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Steps

Example Request

Example Response

1

Contact the VSee team to configure which insurers you want to support. Once configured, use https://vsee.atlassian.net/wiki/spaces/VD/pages/55083127/Insurance+API#GET-%2Finsurance%2F to pull the list which will also contain insurer_id.

Code Block
curl --location --request GET 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/insurances/' \ --header 'X-ApiToken: xxxx'

Code Block

language	json

{
    "data": {
        "insurers": [
            {
                "id": "car7551",
                "name": "AETNA"
            },
            {
                "id": "car7414",
                "name": "AETNA BETTER HEALTH OF ILLINOIS"
            },
            {
                "id": "car11406",
                "name": "ANTHEM BLUE SHIELD"
            },
            {
                "id": "car7147",
                "name": "CIGNA HEALTH CARE"
            },
            {
                "id": "car7580",
                "name": "MONTGOMERY HEALTH INSURANCE"
            },
            {
                "id": "car7556",
                "name": "HEALTH CHOICE ARIZONA"
            }
        ]
    }
}

2

Create a VSee Clinic user via https://vsee.atlassian.net/wiki/spaces/VD/pages/14942243/User+API#POST-%2Fusers%2Fsso

As a response you will receive patient data on VSee side.

Code Block

curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/sso' \
--header 'X-AccountCode: vclinic' \
--header 'X-ApiKey: xxx' \
--header 'X-ApiSecret: xxx' \
--header 'X-ApiToken: xxx' \
--form 'first_name="Edward"' \
--form 'last_name="VSee"' \
--form 'type="200"' \
--form 'code="edward+001.vclinic@vseelab.com"' \
--form 'email="edward+001.vclinic@vseelab.com"' \
--form 'dob="1986-01-01"' \
--form 'gender="1"' \
--form 'street_addr="2868 Tully Street"' \
--form 'state="Detroit"' \
--form 'city="MI"' \
--form 'zip="48226"' \
--form 'insurance__primary__carrier_code="car11400"' \
--form 'insurance__primary__subscriber_num="10000022"' \
--form 'insurance__primary__group_number="test"' \
--form 'insurance__primary__card_front="card_front_url"' \
--form 'insurance__primary__card_back="card_back_url"' \
--form 'insurance__secondary__carrier_code="car11406"' \
--form 'insurance__secondary__group_number="XX1243"' \
--form 'insurance__secondary__subscriber_num="5678"' \
--form 'insurance__secondary__card_front="card_front_url"' \
--form 'insurance__secondary__card_back="card_back_url"' \
--form 'insurance__patient__respparty="self"' \
--form 'insurance__patient__guarantor_name="Edward VSee"' \
--form 'insurance__patient__guarantor_dob="1986-01-01"' \
--form 'insurance__patient__guarantor_city="NY"' \
--form 'insurance__patient__guarantor_zip="10001"' \
--form 'insurance__patient__guarantor_address="test"' \
--form 'extra__th_id="123456"'

Code Block

language	json

{
    "data": {
        "id": "132407",
        "code": "edward+001.vclinic@vseelab.com",
        "first_name": "Edward",
        "last_name": "VSee",
        "full_name": "Edward VSee",
        "username": "edward+001.vclinic@vseelab.com",
        "vseeid": "ccpreview+6258012d656449b8b5e73ad964457b1f",
        "dob": "1986-01-01",
        "email": "edward+001.vclinic@vseelab.com",
        "gender": 1,
        "active": true,
        "tos": false,
        "status": 20,
        "subtype": "",
        "street_addr": "2868 Tully Street",
        "state": "Detroit",
        "city": "MI",
        "zip": "48226",
        "timezone": "America/Los_Angeles",
        "email_verified": true,
        "insurance": {
            "primary": {
                "carrier_code": "car11400",
                "subscriber_num": "10000022",
                "group_number": "test"
            },
            "patient": {
                "respparty": "self",
                "guarantor_name": "Edward VSee",
                "guarantor_city": "NY",
                "guarantor_zip": "10001",
                "guarantor_address": "test"
            },
            "guarantor_dob": "1986-01-01"
        },
        "account_code": "vclinic",
        "clinics": [
            "vclinic"
        ],
        "created": 1649934637,
        "token": {
            "user_id": "132407",
            "token": "xxxx",
            "expiry": 1650021037,
            "created": 1649934637,
            "user_type": "200",
            "refresh_token": {
                "user_id": "132407",
                "token": "xxxx",
                "expiry": 1652526637,
                "created": 1649934637
            }
        }
    }
}

3

Run Insurance API (Draft) | POST-/users/:id/:carrier_code/eligibility to trigger the eligibility check for the given user_id. The eligibility check may take some time. A cron job will be created. The cron job will run after 10 seconds and the response will be saved in the user_data.insurance.{primary/secondary}.eligibility_response

Use the Token provided with your API Credentials for the X-ApiToken header.

Code Block
curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/dev/api_v3/users/132407/car7556/eligibility' \ --header 'X-AccountCode: vclinic' \ --header 'X-ApiToken: xxxx'

Code Block

language	json

{
    "data": {
        "eligibility_id": "2505465",
        "carrier_code": "car7556"
    }
}

4

Receive a webhook request with eligibility_response message which will contain the result of the eligibility check. Skip this step if the clinic doesn’t have webhook.

Code Block

language	json

{
  "id": "62583ab3-8cfc-4a47-b6c9-272850e631f8",
  "type": "eligibility.checked",
  "created": 1649949363,
  "account_code": "vclinic",
  "data": {
    "eligibility_id": "2505464",
    "member_id": "132407",
    "eligibility_response": "No response received by clearinghouse",
    "external_member_id": "5991794"
  }
}

5

If the user is eligible, trigger a claim submission process for the member_id https://vsee.atlassian.net/wiki/spaces/VD/pages/55083127/Insurance+API#POST-%2Finsurance%2Fclaims

Code Block

curl --location --request POST 'https://api-vclinic.vseepreview.com/vc/devapi_v3/insurances/claims' \
--header 'X-AccountCode: vclinic' \
--header 'X-ApiKey: xxx' \
--header 'X-ApiSecret: xxx' \
--header 'X-ApiToken: xxx' \
--data-raw '{
    "member_id": "2186945",
    "date_of_service": "08/19/2022",
    "location": "41",
    "charge_list": [
        {
            "procedure_code": "10022",
            "units": 1,
            "diagnosis_code": "Z20.822 R05.9"
        },
         {
            "procedure_code": "10022",
            "units": 1,
            "diagnosis_code": "Z209822Z20.822"
        }
    ]
}'

Code Block

language	json

{
  "data": {
    "id": "82828",
  }
}

6

Receive a webhook request which will contain the result of the claim.

TBD

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Versions Compared

Old Version 46

New Version 47

Key