How?

A request will be sent to the URL configured by your account holder on the API Management page. Only two requirements for your configured endpoint:

The URL configured must be secured by HTTPS.
The request will be sent as a POST

Why?

When submitting a full VOB, it will take some time for a benefit specialist to verify the extra information necessary. The immediate response will contain the instantvob® information, as well as some extra details, like the id of the VOB. It's key to store the id of the VOB in the response to reference later, when you receive a webhook request containing updated information on the same VOB.

📘
It's key to store the id of the VOB in the response to reference later

When?

A webhook request is sent to your configured webhook endpoint whenever a VOB changes status. The status is noted in the request body, and typically follows this flow:

Pending the default status when a VOB first gets submitted. No webhook is sent for this status since the data available at this point will be returned immediately.
In Progress this status will trigger a webhook when a benefit specialist has started working on your VOB request. The response will have an updated benefitSpecialistName property containing the name of the specialist working on it.
Needs More Info If necessary the benefit specialist may send the vob back to you for more information requested by the vendor. You response will need to be input directly in the web portal.
Closed this status will trigger a webhook when the VOB is complete, and the request body will contain all of the new information gathered by the benefit specialist. See the new response data in the next section.

What?

A complete VOB webhook request will be the same structure as the response, but it will include many new objects. See this example below:

{
    "status": 1,
    "statusName": "SUCCESS",
    "warnings": [],
    "vob": {
        "id": "kW5m5HH3A4ZhXintt",
        "status": "Pending",
        "benefitSpecialistName": "",
        "outreachCoordinatorName": "Max OC",
        "note": "testing...."
        "submissionDate": "2023-08-14T13:47:13.420Z",
        "patient": {
            "firstName": "John",
            "lastName": "Doe",
            "dateOfBirth": "1994-05-18T04:00:00.000Z",
            "address": "123 TEST RD",
            "city": "TEST",
            "state": "FL",
            "zip": "12345"
        },
        "plan": {
            "status": 1,
            "statusName": "ACTIVE",
            "planDateBegin": "2023-01-01T05:00:00.000Z",
            "planDateEnd": "2023-12-31T05:00:00.000Z",
            "schedule": "Plan Year",
            "type": "Commercial",
            "planDescription": "SELECT PLUS PPO PLATINUM"
        },
        "insurance": {
            "employer": "Test Employer",
            "groupNumber": "GQ12345",
            "memberId": "123456789",
            "vendorName": "TEST VENDOR",
            "vendorPhone": "(800) 888-8888"
        },
        "coverages": [
            {
                "name": "Health Benefit Plan Coverage",
                "note": "SERVICES PROVIDED TO THIS PATIENT ARE SUBJECT TO STATE LAWS.",
                "inNetwork": true,
                "individual": {
                    "outOfPocket": 3600,
                    "outOfPocketMet": 467.38,
                    "outOfPocketRemaining": 3132.62,
                    "deductible": 1000,
                    "deductibleMet": 467.38,
                    "deductibleRemaining": 532.62,
                    "copay": 0,
                    "coInsurance": 0
                },
                "family": {
                    "outOfPocket": 7200,
                    "outOfPocketMet": 500.71,
                    "outOfPocketRemaining": 6699.29,
                    "deductible": 2000,
                    "deductibleMet": 467.32,
                    "deductibleRemaining": 1532.62,
                    "copay": 0,
                    "coInsurance": 0
                }
            },
            {
                "name": "Alcoholism",
                "note": "",
                "inNetwork": true,
                "individual": {
                    "copay": 15,
                    "coInsurance": 0
                },
                "family": {}
            },
            {
                "name": "Alcoholism",
                "note": "",
                "inNetwork": false,
                "individual": {
                    "copay": 0,
                    "coInsurance": 0.5
                },
                "family": {}
            },
            {
                "name": "Drug Addiction",
                "note": "",
                "inNetwork": true,
                "individual": {
                    "copay": 15,
                    "coInsurance": 0
                },
                "family": {}
            },
            {
                "name": "Drug Addiction",
                "note": "",
                "inNetwork": false,
                "individual": {
                    "copay": 0,
                    "coInsurance": 0.5
                },
                "family": {}
            },
            {
                "name": "Health Benefit Plan Coverage",
                "note": "SERVICES PROVIDED TO THIS PATIENT ARE SUBJECT TO STATE LAWS.",
                "inNetwork": false,
                "individual": {
                    "outOfPocket": 7200,
                    "outOfPocketMet": 0,
                    "outOfPocketRemaining": 7200,
                    "deductible": 1000,
                    "deductibleMet": 0,
                    "deductibleRemaining": 1000
                },
                "family": {
                    "outOfPocket": 14400,
                    "outOfPocketMet": 0,
                    "outOfPocketRemaining": 14400,
                    "deductible": 2000,
                    "deductibleMet": 0,
                    "deductibleRemaining": 2000
                }
            }
        ],
        "benefits": {
            "individualLevelsOfCare": [
              {
                "levelOfCare": "Test 3",
                "deductible": "$0.00",
                "dedMet": "$0.00",
                "dedRemaining": "$0.00",
                "oop": "$3600.00",
                "oopMet": "$467.38",
                "oopRemaining": "$3132.62",
                "copayPercentage": "",
                "daysPCY": "",
                "ltm": "",
                "daysUsed": "",
                "copay": "",
                "note": ""
              },
              {
                "levelOfCare": "Test 2",
                "deductible": "$0.00",
                "dedMet": "$0.00",
                "dedRemaining": "$0.00",
                "oop": "$3600.00",
                "oopMet": "$467.38",
                "oopRemaining": "$3132.62",
                "copayPercentage": "",
                "daysPCY": "",
                "ltm": "",
                "daysUsed": "",
                "copay": "",
                "note": ""
              },
              {
                "levelOfCare": "Test",
                "deductible": "$0.00",
                "dedMet": "$0.00",
                "dedRemaining": "$0.00",
                "oop": "$3600.00",
                "oopMet": "$467.38",
                "oopRemaining": "$3132.62",
                "copayPercentage": "",
                "daysPCY": "",
                "ltm": "",
                "daysUsed": "",
                "copay": "",
                "note": ""
              }
            ],
            "familyLevelsOfCare": [
              {
                "levelOfCare": "Test 3",
                "deductible": "$0.00",
                "dedMet": "$0.00",
                "dedRemaining": "$0.00",
                "oop": "$7200.00",
                "oopMet": "$500.71",
                "oopRemaining": "$6699.29",
                "copayPercentage": "",
                "daysPCY": "",
                "ltm": "",
                "daysUsed": "",
                "copay": "",
                "note": ""
              },
              {
                "levelOfCare": "Test 2",
                "deductible": "$0.00",
                "dedMet": "$0.00",
                "dedRemaining": "$0.00",
                "oop": "$7200.00",
                "oopMet": "$500.71",
                "oopRemaining": "$6699.29",
                "copayPercentage": "",
                "daysPCY": "",
                "ltm": "",
                "daysUsed": "",
                "copay": "",
                "note": ""
              },
              {
                "levelOfCare": "Test",
                "deductible": "$0.00",
                "dedMet": "$0.00",
                "dedRemaining": "$0.00",
                "oop": "$7200.00",
                "oopMet": "$500.71",
                "oopRemaining": "$6699.29",
                "copayPercentage": "",
                "daysPCY": "",
                "ltm": "",
                "daysUsed": "",
                "copay": "",
                "note": ""
              }
            ],
            "deductibleAppliesToOOP": false,
            "copayAppliesToOOP": false,
            "substanceMentalCombined": false,
            "authorizationRequired": true,
            "referralRequiredInNetwork": true,
            "referralRequiredInNetworkAll": false,
            "referralRequiredInNetworkPhpSub": true,
            "referralRepresentativeName": "Test",
            "referralNumber": "123123",
            "note": "",
            "inNetwork": true,
            "copayTypeIndividual": "Copay",
            "copayTypeFamily": "Copay"
        },
        "claimInformation": {
          "behavioralClaimPayerId": "",
          "behavioralClaimAddress": "",
          "behavioralClaimState": "",
          "behavioralClaimZip": "",
          "behavioralClaimName": "",
          "behavioralClaimCity": "",
          "medicalClaimPayerId": "",
          "medicalClaimAddress": "",
          "medicalClaimState": "",
          "medicalClaimZip": "",
          "medicalClaimName": "",
          "medicalClaimCity": ""
        },
        "payment": { 
          "payRate": "MNRP", 
          "percentageRate": "85" 
        },
        "preCertification": {
          "company": "Example Company",
          "phone": "",
          "penalty": true,
          "penaltyTerms": "Terms example",
          "timeReq": "",
          "ip": true,
          "rtc": true,
          "iop": true,
          "op1Hr": false,
          "op": false,
          "opDetox": true,
          "detox": true,
          "php": true,
          "medications": []
        }
    }
}

Full Complete VOB new data added

These are the objects added to a Full VOB after it's been completed:

`benefits`

Field	Description
individualLevelsOfCare	The levels of care and specific benefits that may apply for the patient as an individual.
familyLevelsOfCare	The levels of care and specific benefits that may apply for the patient from their family plan.
deductibleAppliesToOOP	Deductible applies to out of pocket
copayAppliesToOOP	Copay applies to OOP
substanceMentalCombined	Substance abuse and mental health combined.
authorizationRequired	Is authorization required
referralRequiredInNetwork	Is a referral required in network?
referralRequiredInNetworkAll	Is a referral required in network for all levels of care?
referralRequiredInNetworkPhpSub	Is a referral required in network just for PHP-SUB?
referralRepresentativeName	Name of the referral representative.
referralNumber	Referral identification number
inNetwork	Whether or not the verification is for in network or out of network.
copayTypeIndividual	Copay payment type for individual levels of care
copayTypeFamily	Copay payment type for family levels of care

`claimInformation`

Field	Description
behavioralClaimPayerID	Payer ID for behavioralclaims
behavioralClaimPayerName	Payer Name for behavioralclaims
behavioralClaimPayerAddress	Payer Address for behavioralclaims
behavioralClaimPayerCity	Payer City for behavioralclaims
behavioralClaimPayerState	Payer State for behavioralclaims
behavioralClaimPayerZip	Payer Zip for behavioralclaims
medicalClaimPayerID	Payer ID for medical claims
medicalClaimPayerName	Payer Name for medical claims
medicalClaimPayerAddress	Payer Address for medical claims
medicalClaimPayerCity	Payer City for medical claims
medicalClaimPayerState	Payer State for medical claims
medicalClaimPayerZip	Payer Zip for medical claims

`payment`

Field	Description
payRate	Rate at payment made to facility.
percentageRate	Rate of coverage.

`preCertification`

Field	Description
company	Pre-Cert company
phone	Pre-Cert company phone number.
penalty	Is there a Pre-Cert Penalty?
penaltyTerms	Terms of the penalty
timeReq	Pre-Cert Time Requirement
ip	IP
rtc	RTC
iop	IOP
op1hr	OP 1Hr (90837)
op	OP (90853)
opDetox	OP Detox
detox	Detox
php	PHP
medications	List of medications covered.

What’s Next

What’s Next