Configure your application to receive updates when a VOB changes status.
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
idof 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
benefitSpecialistNameproperty 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
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
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
payment| Field | Description |
|---|---|
| payRate | Rate at payment made to facility. |
| percentageRate | Rate of coverage. |
preCertification
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. |