `json:"effective_date,omitempty"`

	// Expiration date of coverage.
	ExpirationDate string `json:"expiration_date,omitempty"`

	// Description of costs when visiting the ER
	EmergencyRoom string `json:"emergency_room,omitempty"`

	// Deductible for drugs when a family is on the plan.
	FamilyDrugDeductible string `json:"family_drug_deductible,omitempty"`

	// Maximum out-of-pocket for drugs when a family is on the plan
	FamilyDrugMoop string `json:"family_drug_moop,omitempty"`

	// Deductible when a family is on the plan
	FamilyMedicalDeductible string `json:"family_medical_deductible,omitempty"`

	// Maximum out-of-pocket when a family is on the plan
	FamilyMedicalMoop string `json:"family_medical_moop,omitempty"`

	// True if plan does not cover family planning
	FpRider bool `json:"fp_rider,omitempty"`

	// Cost for generic drugs
	GenericDrugs string `json:"generic_drugs,omitempty"`

	// Habilitation services benefits summary
	HabilitationServices string `json:"habilitation_services,omitempty"`

	//
	HiosIssuerId string `json:"hios_issuer_id,omitempty"`

	// Home health care benefits summary
	HomeHealthCare string `json:"home_health_care,omitempty"`

	// Hospice service benefits summary
	HospiceService string `json:"hospice_service,omitempty"`

	// Is the plan HSA eligible?
	HsaEligible bool `json:"hsa_eligible,omitempty"`

	// Government-issued HIOS plan ID
	Id string `json:"id,omitempty"`

	// Benefits summary for imaging coverage
	Imaging string `json:"imaging,omitempty"`

	// List of NPI numbers for Providers passed in who accept this Plan
	InNetworkIds []int32 `json:"in_network_ids,omitempty"`

	// Deductible for drugs when an individual is on the plan
	IndividualDrugDeductible string `json:"individual_drug_deductible,omitempty"`

	// Maximum out-of-pocket for drugs when an individual is on the plan
	IndividualDrugMoop string `json:"individual_drug_moop,omitempty"`

	// Deductible when an individual is on the plan
	IndividualMedicalDeductible string `json:"individual_medical_deductible,omitempty"`

	// Maximum out-of-pocket when an individual is on the plan
	IndividualMedicalMoop string `json:"individual_medical_moop,omitempty"`

	// Inpatient birth benefits summary
	InpatientBirth string `json:"inpatient_birth,omitempty"`

	// Cost under the plan for an inpatient facility
	InpatientFacility string `json:"inpatient_facility,omitempty"`

	// Inpatient mental helath benefits summary
	InpatientMentalHealth string `json:"inpatient_mental_health,omitempty"`

	// Cost under the plan for an inpatient physician
	InpatientPhysician string `json:"inpatient_physician,omitempty"`

	// Inpatient substance abuse benefits summary
	InpatientSubstance string `json:"inpatient_substance,omitempty"`

	// Plan metal grouping (e.g. platinum, gold, silver, etc)
	Level string `json:"level,omitempty"`

	// Link to a copy of the insurance carrier's logo
	LogoUrl string `json:"logo_url,omitempty"`

	// Marketing name of the plan
	Name string `json:"name,omitempty"`

	// Cost under the plan for non-preferred brand drugs
	NonPreferredBrandDrugs string `json:"non_preferred_brand_drugs,omitempty"`

	// Is the plan on-market?
	OnMarket bool `json:"on_market,omitempty"`

	// Is the plan off-market?
	OffMarket bool `json:"off_market,omitempty"`

	// Does this plan provide any out of network coverage?
	OutOfNetworkCoverage bool `json:"out_of_network_coverage,omitempty"`

	// List of NPI numbers for Providers passed in who do not accept this Plan
	OutOfNetworkIds []int32 `json:"out_of_network_ids,omitempty"`

	// Benefits summary for outpatient facility coverage
	OutpatientFacility string `json:"outpatient_facility,omitempty"`

	// Benefits summary for outpatient mental health coverage
	OutpatientMentalHealth string `json:"outpatient_mental_health,omitempty"`

	// Benefits summary for outpatient physician coverage
	OutpatientPhysician string `json:"outpatient_physician,omitempty"`

	// Outpatient substance abuse benefits summary
	OutpatientSubstance string `json:"outpatient_substance,omitempty"`

	// Market in which the plan is offered (on_marketplace, shop, etc)
	PlanMarket string `json:"plan_market,omitempty"`

	// Category of the plan (e.g. EPO, HMO, PPO, POS, Indemnity)
	PlanType string `json:"plan_type,omitempty"`

	// Cost under the plan for perferred brand drugs
	PreferredBrandDrugs string `json:"preferred_brand_drugs,omitempty"`

	// Inpatient substance abuse benefits summary
	PrenatalPostnatalCare string `json:"prenatal_postnatal_care,omitempty"`

	// Benefits summary for preventative care
	PreventativeCare string `json:"preventative_care,omitempty"`

	// Cumulative premium amount after subsidy
	PremiumSubsidized float32 `json:"premium_subsidized,omitempty"`

	// Cumulative premium amount
	Premium float32 `json:"premium,omitempty"`

	// Source of the base pricing data
	PremiumSource string `json:"premium_source,omitempty"`

	// Cost under the plan to visit a Primary Care Physician
	PrimaryCarePhysician string `json:"primary_care_physician,omitempty"`

	// Benefits summary for rehabilitation services
	RehabilitationServices string `json:"rehabilitation_services,omitempty"`

	// Foreign key for service area
	ServiceAreaId string `json:"service_area_id,omitempty"`

	// Benefits summary for skilled nursing services
	SkilledNursing string `json:"skilled_nursing,omitempty"`

	// Cost under the plan to visit a specialist
	Specialist string `json:"specialist,omitempty"`

	// Cost under the plan for specialty drugs
	SpecialtyDrugs string `json:"specialty_drugs,omitempty"`

	// Benefits summary for urgent care
	UrgentCare string `json:"urgent_care,omitempty"`

	// Percentage of doctors who matched this Plan
	MatchPercentage int32 `json:"match_percentage,omitempty"`

	// Percentage of employees with 100% match
	PerfectMatchPercentage int32 `json:"perfect_match_percentage,omitempty"`

	// Cumulative premium amount for employees
	EmployeePremium float32 `json:"employee_premium,omitempty"`

	// Cumulative premium amount for dependents
	DependentPremium float32 `json:"dependent_premium,omitempty"`
}

type PlanShowResponse

type PlanShowResponse struct {

	// Plan response
	Plan Plan `json:"plan,omitempty"`
}

type PlansApi

type PlansApi struct {
	Configuration *Configuration
}

func NewPlansApi

func NewPlansApi() *PlansApi

func NewPlansApiWithBasePath

func NewPlansApiWithBasePath(basePath string) *PlansApi

func (PlansApi) FindPlans

*

  • Find Plans
  • ### Location Information Searching for a set of plans requires a &#x60;zip_code&#x60; and &#x60;fips_code&#x60; code. These are used to determine pricing and availabity of health plans. This endpoint is paginated. Optionally, you may provide a list of Applicants or Providers ### Applicants This is a list of people who will be covered by the plan. We use this list to calculate the premium. You must include &#x60;age&#x60; and can include &#x60;smoker&#x60;, which also factors into pricing in some states. Applicants *must* include an age. If smoker is omitted, its value is assumed to be false. #### Multiple Applicants To get pricing for multiple applicants, just append multiple sets of data to the URL with the age and smoking status of each applicant next to each other. For example, given two applicants - one age 32 and a non-smoker and one age 29 and a smoker, you could use the following request &#x60;GET /plans?zip_code&#x3D;07451&amp;fips_code&#x3D;33025&amp;applicants[][age]&#x3D;32&amp;applicants[][age]&#x3D;29&amp;applicants[][smoker]&#x3D;true&#x60; It would also be acceptible to include &#x60;applicants[][smoker]&#x3D;false&#x60; after the first applicant&#39;s age. ### Providers We identify Providers (Doctors) by their National Practitioner Index number (NPI). If you pass a list of Providers, keyed by their NPI number, we will return a list of which Providers are in and out of network for each plan returned. For example, if we had two providers with the NPI numbers &#x60;12345&#x60; and &#x60;23456&#x60; you would make the following request &#x60;GET /plans?zip_code&#x3D;07451&amp;fips_code&#x3D;33025&amp;providers[][npi]&#x3D;12345&amp;providers[][npi]&#x3D;23456&#x60; ### Enrollment Date To calculate plan pricing and availability, we default to the current date as the enrollment date. To specify a date in the future (or the past), pass a string with the format &#x60;YYYY-MM-DD&#x60; in the &#x60;enrollment_date&#x60; parameter. &#x60;GET /plans?zip_code&#x3D;07451&amp;fips_code&#x3D;33025&amp;enrollment_date&#x3D;2016-01-01&#x60; ### Subsidy On-marketplace plans are eligible for a subsidy based on the &#x60;household_size&#x60; and &#x60;household_income&#x60; of the applicants. If you pass those values, we will calculate the &#x60;subsidized_premium&#x60; and return it for each plan. If no values are provided, the &#x60;subsidized_premium&#x60; will be the same as the &#x60;premium&#x60; &#x60;GET /plans?zip_code&#x3D;07451&amp;fips_code&#x3D;33025&amp;household_size&#x3D;4&amp;household_income&#x3D;40000&#x60; ### Sorting Plans can be sorted by the &#x60;premium&#x60;, &#x60;carrier_name&#x60;, &#x60;level&#x60;, and &#x60;plan_type&#x60; fields, by either ascending (as &#x60;asc&#x60;) or descending (as &#x60;dsc&#x60;) sort under the &#x60;sort&#x60; field. For example, to sort plans by level, the sort parameter would be &#x60;level:asc&#x60;. *
  • @param body
  • @return *PlanSearchResponse

func (PlansApi) ShowPlan

func (a PlansApi) ShowPlan(id string, year int32) (*PlanShowResponse, *APIResponse, error)

*

  • Show Plan
  • Show the details of an individual Plan. This includes deductibles, maximums out of pocket, and co-pay/coinsurance for benefits (See [Benefits summary format](#header-benefits-summary-format) above.) *
  • @param id ID of the Plan
  • @param year Plan year (defaults to current year)
  • @return *PlanShowResponse

type Pricing

type Pricing struct {

	// Age of applicant
	Age int32 `json:"age,omitempty"`

	// Effective date of plan
	EffectiveDate time.Time `json:"effective_date,omitempty"`

	// Plan expiration date
	ExpirationDate time.Time `json:"expiration_date,omitempty"`

	// Foreign key to plans
	PlanId int32 `json:"plan_id,omitempty"`

	// Child-only premium
	PremiumChildOnly float32 `json:"premium_child_only,omitempty"`

	// Family premium
	PremiumFamily float32 `json:"premium_family,omitempty"`

	// Single-person premium
	PremiumSingle float32 `json:"premium_single,omitempty"`

	// Single person including children premium
	PremiumSingleAndChildren float32 `json:"premium_single_and_children,omitempty"`

	// Person with spouse premium
	PremiumSingleAndSpouse float32 `json:"premium_single_and_spouse,omitempty"`

	// Premium for single smoker
	PremiumSingleSmoker float32 `json:"premium_single_smoker,omitempty"`

	// Foreign key to rating areas
	RatingAreaId string `json:"rating_area_id,omitempty"`

	// Where was this pricing data extracted from?
	PremiumSource string `json:"premium_source,omitempty"`

	// Time when pricing was last updated
	UpdatedAt string `json:"updated_at,omitempty"`
}

type Provider

type Provider struct {

	// City name (e.g. Springfield).
	City string `json:"city,omitempty"`

	// Primary email address to contact the provider.
	Email string `json:"email,omitempty"`

	// Provider's gender (M or F)
	Gender string `json:"gender,omitempty"`

	// Given name for the provider.
	FirstName string `json:"first_name,omitempty"`

	// National Provider Index (NPI) number
	Id int32 `json:"id,omitempty"`

	// Family name for the provider.
	LastName string `json:"last_name,omitempty"`

	// Latitude of provider
	Latitude float32 `json:"latitude,omitempty"`

	// Longitude of provider
	Longitude float32 `json:"longitude,omitempty"`

	// Middle name for the provider.
	MiddleName string `json:"middle_name,omitempty"`

	// Array of network ids
	NetworkIds []int32 `json:"network_ids,omitempty"`

	// name for the providers of type: organization.
	OrganizationName string `json:"organization_name,omitempty"`

	// Personal contact phone for the provider.
	PersonalPhone string `json:"personal_phone,omitempty"`

	// Office phone for the provider
	Phone string `json:"phone,omitempty"`

	// Preferred name for display (e.g. Dr. Francis White may prefer Dr. Frank White)
	PresentationName string `json:"presentation_name,omitempty"`

	// Name of the primary Specialty
	Specialty string `json:"specialty,omitempty"`

	// State code for the provider's address (e.g. NY).
	State string `json:"state,omitempty"`

	// Foreign key to States
	StateId int32 `json:"state_id,omitempty"`

	// First line of the provider's street address.
	StreetLine1 string `json:"street_line_1,omitempty"`

	// Second line of the provider's street address.
	StreetLine2 string `json:"street_line_2,omitempty"`

	// Suffix for the provider's name (e.g. Jr)
	Suffix string `json:"suffix,omitempty"`

	// Professional title for the provider (e.g. Dr).
	Title string `json:"title,omitempty"`

	// Type of NPI number (individual provider vs organization).
	Type_ string `json:"type,omitempty"`

	// Postal code for the provider's address (e.g. 11215)
	ZipCode string `json:"zip_code,omitempty"`
}

type ProviderDetails

type ProviderDetails struct {

	// City name (e.g. Springfield).
	City string `json:"city,omitempty"`

	// Primary email address to contact the provider.
	Email string `json:"email,omitempty"`

	// Provider's gender (M or F)
	Gender string `json:"gender,omitempty"`

	// Given name for the provider.
	FirstName string `json:"first_name,omitempty"`

	// National Provider Index (NPI) number
	Id int32 `json:"id,omitempty"`

	// Family name for the provider.
	LastName string `json:"last_name,omitempty"`

	// Latitude of provider
	Latitude float32 `json:"latitude,omitempty"`

	// Longitude of provider
	Longitude float32 `json:"longitude,omitempty"`

	// Middle name for the provider.
	MiddleName string `json:"middle_name,omitempty"`

	// Array of network ids
	NetworkIds []int32 `json:"network_ids,omitempty"`

	// name for the providers of type: organization.
	OrganizationName string `json:"organization_name,omitempty"`

	// Personal contact phone for the provider.
	PersonalPhone string `json:"personal_phone,omitempty"`

	// Office phone for the provider
	Phone string `json:"phone,omitempty"`

	// Preferred name for display (e.g. Dr. Francis White may prefer Dr. Frank White)
	PresentationName string `json:"presentation_name,omitempty"`

	// Name of the primary Specialty
	Specialty string `json:"specialty,omitempty"`

	// State code for the provider's address (e.g. NY).
	State string `json:"state,omitempty"`

	// Foreign key to States
	StateId int32 `json:"state_id,omitempty"`

	// First line of the provider's street address.
	StreetLine1 string `json:"street_line_1,omitempty"`

	// Second line of the provider's street address.
	StreetLine2 string `json:"street_line_2,omitempty"`

	// Suffix for the provider's name (e.g. Jr)
	Suffix string `json:"suffix,omitempty"`

	// Professional title for the provider (e.g. Dr).
	Title string `json:"title,omitempty"`

	// Type of NPI number (individual provider vs organization).
	Type_ string `json:"type,omitempty"`

	// Postal code for the provider's address (e.g. 11215)
	ZipCode string `json:"zip_code,omitempty"`

	// List of HIOS ids for this provider
	HiosIds []string `json:"hios_ids,omitempty"`
}

type ProviderGeocode

type ProviderGeocode struct {

	// National Provider Index (NPI) number
	Id int32 `json:"id,omitempty"`

	// Latitude of provider
	Latitude float32 `json:"latitude,omitempty"`

	// Longitude of provider
	Longitude float32 `json:"longitude,omitempty"`
}

type ProviderShowResponse

type ProviderShowResponse struct {

	// The requested provider.
	Provider Provider `json:"provider,omitempty"`
}

type ProvidersApi

type ProvidersApi struct {
	Configuration *Configuration
}

func NewProvidersApi

func NewProvidersApi() *ProvidersApi

func NewProvidersApiWithBasePath

func NewProvidersApiWithBasePath(basePath string) *ProvidersApi

func (ProvidersApi) GetProvider

func (a ProvidersApi) GetProvider(npi string, year string, state string) (*ProviderShowResponse, *APIResponse, error)

*

  • Find a Provider
  • To retrieve a specific provider, just perform a GET using his NPI number *
  • @param npi NPI number
  • @param year Only show plan ids for the given year
  • @param state Only show plan ids for the given state
  • @return *ProviderShowResponse

func (ProvidersApi) GetProviders

*

  • Find Providers
  • ### Provider Details All searches can take a &#x60;search_term&#x60;, which is used as a component in the score (and thus the ranking/order) of the results. This is combined with the proximity to the location in ranking results. For example, we would want \&quot;Dr. John Smith\&quot; who is 5 miles away from a given Zip Code to appear before \&quot;Dr. John Smith\&quot; who is 100 miles away. The weighting also allows for non-exact matches. In our prior example, we would want \&quot;Dr. Jon Smith\&quot; who is 2 miles away to appear before the exact match \&quot;Dr. John Smith\&quot; who is 100 miles away because it is more likely that the user just entered an incorrect name. The free text search also supports Specialty name search and \&quot;body part\&quot; Specialty name search. So, searching \&quot;John Smith nose\&quot; would return \&quot;Dr. John Smith\&quot;, the ENT Specialist before \&quot;Dr. John Smith\&quot; the Internist. In addition, we can filter &#x60;Providers&#x60; by whether or not they accept *any* insurance. Our data set includes over 4 million &#x60;Providers&#x60;, some of whom do not accept any insurance at all. This filter makes it more likely that the user will find his or her practitioner in some cases. We can also use &#x60;min_score&#x60; to omit less relevant results. This makes sense in the case where your application wants to display *all* of the results returned regardless of how many there are. Otherwise, using our default &#x60;min_score&#x60; and pagination should be sufficient. ### Location Information All &#x60;Provider&#x60; searches that do *not* specify &#x60;plan_ids&#x60; or &#x60;network_ids&#x60;require some type of location information. We use this information either to weight results or to filter results, depending on the type. #### Zip Code When providing the &#x60;zip_code&#x60; parameter, we order the &#x60;Providers&#x60; returned based on their score, which incorporates their proximity to the given Zip Code and the closeness of match to the search text. If a &#x60;radius&#x60; is also provided, we filter out &#x60;Providers&#x60; who are outside of that radius from the center of the Zip Code provided #### Polygon When providing the &#x60;polygon&#x60; parameter, we filter providers who are outside the bounds of the shape provided. This is mutually exclusive with &#x60;zip_code&#x60; and &#x60;radius&#x60;. ### Plan/Network Information We can also filter based on &#x60;Plan&#x60; and &#x60;Network&#x60; participation. These filters are mutually exclusive and return the union of the resulting sets for each &#x60;Plan&#x60; or &#x60;Network&#x60;. I.e. if you provider Plan A and Plan B, you will receive &#x60;Providers&#x60; who accept *either* &#x60;Plan&#x60;. The same is true for &#x60;Networks&#x60;. ### Examples *Find Dr. Foo near Brooklyn* &#x60;{ \&quot;search_term\&quot;: \&quot;Foo\&quot;, \&quot;zip_code\&quot;: \&quot;11215\&quot; }&#x60; *Find all Providers within 5 miles of Brooklyn who accept a Plan* &#x60;{ \&quot;zip_code\&quot;: \&quot;11215\&quot;, \&quot;radius\&quot;: 5, \&quot;hios_ids\&quot;: [\&quot;88582NY0230001\&quot;] }&#x60; *Find all providers on a map of Brooklyn ordered by a combination of proximity to the center point of the map and relevance to the search term \&quot;ENT\&quot;* &#x60;&#x60;&#x60; { \&quot;polygon\&quot;: [ {\&quot;lon\&quot;:-74.0126609802,\&quot;lat\&quot;:40.6275684851 }, {\&quot;lon\&quot;:-74.0126609802,\&quot;lat\&quot;:40.7097269508 }, {\&quot;lon\&quot;:-73.9367866516,\&quot;lat\&quot;:40.7097269508 }, {\&quot;lon\&quot;:-73.9367866516,\&quot;lat\&quot;:40.6275684851 } ], \&quot;search_term\&quot; : \&quot;ENT\&quot; } &#x60;&#x60;&#x60; *
  • @param body
  • @return *ProvidersSearchResponse

func (ProvidersApi) GetProviders_1

*

  • Find Providers
  • ### Provider Details All searches can take a &#x60;search_term&#x60;, which is used as a component in the score (and thus the ranking/order) of the results. This is combined with the proximity to the location in ranking results. For example, we would want \&quot;Dr. John Smith\&quot; who is 5 miles away from a given Zip Code to appear before \&quot;Dr. John Smith\&quot; who is 100 miles away. The weighting also allows for non-exact matches. In our prior example, we would want \&quot;Dr. Jon Smith\&quot; who is 2 miles away to appear before the exact match \&quot;Dr. John Smith\&quot; who is 100 miles away because it is more likely that the user just entered an incorrect name. The free text search also supports Specialty name search and \&quot;body part\&quot; Specialty name search. So, searching \&quot;John Smith nose\&quot; would return \&quot;Dr. John Smith\&quot;, the ENT Specialist before \&quot;Dr. John Smith\&quot; the Internist. In addition, we can filter &#x60;Providers&#x60; by whether or not they accept *any* insurance. Our data set includes over 4 million &#x60;Providers&#x60;, some of whom do not accept any insurance at all. This filter makes it more likely that the user will find his or her practitioner in some cases. We can also use &#x60;min_score&#x60; to omit less relevant results. This makes sense in the case where your application wants to display *all* of the results returned regardless of how many there are. Otherwise, using our default &#x60;min_score&#x60; and pagination should be sufficient. ### Location Information All &#x60;Provider&#x60; searches that do *not* specify &#x60;plan_ids&#x60; or &#x60;network_ids&#x60;require some type of location information. We use this information either to weight results or to filter results, depending on the type. #### Zip Code When providing the &#x60;zip_code&#x60; parameter, we order the &#x60;Providers&#x60; returned based on their score, which incorporates their proximity to the given Zip Code and the closeness of match to the search text. If a &#x60;radius&#x60; is also provided, we filter out &#x60;Providers&#x60; who are outside of that radius from the center of the Zip Code provided #### Polygon When providing the &#x60;polygon&#x60; parameter, we filter providers who are outside the bounds of the shape provided. This is mutually exclusive with &#x60;zip_code&#x60; and &#x60;radius&#x60;. ### Plan/Network Information We can also filter based on &#x60;Plan&#x60; and &#x60;Network&#x60; participation. These filters are mutually exclusive and return the union of the resulting sets for each &#x60;Plan&#x60; or &#x60;Network&#x60;. I.e. if you provider Plan A and Plan B, you will receive &#x60;Providers&#x60; who accept *either* &#x60;Plan&#x60;. The same is true for &#x60;Networks&#x60;. ### Examples *Find Dr. Foo near Brooklyn* &#x60;{ \&quot;search_term\&quot;: \&quot;Foo\&quot;, \&quot;zip_code\&quot;: \&quot;11215\&quot; }&#x60; *Find all Providers within 5 miles of Brooklyn who accept a Plan* &#x60;{ \&quot;zip_code\&quot;: \&quot;11215\&quot;, \&quot;radius\&quot;: 5, \&quot;hios_ids\&quot;: [\&quot;88582NY0230001\&quot;] }&#x60; *Find all providers on a map of Brooklyn ordered by a combination of proximity to the center point of the map and relevance to the search term \&quot;ENT\&quot;* &#x60;&#x60;&#x60; { \&quot;polygon\&quot;: [ {\&quot;lon\&quot;:-74.0126609802,\&quot;lat\&quot;:40.6275684851 }, {\&quot;lon\&quot;:-74.0126609802,\&quot;lat\&quot;:40.7097269508 }, {\&quot;lon\&quot;:-73.9367866516,\&quot;lat\&quot;:40.7097269508 }, {\&quot;lon\&quot;:-73.9367866516,\&quot;lat\&quot;:40.6275684851 } ], \&quot;search_term\&quot; : \&quot;ENT\&quot; } &#x60;&#x60;&#x60; *
  • @param body
  • @return *ProvidersGeocodeResponse

type ProvidersGeocodeResponse

type ProvidersGeocodeResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// Providers that fit the requested criterion.
	Providers []Provider `json:"providers,omitempty"`
}

type ProvidersSearchResponse

type ProvidersSearchResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// Providers that fit the requested criterion.
	Providers []Provider `json:"providers,omitempty"`

	// States that fit the requested criterion.
	States []State `json:"states,omitempty"`
}

type RatingArea

type RatingArea struct {

	// Name of the Rating Area
	Id string `json:"id,omitempty"`

	// State Code
	StateId string `json:"state_id,omitempty"`
}

type RequestPlanFind

type RequestPlanFind struct {

	// Applicants for desired plans.
	Applicants []RequestPlanFindApplicant `json:"applicants,omitempty"`

	// Date of enrollment
	EnrollmentDate string `json:"enrollment_date,omitempty"`

	// National Drug Code Package Id
	DrugPackages []RequestPlanFindDrugPackage `json:"drug_packages,omitempty"`

	// County code to determine eligibility
	FipsCode string `json:"fips_code,omitempty"`

	// Total household income.
	HouseholdIncome int32 `json:"household_income,omitempty"`

	// Number of people living in household.
	HouseholdSize int32 `json:"household_size,omitempty"`

	// List of plan IDs to filter by
	Ids []int32 `json:"ids,omitempty"`

	// Type of plan to search for.
	Market string `json:"market,omitempty"`

	// List of providers to search for.
	Providers []RequestPlanFindProvider `json:"providers,omitempty"`

	// Selected page of paginated response.
	Page int32 `json:"page,omitempty"`

	// Results per page of response.
	PerPage int32 `json:"per_page,omitempty"`

	// Sort responses by plan field.
	Sort string `json:"sort,omitempty"`

	// 5-digit zip code - this helps determine pricing.
	ZipCode string `json:"zip_code,omitempty"`
}

type RequestPlanFindApplicant

type RequestPlanFindApplicant struct {

	// Age of applicant to search for
	Age int32 `json:"age,omitempty"`

	// Is this applicant a child?
	Child bool `json:"child,omitempty"`

	// Does this applicant smoke?
	Smoker bool `json:"smoker,omitempty"`
}

type RequestPlanFindDrugPackage

type RequestPlanFindDrugPackage struct {

	// National Drug Code ID (Package)
	Id string `json:"id,omitempty"`

	// Med ID
	MedId int32 `json:"med_id,omitempty"`
}

type RequestPlanFindProvider

type RequestPlanFindProvider struct {

	// NPI of provider to search for
	Npi int32 `json:"npi,omitempty"`
}

type RequestProvidersSearch

type RequestProvidersSearch struct {

	// Limit results to Providers who accept at least one insurance         plan.  Note that the inverse of this filter is not supported and         any value will evaluate to true
	AcceptsInsurance bool `json:"accepts_insurance,omitempty"`

	// Minimum search threshold to be included in the results
	MinScore float32 `json:"min_score,omitempty"`

	// List of Vericred network ids
	NetworkIds []int32 `json:"network_ids,omitempty"`

	// Page number
	Page int32 `json:"page,omitempty"`

	// Number of records to return per page
	PerPage int32 `json:"per_page,omitempty"`

	// Define a custom search polygon, mutually exclusive with zip_code search
	Polygon int32 `json:"polygon,omitempty"`

	// Radius (in miles) to use to limit results
	Radius int32 `json:"radius,omitempty"`

	// String to search by
	SearchTerm string `json:"search_term,omitempty"`

	// specify sort mode (distance or random)
	Sort string `json:"sort,omitempty"`

	// Seed value for random sort. Randomly-ordered searches with the same seed return results in consistent order.
	SortSeed int32 `json:"sort_seed,omitempty"`

	// Either organization or individual
	Type_ string `json:"type,omitempty"`

	// Zip Code to search near
	ZipCode string `json:"zip_code,omitempty"`
}

type ServiceArea

type ServiceArea struct {

	// Primary key
	Id string `json:"id,omitempty"`

	// Issuer foreign key
	IssuerId string `json:"issuer_id,omitempty"`

	// Name of the Service Area
	Name string `json:"name,omitempty"`
}

type ServiceAreaZipCounty

type ServiceAreaZipCounty struct {

	// Foreign key to county
	CountyId string `json:"county_id,omitempty"`

	// Foreign key to service area
	ServiceAreaId string `json:"service_area_id,omitempty"`

	// Foreign key to zip code
	ZipCodeId string `json:"zip_code_id,omitempty"`
}

type State

type State struct {

	// Primary Key of State
	Id int32 `json:"id,omitempty"`

	// Name of state
	Name string `json:"name,omitempty"`

	// 2 letter code for state
	Code string `json:"code,omitempty"`

	// National FIPs number
	FipsNumber string `json:"fips_number,omitempty"`

	// Last date this state is live for individuals
	LastDateForIndividual time.Time `json:"last_date_for_individual,omitempty"`

	// Last date this state is live for shop
	LastDateForShop time.Time `json:"last_date_for_shop,omitempty"`

	// Is this State available for businesses
	LiveForBusiness bool `json:"live_for_business,omitempty"`

	// Is this State available for individuals
	LiveForConsumers bool `json:"live_for_consumers,omitempty"`
}

type StateNetworkSizeRequest

type StateNetworkSizeRequest struct {

	// List of Network Ids
	NetworkIds []int32 `json:"network_ids,omitempty"`

	// List of State Ids
	StateIds []string `json:"state_ids,omitempty"`
}

type StateNetworkSizeResponse

type StateNetworkSizeResponse struct {

	// Meta-data
	Meta Meta `json:"meta,omitempty"`

	// Network Sizes
	NetworkSizes []NetworkSize `json:"network_sizes,omitempty"`
}

type VendoredPlanBulk

type VendoredPlanBulk struct {

	// Does the plan provide dental coverage for adults?
	AdultDental bool `json:"adult_dental,omitempty"`

	// True if the plan allows dependents up to age 29
	Age29Rider bool `json:"age29_rider,omitempty"`

	// Benefits string for ambulance coverage
	Ambulance string `json:"ambulance,omitempty"`

	// Link to the summary of benefits and coverage (SBC) document.
	BenefitsSummaryUrl string `json:"benefits_summary_url,omitempty"`

	// Link to a location to purchase the plan.
	BuyLink string `json:"buy_link,omitempty"`

	// Name of the insurance carrier
	CarrierName string `json:"carrier_name,omitempty"`

	// Does the plan provide dental coverage for children?
	ChildDental bool `json:"child_dental,omitempty"`

	// Child eyewear benefits summary
	ChildEyewear string `json:"child_eyewear,omitempty"`

	// Child eye exam benefits summary
	ChildEyeExam string `json:"child_eye_exam,omitempty"`

	// Phone number to contact the insurance carrier
	CustomerServicePhoneNumber string `json:"customer_service_phone_number,omitempty"`

	// Benefits summary for durable medical equipment
	DurableMedicalEquipment string `json:"durable_medical_equipment,omitempty"`

	// Diagnostic tests benefit summary
	DiagnosticTest string `json:"diagnostic_test,omitempty"`

	// Alternate name for the Plan
	DisplayName string `json:"display_name,omitempty"`

	// True if plan does not cover domestic partners
	DpRider bool `json:"dp_rider,omitempty"`

	// Link to the summary of drug benefits for the plan
	DrugFormularyUrl string `json:"drug_formulary_url,omitempty"`

	// Effective date of coverage.
	EffectiveDate string `json:"effective_date,omitempty"`

	// Expiration date of coverage.
	ExpirationDate string `json:"expiration_date,omitempty"`

	// Description of costs when visiting the ER
	EmergencyRoom string `json:"emergency_room,omitempty"`

	// Deductible for drugs when a family is on the plan.
	FamilyDrugDeductible string `json:"family_drug_deductible,omitempty"`

	// Maximum out-of-pocket for drugs when a family is on the plan
	FamilyDrugMoop string `json:"family_drug_moop,omitempty"`

	// Deductible when a family is on the plan
	FamilyMedicalDeductible string `json:"family_medical_deductible,omitempty"`

	// Maximum out-of-pocket when a family is on the plan
	FamilyMedicalMoop string `json:"family_medical_moop,omitempty"`

	// True if plan does not cover family planning
	FpRider bool `json:"fp_rider,omitempty"`

	// Cost for generic drugs
	GenericDrugs string `json:"generic_drugs,omitempty"`

	// Habilitation services benefits summary
	HabilitationServices string `json:"habilitation_services,omitempty"`

	//
	HiosIssuerId string `json:"hios_issuer_id,omitempty"`

	// Home health care benefits summary
	HomeHealthCare string `json:"home_health_care,omitempty"`

	// Hospice service benefits summary
	HospiceService string `json:"hospice_service,omitempty"`

	// Is the plan HSA eligible?
	HsaEligible bool `json:"hsa_eligible,omitempty"`

	// Government-issued HIOS plan ID
	Id string `json:"id,omitempty"`

	// Benefits summary for imaging coverage
	Imaging string `json:"imaging,omitempty"`

	// List of NPI numbers for Providers passed in who accept this Plan
	InNetworkIds []int32 `json:"in_network_ids,omitempty"`

	// Deductible for drugs when an individual is on the plan
	IndividualDrugDeductible string `json:"individual_drug_deductible,omitempty"`

	// Maximum out-of-pocket for drugs when an individual is on the plan
	IndividualDrugMoop string `json:"individual_drug_moop,omitempty"`

	// Deductible when an individual is on the plan
	IndividualMedicalDeductible string `json:"individual_medical_deductible,omitempty"`

	// Maximum out-of-pocket when an individual is on the plan
	IndividualMedicalMoop string `json:"individual_medical_moop,omitempty"`

	// Inpatient birth benefits summary
	InpatientBirth string `json:"inpatient_birth,omitempty"`

	// Cost under the plan for an inpatient facility
	InpatientFacility string `json:"inpatient_facility,omitempty"`

	// Inpatient mental helath benefits summary
	InpatientMentalHealth string `json:"inpatient_mental_health,omitempty"`

	// Cost under the plan for an inpatient physician
	InpatientPhysician string `json:"inpatient_physician,omitempty"`

	// Inpatient substance abuse benefits summary
	InpatientSubstance string `json:"inpatient_substance,omitempty"`

	// Plan metal grouping (e.g. platinum, gold, silver, etc)
	Level string `json:"level,omitempty"`

	// Link to a copy of the insurance carrier's logo
	LogoUrl string `json:"logo_url,omitempty"`

	// Marketing name of the plan
	Name string `json:"name,omitempty"`

	// Total number of Providers in network
	NetworkSize int32 `json:"network_size,omitempty"`

	// Cost under the plan for non-preferred brand drugs
	NonPreferredBrandDrugs string `json:"non_preferred_brand_drugs,omitempty"`

	// Is the plan on-market?
	OnMarket bool `json:"on_market,omitempty"`

	// Is the plan off-market?
	OffMarket bool `json:"off_market,omitempty"`

	// Does this plan provide any out of network coverage?
	OutOfNetworkCoverage bool `json:"out_of_network_coverage,omitempty"`

	// List of NPI numbers for Providers passed in who do not accept this Plan
	OutOfNetworkIds []int32 `json:"out_of_network_ids,omitempty"`

	// Benefits summary for outpatient facility coverage
	OutpatientFacility string `json:"outpatient_facility,omitempty"`

	// Benefits summary for outpatient mental health coverage
	OutpatientMentalHealth string `json:"outpatient_mental_health,omitempty"`

	// Benefits summary for outpatient physician coverage
	OutpatientPhysician string `json:"outpatient_physician,omitempty"`

	// Outpatient substance abuse benefits summary
	OutpatientSubstance string `json:"outpatient_substance,omitempty"`

	// Market in which the plan is offered (on_marketplace, shop, etc)
	PlanMarket string `json:"plan_market,omitempty"`

	// Category of the plan (e.g. EPO, HMO, PPO, POS, Indemnity)
	PlanType string `json:"plan_type,omitempty"`

	// Cost under the plan for perferred brand drugs
	PreferredBrandDrugs string `json:"preferred_brand_drugs,omitempty"`

	// Inpatient substance abuse benefits summary
	PrenatalPostnatalCare string `json:"prenatal_postnatal_care,omitempty"`

	// Benefits summary for preventative care
	PreventativeCare string `json:"preventative_care,omitempty"`

	// Cumulative premium amount after subsidy
	PremiumSubsidized float32 `json:"premium_subsidized,omitempty"`

	// Cumulative premium amount
	Premium float32 `json:"premium,omitempty"`

	// Source of the base pricing data
	PremiumSource string `json:"premium_source,omitempty"`

	// Cost under the plan to visit a Primary Care Physician
	PrimaryCarePhysician string `json:"primary_care_physician,omitempty"`

	// Benefits summary for rehabilitation services
	RehabilitationServices string `json:"rehabilitation_services,omitempty"`

	// Foreign key for service area
	ServiceAreaId string `json:"service_area_id,omitempty"`

	// Benefits summary for skilled nursing services
	SkilledNursing string `json:"skilled_nursing,omitempty"`

	// Cost under the plan to visit a specialist
	Specialist string `json:"specialist,omitempty"`

	// Cost under the plan for specialty drugs
	SpecialtyDrugs string `json:"specialty_drugs,omitempty"`

	// Benefits summary for urgent care
	UrgentCare string `json:"urgent_care,omitempty"`

	// Vendor-specific ID
	VendorId string `json:"vendor_id,omitempty"`
}

type ZipCode

type ZipCode struct {

	// 5 digit code (e.g. 11215)
	Code string `json:"code,omitempty"`

	// Primary key
	Id int32 `json:"id,omitempty"`
}

type ZipCountiesApi

type ZipCountiesApi struct {
	Configuration *Configuration
}

func NewZipCountiesApi

func NewZipCountiesApi() *ZipCountiesApi

func NewZipCountiesApiWithBasePath

func NewZipCountiesApiWithBasePath(basePath string) *ZipCountiesApi

func (ZipCountiesApi) GetZipCounties

func (a ZipCountiesApi) GetZipCounties(zipPrefix string) (*ZipCountyResponse, *APIResponse, error)

*

  • Search for Zip Counties
  • Our &#x60;Plan&#x60; endpoints require a zip code and a fips (county) code. This is because plan pricing requires both of these elements. Users are unlikely to know their fips code, so we provide this endpoint to look up a &#x60;ZipCounty&#x60; by zip code and return both the selected zip and fips codes. *
  • @param zipPrefix Partial five-digit Zip
  • @return *ZipCountyResponse

type ZipCountiesResponse

type ZipCountiesResponse struct {

	// Counties that exist in the provided zip prefix.
	Counties []County `json:"counties,omitempty"`

	// States that exist in the provided zip prefix.
	States []State `json:"states,omitempty"`

	// ZipCounties that exist in the provided zip prefix.
	ZipCounties []ZipCounty `json:"zip_counties,omitempty"`

	// ZipCodes that exist in the provided zip prefix.
	ZipCodes []ZipCode `json:"zip_codes,omitempty"`
}

type ZipCounty

type ZipCounty struct {

	// ID of the parent County in Vericred's API
	CountyId int32 `json:"county_id,omitempty"`

	// Primary key
	Id int32 `json:"id,omitempty"`

	// ID of the parent Zip Code in Vericred's API
	ZipCodeId int32 `json:"zip_code_id,omitempty"`
}

type ZipCountyBulk

type ZipCountyBulk struct {

	// Primary key
	Id int32 `json:"id,omitempty"`

	// Foreign key for rating area
	RatingAreaId string `json:"rating_area_id,omitempty"`

	// Foreign key for county (fips code)
	CountyId string `json:"county_id,omitempty"`

	// Foreign key for zip code (zip code)
	ZipCodeId string `json:"zip_code_id,omitempty"`
}

type ZipCountyResponse

type ZipCountyResponse struct {

	// Counties that exist in the provided zip prefix.
	Counties []County `json:"counties,omitempty"`

	// States that exist in the provided zip prefix.
	States []State `json:"states,omitempty"`

	// ZipCodes that exist in the provided zip prefix.
	ZipCodes []ZipCode `json:"zip_codes,omitempty"`

	// ZipCounty data
	ZipCounty ZipCounty `json:"zip_county,omitempty"`
}

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