Search-all

Nineteen payers, five statuses and two eligible policies: how to read aggregated_results without turning a broken check into "not covered".

A search-all asks every payer your clinic has credentials for. The response is aggregated_results, one entry per payer that answered, and in production a single check produces between 17 and 19 of them across four or five different statuses.

Two things go wrong here, and both produce a confident wrong answer rather than an error: reading the first entry, and treating everything that is not found as "the patient is not covered".

What came back

Seventeen payer results, four statuses, one match

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "",
"value": ""
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"payer_id": "TPA026",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:45.657000",
"message": "Member with ID 784-0000-0000000-0 not found or referral code was incorrect.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:02:18.221000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA029",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:29.075000",
"message": "TPA `TPA029` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA036",
"status": "member_not_found",
"data": {
"payer_id": "TPA036",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:39.046000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:47.429000",
"message": "Failed to login - invalid credentials",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The page does not provide valid insurance details or confirmation of eligibility. It specifically shows a 'Member not found' error message, lacking any policy details or copay information.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:52.589000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "member_not_found",
"data": {
"payer_id": "TPA002",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:39.969000",
"message": "`This beneficiary is  Invalid ` was seen",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:41.289000",
"message": "No results found for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA008",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA008",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document contains an error ('Member ID does not match...') and lacks evidence of eligibility, making the person not eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:48.878000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2025-10-12T10:00:27.636000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The page lacks concrete insurance details such as copay information, policy numbers, or eligibility checkboxes. It serves only as a navigation portal without the necessary information to confirm eligibility.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:20.503000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA004",
"status": "found",
"data": {
"payer_id": "TPA004",
"is_eligible": true,
"patient_info": {
"patient_id_info": {
"client_number": "INS016",
"dha_member_id": "0000000000",
"policy_number": "POL-0000000",
"tpa_member_id": "MBR-0000000",
"reference_number": "REF-0000000"
},
"policy_holder_dob": "01-01-1990",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_holder_phone": null,
"policy_holder_gender": "MALE",
"policy_primary_member_id": "MBR-0000000",
"policy_holder_relationship": null,
"policy_holder_date_of_birth": "01-01-1990",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Consultation",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Laboratory",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Radiology",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Physiotherapy",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Acute Drugs, Chronic Drugs, Immunomodulators, Vitamins | \n\n ",
"visit_type": "Pharmacy",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 50% applicable for : Circumcision | \n\n ",
"visit_type": "Other Services",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "50.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n Automatically added as Consultation, Lab, and Radiology have same copay.",
"visit_type": "Procedure",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
}
],
"waiting_period": "Not Specified",
"special_remarks": [
"No referral required for specialist consultation"
],
"new_version_of_copay_analysis": {
"benefits": [
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Consultation / Evaluation and Management",
"service_category_standardized": "Consultation"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Laboratory"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Radiology NEC",
"service_category_standardized": "Radiology"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Physiotherapy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Pharmacy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 50,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Circumcision",
"service_category_standardized": "Other Services"
},
{
"limits": null,
"remarks": "Automatically added as Consultation, Lab, and Radiology have same copay.",
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Procedure"
}
],
"policy_info": {
"waiting_period": "Not Specified",
"policy_period_end": null,
"policy_jurisdiction": "Not Specified",
"policy_period_start": null,
"beneficiary_start_date": null
},
"general_remarks": [
"No referral required for specialist consultation"
],
"abbreviations_defined": null
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "Not Mentioned",
"payer_name": "SUKOON TAKAFUL - INS016",
"sponsor_id": "INS016",
"start_date": "2025-06-01",
"valid_upto": "2026-05-31",
"all_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"package_name": null,
"is_gatekeeper": "Not Mentioned",
"waiting_period": null,
"policy_authority": "DHA",
"policy_plan_name": null,
"applicable_tariff": "General Network",
"work_site_covered": "Yes",
"policy_holder_name": null,
"network_payment_limit": 700,
"payer_name_as_in_text": "Sukoon Takaful",
"is_consultation_excluded_from_payment_limit": true,
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "01-01-1990",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Alternative Screenshot",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Approval Requirements",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form",
"tag": "Consultation/Claim form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"LAB": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:02:06.820000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:29.064000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS017",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance eligibility check failed because the document indicates that the provided Member ID/Emirates ID is invalid, which serves as an explicit disqualification.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:02.727000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:28.360000",
"message": "TPA `INS012` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:57.922000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA001",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance eligibility page clearly states 'Not Eligible' and shows an invalid member identifier, leading to a final determination of not eligible despite the effective dates matching today's date.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:21.295000",
"message": null,
"screenshot_url": null
}
],
"total_tpas_checked": 17,
"found_results": 1,
"created_at": "2025-10-12T10:00:25.317000",
"updated_at": "2025-10-12T10:02:26.837000"
}

Highlighted on every entry of aggregated_results: tpa_name, status, data.is_eligible, message. The rest of the keys are documented on Results.

That is one production check. Sixteen of the seventeen entries are not the answer, and they are not all the same kind of not-the-answer:

`status`	Entries	What it means
`found`	1	This payer holds a policy. Read `data.is_eligible`.
`member_not_found`	11	This payer has no member with that identifier. A real answer.
`failed`	4	The check did not complete at this payer. Not an answer at all.
`delegated_to_search_all_pool`	1	Bookkeeping, see below.

The envelope

A search-all response has no eligibility_result. It carries is_search_all, search_all_status, aggregated_results, total_tpas_checked and found_results instead. found_results counts entries whose status is found or member_found; it does not count how many of those are eligible, so a found_results of 1 can still be a member whose policy has lapsed.

delegated_to_search_all_pool

Every search-all in production carries one entry that is not a payer result.

The routing entry every search-all carries

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "",
"value": ""
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"payer_id": "TPA026",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:45.657000",
"message": "Member with ID 784-0000-0000000-0 not found or referral code was incorrect.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:02:18.221000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA029",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:29.075000",
"message": "TPA `TPA029` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA036",
"status": "member_not_found",
"data": {
"payer_id": "TPA036",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:39.046000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:47.429000",
"message": "Failed to login - invalid credentials",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The page does not provide valid insurance details or confirmation of eligibility. It specifically shows a 'Member not found' error message, lacking any policy details or copay information.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:52.589000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "member_not_found",
"data": {
"payer_id": "TPA002",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:39.969000",
"message": "`This beneficiary is  Invalid ` was seen",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:41.289000",
"message": "No results found for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA008",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA008",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document contains an error ('Member ID does not match...') and lacks evidence of eligibility, making the person not eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:48.878000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2025-10-12T10:00:27.636000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The page lacks concrete insurance details such as copay information, policy numbers, or eligibility checkboxes. It serves only as a navigation portal without the necessary information to confirm eligibility.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:20.503000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA004",
"status": "found",
"data": {
"payer_id": "TPA004",
"is_eligible": true,
"patient_info": {
"patient_id_info": {
"client_number": "INS016",
"dha_member_id": "0000000000",
"policy_number": "POL-0000000",
"tpa_member_id": "MBR-0000000",
"reference_number": "REF-0000000"
},
"policy_holder_dob": "01-01-1990",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_holder_phone": null,
"policy_holder_gender": "MALE",
"policy_primary_member_id": "MBR-0000000",
"policy_holder_relationship": null,
"policy_holder_date_of_birth": "01-01-1990",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Consultation",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Laboratory",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Radiology",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Physiotherapy",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Acute Drugs, Chronic Drugs, Immunomodulators, Vitamins | \n\n ",
"visit_type": "Pharmacy",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 50% applicable for : Circumcision | \n\n ",
"visit_type": "Other Services",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "50.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n Automatically added as Consultation, Lab, and Radiology have same copay.",
"visit_type": "Procedure",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
}
],
"waiting_period": "Not Specified",
"special_remarks": [
"No referral required for specialist consultation"
],
"new_version_of_copay_analysis": {
"benefits": [
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Consultation / Evaluation and Management",
"service_category_standardized": "Consultation"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Laboratory"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Radiology NEC",
"service_category_standardized": "Radiology"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Physiotherapy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Pharmacy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 50,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Circumcision",
"service_category_standardized": "Other Services"
},
{
"limits": null,
"remarks": "Automatically added as Consultation, Lab, and Radiology have same copay.",
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Procedure"
}
],
"policy_info": {
"waiting_period": "Not Specified",
"policy_period_end": null,
"policy_jurisdiction": "Not Specified",
"policy_period_start": null,
"beneficiary_start_date": null
},
"general_remarks": [
"No referral required for specialist consultation"
],
"abbreviations_defined": null
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "Not Mentioned",
"payer_name": "SUKOON TAKAFUL - INS016",
"sponsor_id": "INS016",
"start_date": "2025-06-01",
"valid_upto": "2026-05-31",
"all_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"package_name": null,
"is_gatekeeper": "Not Mentioned",
"waiting_period": null,
"policy_authority": "DHA",
"policy_plan_name": null,
"applicable_tariff": "General Network",
"work_site_covered": "Yes",
"policy_holder_name": null,
"network_payment_limit": 700,
"payer_name_as_in_text": "Sukoon Takaful",
"is_consultation_excluded_from_payment_limit": true,
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "01-01-1990",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Alternative Screenshot",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Approval Requirements",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form",
"tag": "Consultation/Claim form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"LAB": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:02:06.820000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:29.064000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS017",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance eligibility check failed because the document indicates that the provided Member ID/Emirates ID is invalid, which serves as an explicit disqualification.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:02.727000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:28.360000",
"message": "TPA `INS012` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:57.922000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA001",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance eligibility page clearly states 'Not Eligible' and shows an invalid member identifier, leading to a final determination of not eligible despite the effective dates matching today's date.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:21.295000",
"message": null,
"screenshot_url": null
}
],
"total_tpas_checked": 17,
"found_results": 1,
"created_at": "2025-10-12T10:00:25.317000",
"updated_at": "2025-10-12T10:02:26.837000"
}

Highlighted: aggregated_results.9. Every other key on the response is documented on Results.

It reports how the check was routed, not whether the member was found. Some responses also carry a search_all_pool entry in the same spirit.

delegated_to_search_all_pool is not in the status enum

It is absent from the result status table and appears on essentially every search-all. A client that switches exhaustively on status and throws on the default hits an unhandled branch on every search-all it ever runs. Handle unknown statuses by ignoring the entry, never by failing the response.

data is null, not empty

On found and member_not_found, the entry carries a data object. On every other status, data is null.

`status`	`data`	`data.is_eligible`
`found`	object	`true` or `false`
`member_not_found`	object, occasionally `null`	`false`, with `show_data: false`
`tpa_not_configured`	object	`false`
`failed`, `error`, `backoff`, `invalid_credentials`	`null`	not reachable
`delegated_to_search_all_pool`	`null`	not reachable

tpa_not_configured reports is_eligible: false here

The enums page says tpa_not_configured sets is_eligible to null, on the reasoning that no determination was made. Inside aggregated_results that is not what ships: in every production instance the entry carries data.is_eligible: false and show_data: false. So the field cannot be used to tell "we asked and the answer was no" from "we never asked". Use status for that, on every entry, every time.

The same problem, two different statuses

A payer your clinic has no credentials for is reported as tpa_not_configured in one check and as failed in another, with the identical message.

One check calls it tpa_not_configured

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "THE NATIONAL INSURANCE COMPANY (DAMAN) PJSC",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "LocationGroup",
"value": "OUTPATIENT",
"request_start_time": 1775868902.4697683
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:16.396000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA004",
"status": "member_not_found",
"data": {
"payer_id": "TPA004",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:23.117000",
"message": "Member not found, Final page was not member not found page.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:36:13.924000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "search_all_pool",
"status": "member_not_found",
"data": null,
"created_at": "2026-04-11T02:20:18.002000",
"message": "Eligibility checks completed for all prioritized TPAs, no active policy found.",
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA037",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:48.221000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA008",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA008",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:58.065000",
"message": "TPA `TPA008` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance enrollment check shows an explicit message 'NOT ELIGIBLE' with the reason 'Invalid Emirates ID', therefore the insurance policy is not valid for the patient.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:04.038000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA029",
"status": "member_not_found",
"data": {
"payer_id": "TPA029",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:13.907000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "member_not_found",
"data": {
"payer_id": "INS038",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:23.962000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"payer_id": "INS017",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:24.072000",
"message": "Member not eligible: Given Member ID/Emirates ID is invalid",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2026-04-11T01:02:55.314000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "member_not_found",
"data": {
"payer_id": "TPA002",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:35.563000",
"message": "`This beneficiary is  Invalid ` was seen",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"payer_id": "TPA001",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:42.764000",
"message": "Member not found, Final page was not member not found page.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:55.128000",
"message": "Saw `No data found` for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA036",
"status": "member_not_found",
"data": {
"payer_id": "TPA036",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:39.508000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document is just a portal navigation page without any specific insurance details or eligibility indicators such as copay or policy dates. Therefore, we cannot confirm active insurance coverage.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:46.180000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS012",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Ineligible - as indicated by the portal's transaction actions field",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:36:02.515000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA032",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA032",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:09.436000",
"message": "TPA `TPA032` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"payer_id": "TPA026",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:24.372000",
"message": "Member with ID 784-0000-0000000-0 not found or member is inactive. Notification:  member not found !!",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"total_tpas_checked": 19,
"found_results": 0,
"created_at": "2026-04-11T00:55:02.478000",
"updated_at": "2026-04-11T02:20:18.216000"
}

Highlighted on aggregated_results.4: tpa_name, status, message. The rest of the keys are documented on Results.

Another calls the same thing failed

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "",
"value": ""
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"payer_id": "TPA026",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:45.657000",
"message": "Member with ID 784-0000-0000000-0 not found or referral code was incorrect.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:02:18.221000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA029",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:29.075000",
"message": "TPA `TPA029` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA036",
"status": "member_not_found",
"data": {
"payer_id": "TPA036",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:39.046000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:47.429000",
"message": "Failed to login - invalid credentials",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The page does not provide valid insurance details or confirmation of eligibility. It specifically shows a 'Member not found' error message, lacking any policy details or copay information.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:52.589000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "member_not_found",
"data": {
"payer_id": "TPA002",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:39.969000",
"message": "`This beneficiary is  Invalid ` was seen",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:41.289000",
"message": "No results found for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA008",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA008",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document contains an error ('Member ID does not match...') and lacks evidence of eligibility, making the person not eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:48.878000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2025-10-12T10:00:27.636000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The page lacks concrete insurance details such as copay information, policy numbers, or eligibility checkboxes. It serves only as a navigation portal without the necessary information to confirm eligibility.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:20.503000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA004",
"status": "found",
"data": {
"payer_id": "TPA004",
"is_eligible": true,
"patient_info": {
"patient_id_info": {
"client_number": "INS016",
"dha_member_id": "0000000000",
"policy_number": "POL-0000000",
"tpa_member_id": "MBR-0000000",
"reference_number": "REF-0000000"
},
"policy_holder_dob": "01-01-1990",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_holder_phone": null,
"policy_holder_gender": "MALE",
"policy_primary_member_id": "MBR-0000000",
"policy_holder_relationship": null,
"policy_holder_date_of_birth": "01-01-1990",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Consultation",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Laboratory",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Radiology",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n ",
"visit_type": "Physiotherapy",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Acute Drugs, Chronic Drugs, Immunomodulators, Vitamins | \n\n ",
"visit_type": "Pharmacy",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 50% applicable for : Circumcision | \n\n ",
"visit_type": "Other Services",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "50.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Copay 20% applicable for : Consultation / Evaluation and Management, Laboratory, Ultrasound, X-Ray, C.T Scan, M.R.I, Radiology NEC, Physiotherapy, PET Scan, Endoscopy, Teleconsultations, Diagnostics NEC | \n\n Automatically added as Consultation, Lab, and Radiology have same copay.",
"visit_type": "Procedure",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "20.0",
"coinsurance_percentage": null
}
],
"waiting_period": "Not Specified",
"special_remarks": [
"No referral required for specialist consultation"
],
"new_version_of_copay_analysis": {
"benefits": [
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Consultation / Evaluation and Management",
"service_category_standardized": "Consultation"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Laboratory"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Radiology NEC",
"service_category_standardized": "Radiology"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Physiotherapy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Pharmacy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 50,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Circumcision",
"service_category_standardized": "Other Services"
},
{
"limits": null,
"remarks": "Automatically added as Consultation, Lab, and Radiology have same copay.",
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": null,
"service_category_standardized": "Procedure"
}
],
"policy_info": {
"waiting_period": "Not Specified",
"policy_period_end": null,
"policy_jurisdiction": "Not Specified",
"policy_period_start": null,
"beneficiary_start_date": null
},
"general_remarks": [
"No referral required for specialist consultation"
],
"abbreviations_defined": null
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "Not Mentioned",
"payer_name": "SUKOON TAKAFUL - INS016",
"sponsor_id": "INS016",
"start_date": "2025-06-01",
"valid_upto": "2026-05-31",
"all_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"package_name": null,
"is_gatekeeper": "Not Mentioned",
"waiting_period": null,
"policy_authority": "DHA",
"policy_plan_name": null,
"applicable_tariff": "General Network",
"work_site_covered": "Yes",
"policy_holder_name": null,
"network_payment_limit": 700,
"payer_name_as_in_text": "Sukoon Takaful",
"is_consultation_excluded_from_payment_limit": true,
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "01-01-1990",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Alternative Screenshot",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Approval Requirements",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form",
"tag": "Consultation/Claim form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"LAB": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "GN",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "GN",
"visit_type": "Not Specified",
"network_code": null,
"network_value": "General Network",
"raw_plan_string": "INS012 - SUKOON TAKAFUL - NAS - GN - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "Restricted Network [Applicable Tariff: General Network]"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:02:06.820000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:29.064000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS017",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance eligibility check failed because the document indicates that the provided Member ID/Emirates ID is invalid, which serves as an explicit disqualification.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:02.727000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "failed",
"data": null,
"created_at": "2025-10-12T10:00:28.360000",
"message": "TPA `INS012` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:00:57.922000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA001",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance eligibility page clearly states 'Not Eligible' and shows an invalid member identifier, leading to a final determination of not eligible despite the effective dates matching today's date.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2025-10-12T10:01:21.295000",
"message": null,
"screenshot_url": null
}
],
"total_tpas_checked": 17,
"found_results": 1,
"created_at": "2025-10-12T10:00:25.317000",
"updated_at": "2025-10-12T10:02:26.837000"
}

Highlighted on aggregated_results.12: tpa_name, status, message. The rest of the keys are documented on Results.

Same payer, same message, two statuses. Treat failed and tpa_not_configured as the same thing for display purposes: neither is a statement about the patient.

Two eligible policies

A patient can genuinely hold two active policies, and a search-all finds both.

Eighteen payers, two eligible

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "MEDNET GLOBAL HEALTHCARE SOLUTIONS L.L.C.",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "LocationGroup",
"value": "OUTPATIENT"
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2026-02-24T10:34:21.285000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Document explicitly states NOT ELIGIBLE and Invalid member, overriding any policy start/end dates; therefore the member is not eligible for the claimed benefits.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:07.951000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Document does not contain any insurance eligibility indicators (no policy number, copays, eligibility status, or transaction/date). Therefore cannot determine eligibility from provided content.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:34.382000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA029",
"status": "member_not_found",
"data": {
"payer_id": "TPA029",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:28.393000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA008",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA008",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Insufficient visible information to confirm eligibility. The page shows a mismatch message and lacks policy details or explicit status indicating Active/Eligible. Therefore, cannot determine eligibility and defaults to not eligible based on absence of valid indicators.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:48:31.485000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS017",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document explicitly states that the Member ID/Emirates ID is invalid. No explicit eligibility indicators (active policy, coverage, network, or policy numbers) are present. Therefore, not eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:51:07.037000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA037",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:46:48.746000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA032",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA032",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:46:55.657000",
"message": "TPA `TPA032` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "found",
"data": {
"payer_id": "TPA002",
"is_eligible": true,
"patient_info": {
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_primary_member_id": "MBR-0000000",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: Co-Part: 10% | \n\n ",
"visit_type": "Out-Patient",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "10.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: Co-Part: 10% | \n\n ",
"visit_type": "Pharmacy",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "10.0",
"coinsurance_percentage": null
}
],
"waiting_period": "Not Specified",
"special_remarks": [
],
"new_version_of_copay_analysis": {
"benefits": [
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Out-Patient",
"service_category_standardized": "Out-Patient"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Pharmacy",
"service_category_standardized": "Pharmacy"
}
],
"policy_info": {
"waiting_period": "Not Specified",
"policy_period_end": null,
"policy_jurisdiction": "Not Specified",
"policy_period_start": null,
"beneficiary_start_date": {
"DD": 1,
"MM": 1,
"YYYY": 2024
},
"air_arabia_referral_number": "REF-0000000"
},
"general_remarks": [
],
"abbreviations_defined": [
]
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "No",
"payer_name": "DUBAI GOVERNMENT - PROGRAM 2 (ENAYA 2022) - INS002",
"sponsor_id": null,
"start_date": "2024-01-01",
"valid_upto": "2026-12-31",
"all_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"package_name": null,
"is_gatekeeper": "No",
"waiting_period": null,
"policy_authority": "DHA",
"policy_plan_name": "ENAYA Platinum",
"work_site_covered": "Could not determine",
"policy_holder_name": "Sample Policy Holder",
"payer_name_as_in_text": "ENAYA",
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"id": "claim_form",
"tag": "Claim Form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form_image",
"tag": "Claim Form Image",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "table_of_benefits",
"tag": "Table of Benefits",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:19.072000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA004",
"status": "member_not_found",
"data": {
"payer_id": "TPA004",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:30.618000",
"message": "Member not found, Final page was not member not found page.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA036",
"status": "found",
"data": {
"payer_id": "TPA036",
"is_eligible": true,
"patient_info": {
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_holder_phone": "+971 50 000 0000",
"policy_holder_last_name": "Sample Policy Holder",
"policy_holder_first_name": "Sample Policy Holder",
"policy_primary_member_id": "MBR-0000000",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: physician consultation copayment copay 20% max 50 aed applicable | \n\n ",
"visit_type": "Consultation",
"copay_amount": null,
"cost_sharing": {
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"remarks": "Citation: out mat laboratory copayment 100% | \n\n ",
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"remarks": "Citation: out mat pharmaceuticals copayment 100% | \n\n ",
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"beneficiary_start_date": null
},
"general_remarks": [
"nil co-pay on teleconsultation and smartdoc. member is eligible for smartdoc service"
],
"abbreviations_defined": [
]
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "Yes",
"payer_name": "AMERICAN LIFE INSURANCE COMPANY / Metlife - INS013",
"sponsor_id": null,
"start_date": "2025-12-01",
"valid_upto": "2026-11-30",
"all_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"package_name": null,
"is_gatekeeper": "Not Mentioned",
"waiting_period": "0 Month(s)",
"policy_authority": "DHA",
"policy_plan_name": null,
"work_site_covered": "Could not determine",
"policy_holder_name": "Sample Policy Holder",
"payer_name_as_in_text": "AMERICAN LIFE INSURANCE CO_TPA_501",
"HAAD_or_DHA_Approval_Number": "REF-0000000",
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form",
"tag": "Claim form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"LAB": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "50.0",
"should_set_copay": true,
"_deductibleLegacy": "50.0"
},
"PHYSIOTHERAPY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0.0",
"should_set_copay": true,
"_deductibleLegacy": "0.0"
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "50.0",
"should_set_copay": true,
"_deductibleLegacy": "50.0"
},
"PHYSIOTHERAPY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:38.434000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:46:55.436000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:09.566000",
"message": "Saw `No data found` for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:48:34.756000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "member_not_found",
"data": {
"payer_id": "INS038",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:17.068000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA026",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Document lacks concrete eligibility indicators (no policy number, no inception/expiry dates, no eligibility status). TPAs instructions exist but do not confirm eligibility for the patient due to missing data. The placeholder content and invalid credentials suggest this is not a valid eligibility record.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:23.730000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA001",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Policy status indicates expiration before the check date and explicitly states Not Eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Alternative Screenshot",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:55.207000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS012",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The message indicates an invalid health card number and states the patient is ineligible, with no information suggesting active or valid coverage for the current service.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:49:22.788000",
"message": null,
"screenshot_url": null
}
],
"total_tpas_checked": 18,
"found_results": 2,
"created_at": "2026-02-24T10:33:49.196000",
"updated_at": "2026-02-24T10:47:36.229000"
}

Highlighted on every entry of aggregated_results: tpa_name, status, data.is_eligible, created_at. The rest of the keys are documented on Results.

One of those two entries in full, so you can see what a match actually carries:

A single eligible entry

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "MEDNET GLOBAL HEALTHCARE SOLUTIONS L.L.C.",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "LocationGroup",
"value": "OUTPATIENT"
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2026-02-24T10:34:21.285000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Document explicitly states NOT ELIGIBLE and Invalid member, overriding any policy start/end dates; therefore the member is not eligible for the claimed benefits.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:07.951000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Document does not contain any insurance eligibility indicators (no policy number, copays, eligibility status, or transaction/date). Therefore cannot determine eligibility from provided content.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:34.382000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA029",
"status": "member_not_found",
"data": {
"payer_id": "TPA029",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:28.393000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA008",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA008",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Insufficient visible information to confirm eligibility. The page shows a mismatch message and lacks policy details or explicit status indicating Active/Eligible. Therefore, cannot determine eligibility and defaults to not eligible based on absence of valid indicators.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:48:31.485000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS017",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document explicitly states that the Member ID/Emirates ID is invalid. No explicit eligibility indicators (active policy, coverage, network, or policy numbers) are present. Therefore, not eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:51:07.037000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA037",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:46:48.746000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA032",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA032",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:46:55.657000",
"message": "TPA `TPA032` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "found",
"data": {
"payer_id": "TPA002",
"is_eligible": true,
"patient_info": {
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_primary_member_id": "MBR-0000000",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: Co-Part: 10% | \n\n ",
"visit_type": "Out-Patient",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
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"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
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"coinsurance_percentage": null
},
{
"remarks": "Citation: Co-Part: 10% | \n\n ",
"visit_type": "Pharmacy",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
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"visit_setting": "Outpatient",
"copay_currency": "AED",
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"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Outpatient",
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"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "10.0",
"coinsurance_percentage": null
}
],
"waiting_period": "Not Specified",
"special_remarks": [
],
"new_version_of_copay_analysis": {
"benefits": [
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Out-Patient",
"service_category_standardized": "Out-Patient"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Pharmacy",
"service_category_standardized": "Pharmacy"
}
],
"policy_info": {
"waiting_period": "Not Specified",
"policy_period_end": null,
"policy_jurisdiction": "Not Specified",
"policy_period_start": null,
"beneficiary_start_date": {
"DD": 1,
"MM": 1,
"YYYY": 2024
},
"air_arabia_referral_number": "REF-0000000"
},
"general_remarks": [
],
"abbreviations_defined": [
]
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "No",
"payer_name": "DUBAI GOVERNMENT - PROGRAM 2 (ENAYA 2022) - INS002",
"sponsor_id": null,
"start_date": "2024-01-01",
"valid_upto": "2026-12-31",
"all_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"package_name": null,
"is_gatekeeper": "No",
"waiting_period": null,
"policy_authority": "DHA",
"policy_plan_name": "ENAYA Platinum",
"work_site_covered": "Could not determine",
"policy_holder_name": "Sample Policy Holder",
"payer_name_as_in_text": "ENAYA",
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"id": "claim_form",
"tag": "Claim Form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form_image",
"tag": "Claim Form Image",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "table_of_benefits",
"tag": "Table of Benefits",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
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"_copayAmount": "0",
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"should_set_copay": true
},
"PROCEDURE": {
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"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
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"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
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"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
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"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
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"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
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"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
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"_copayAmount": "0",
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"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
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"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
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"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
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"_copayAmount": "0",
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"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "NEXTCARE ENAYA PLATINUM - OP",
"network_status": null,
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP"
},
"available_networks": [
{
"network": "NEXTCARE ENAYA PLATINUM - OP",
"plan_code": "Z079",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ENAYA Platinum",
"raw_plan_string": "INS001 - GOVERNMENT OF DUBAI (ENAYA SCHEME) - PLATINUM - DXB-SHJ",
"matched_plan_name": "NEXTCARE ENAYA PLATINUM - OP",
"network_name_as_in_text": "Network Name: ENAYA Platinum"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:19.072000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA004",
"status": "member_not_found",
"data": {
"payer_id": "TPA004",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:30.618000",
"message": "Member not found, Final page was not member not found page.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA036",
"status": "found",
"data": {
"payer_id": "TPA036",
"is_eligible": true,
"patient_info": {
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"patient_emirates_id": "784-0000-0000000-0",
"policy_holder_phone": "+971 50 000 0000",
"policy_holder_last_name": "Sample Policy Holder",
"policy_holder_first_name": "Sample Policy Holder",
"policy_primary_member_id": "MBR-0000000",
"policy_primary_dha_member_id": "0000000000"
},
"copay_analysis": {
"copay_details": [
{
"remarks": "Citation: physician consultation copayment copay 20% max 50 aed applicable | \n\n ",
"visit_type": "Consultation",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_percentage": 20,
"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": 50,
"coinsurance_percentage": null
},
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": 50,
"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: laboratory services copayment 0% | \n\n ",
"visit_type": "Laboratory",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_percentage": 0,
"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "0.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: radiology services copayment 0% | \n\n ",
"visit_type": "Radiology",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_percentage": 0,
"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "0.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: outpatient procedure copayment 0% | \n\n ",
"visit_type": "Procedure",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_percentage": 0,
"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "0.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: pharmaceutical copayment 0% | \n\n ",
"visit_type": "Pharmacy",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Inpatient",
"copay_currency": "AED",
"copay_percentage": 0,
"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Inpatient",
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},
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"remarks": "Citation: dental copayment 20% | \n\n ",
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},
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},
{
"remarks": "Citation: alternative medicine copayment 10% | \n\n ",
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},
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},
{
"remarks": "",
"visit_type": "Optical",
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"visit_setting": "Outpatient",
"copay_currency": null,
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "Not Covered",
"deductible_scope": null,
"deductible_amount": null,
"deductible_currency": null,
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},
{
"remarks": "Citation: vaccination copayment 0% | \n\n ",
"visit_type": "Vaccination",
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},
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},
{
"remarks": "Citation: out mat physician consultation copayment copay 100% max 0 aed applicable | \n\n ",
"visit_type": "Outpatient Maternity Consultation",
"copay_amount": null,
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"visit_type": "Maternity",
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"visit_setting": "Outpatient",
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},
"visit_setting": "Outpatient",
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"copay_max_amount": 0,
"copay_percentage": "0%",
"coinsurance_percentage": null
},
{
"remarks": "Citation: out mat laboratory copayment 100% | \n\n ",
"visit_type": "Outpatient Maternity Laboratory",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Maternity",
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"visit_setting": "Outpatient",
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},
"visit_setting": "Outpatient",
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"copay_max_amount": null,
"copay_percentage": "0%",
"coinsurance_percentage": null
},
{
"remarks": "Citation: out mat radiology copayment 100% | \n\n ",
"visit_type": "Outpatient Maternity Radiology",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Maternity",
"copay_amount": null,
"visit_setting": "Outpatient",
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},
"visit_setting": "Outpatient",
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"copay_max_amount": null,
"copay_percentage": "0%",
"coinsurance_percentage": null
},
{
"remarks": "Citation: out mat pharmaceuticals copayment 100% | \n\n ",
"visit_type": "Outpatient Maternity Pharmacy",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Maternity",
"copay_amount": null,
"visit_setting": "Outpatient",
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},
"visit_setting": "Outpatient",
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"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "0%",
"coinsurance_percentage": null
},
{
"remarks": "Citation: inpatient copay copay 0% max 1836210 aed applicable | \n\n ",
"visit_type": "Inpatient",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
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"visit_setting": "Inpatient",
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"copay_maximum_amount": 1836210,
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},
"visit_setting": "Inpatient",
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"copay_max_amount": 1836210,
"copay_percentage": "0.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: inpatient psychiatric copayment 20% | \n\n ",
"visit_type": "Inpatient Psychiatric",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": null,
"visit_setting": "Inpatient",
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},
"visit_setting": "Inpatient",
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"copay_percentage": "20.0",
"coinsurance_percentage": null
},
{
"remarks": "Citation: outpatient psychiatric copayment 20% | \n\n ",
"visit_type": "Outpatient Psychiatric",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
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"visit_setting": "Outpatient",
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},
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},
{
"remarks": "Citation: physiotherapy services copayment 0% | \n\n ",
"visit_type": "Physiotherapy",
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"cost_sharing": {
"visit_type": "Outpatient",
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"visit_setting": "Outpatient",
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},
"visit_setting": "Outpatient",
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},
{
"remarks": "Citation: we||ness check up copayment 0% | \n\n ",
"visit_type": "Wellness",
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"cost_sharing": {
"visit_type": "Outpatient",
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"visit_setting": "Outpatient",
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},
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},
{
"remarks": "",
"visit_type": "Check-up",
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"visit_setting": "Outpatient",
"copay_currency": null,
"copay_max_scope": null,
"copay_max_amount": null,
"copay_percentage": "Covered",
"deductible_scope": null,
"deductible_amount": null,
"deductible_currency": null,
"coinsurance_percentage": null
},
{
"remarks": "Citation: nil co-pay on teleconsultation and smartdoc | \n\n member is eligible for smartdoc service",
"visit_type": "Teleconsultation",
"copay_amount": null,
"cost_sharing": {
"visit_type": "Outpatient",
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"visit_setting": "Outpatient",
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},
"visit_setting": "Outpatient",
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"coinsurance_percentage": null
}
],
"waiting_period": "waiting_period_time=0 waiting_period_unit='Months' waiting_period_starting_from='policy_start_date'",
"special_remarks": [
"nil co-pay on teleconsultation and smartdoc. member is eligible for smartdoc service"
],
"new_version_of_copay_analysis": {
"benefits": [
{
"limits": null,
"remarks": null,
"conditions": null,
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{
"visit_type": "Outpatient",
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"visit_setting": "Inpatient",
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"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": 50,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Physician Consultation",
"service_category_standardized": "Consultation"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
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"copay_maximum_scope": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "Laboratory Services",
"service_category_standardized": "Laboratory"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
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}
],
"coverage_status": "Covered",
"service_category_original": "Radiology Services",
"service_category_standardized": "Radiology"
},
{
"limits": null,
"remarks": null,
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"cost_sharing": [
{
"visit_type": "Outpatient",
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"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "Outpatient Procedure",
"service_category_standardized": "Procedure"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
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"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "Pharmaceutical",
"service_category_standardized": "Pharmacy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
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"copay_maximum_scope": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "Dental",
"service_category_standardized": "Dental"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
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"visit_setting": "Inpatient",
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"copay_maximum_scope": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "Alternative Medicine",
"service_category_standardized": "Alternative Medicine"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
],
"coverage_status": "Not Covered",
"service_category_original": "Optical",
"service_category_standardized": "Optical"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
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"visit_setting": "Inpatient",
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"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "Vaccination",
"service_category_standardized": "Vaccination"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Maternity",
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"visit_setting": "Outpatient",
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"applicable_location": "Outside UAE",
"copay_maximum_scope": null,
"copay_maximum_amount": 0,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Out mat physician consultation",
"service_category_standardized": "Outpatient Maternity Consultation"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
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}
],
"coverage_status": "Covered",
"service_category_original": "Out mat laboratory",
"service_category_standardized": "Outpatient Maternity Laboratory"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Maternity",
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"copay_maximum_scope": null,
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}
],
"coverage_status": "Covered",
"service_category_original": "out mat radiology",
"service_category_standardized": "Outpatient Maternity Radiology"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
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"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "out mat pharmaceuticals",
"service_category_standardized": "Outpatient Maternity Pharmacy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
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"visit_setting": "Inpatient",
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"copay_maximum_amount": 1836210,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
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"service_category_standardized": "Inpatient"
},
{
"limits": null,
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"cost_sharing": [
{
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"applicable_location": "Outside UAE",
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}
],
"coverage_status": "Covered",
"service_category_original": "inpatient psychiatric",
"service_category_standardized": "Inpatient Psychiatric"
},
{
"limits": null,
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"conditions": null,
"cost_sharing": [
{
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"applicable_location": "Outside UAE",
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"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "outpatient psychiatric",
"service_category_standardized": "Outpatient Psychiatric"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
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"applicable_location": "Outside UAE",
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}
],
"coverage_status": "Covered",
"service_category_original": "physiotherapy services",
"service_category_standardized": "Physiotherapy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
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}
],
"coverage_status": "Covered",
"service_category_original": "we||ness check up",
"service_category_standardized": "Wellness"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
],
"coverage_status": "Covered",
"service_category_original": "check-up plan",
"service_category_standardized": "Check-up"
},
{
"limits": null,
"remarks": "member is eligible for smartdoc service",
"conditions": null,
"cost_sharing": [
{
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}
],
"coverage_status": "Covered",
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"service_category_standardized": "Teleconsultation"
}
],
"policy_info": {
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"waiting_period_unit": "Months",
"waiting_period_starting_from": "policy_start_date"
},
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"policy_jurisdiction": "Not Specified",
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"beneficiary_start_date": null
},
"general_remarks": [
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],
"abbreviations_defined": [
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}
},
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"all_networks": [
{
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"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"package_name": null,
"is_gatekeeper": "Not Mentioned",
"waiting_period": "0 Month(s)",
"policy_authority": "DHA",
"policy_plan_name": null,
"work_site_covered": "Could not determine",
"policy_holder_name": "Sample Policy Holder",
"payer_name_as_in_text": "AMERICAN LIFE INSURANCE CO_TPA_501",
"HAAD_or_DHA_Approval_Number": "REF-0000000",
"is_general_physician_referral_required_for_specialist_referral": false
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"policy_holder_dob": "1990-01-01",
"policy_holder_name": "Sample Policy Holder",
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"id": "claim_form",
"tag": "Claim form",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
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"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
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"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
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"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "50.0",
"should_set_copay": true,
"_deductibleLegacy": "50.0"
},
"PHYSIOTHERAPY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
},
{
"name": "Maternity",
"values_to_fill": {
"LAB": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "100.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0.0",
"should_set_copay": true,
"_deductibleLegacy": "0.0"
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"MEDICINES": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"PROCEDURE": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"RADIOLOGY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"CONSULTATION": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "50.0",
"should_set_copay": true,
"_deductibleLegacy": "50.0"
},
"PHYSIOTHERAPY": {
"copay": "0.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "20.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
},
{
"name": "Inpatient",
"values_to_fill": {
"LAB": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"MEDICINES": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"RADIOLOGY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
}
},
"primary_network": {
"network": "ML - GOLD",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "ML - GOLD",
"plan_code": "DXSHJ-P299",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "ML - GOLD",
"raw_plan_string": "INS013 - METLIFE - MEDNET COBRAND - ML GOLD - DXB-SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "ML - Gold"
}
],
"has_multiple_networks": false
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:38.434000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:46:55.436000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:09.566000",
"message": "Saw `No data found` for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:48:34.756000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "member_not_found",
"data": {
"payer_id": "INS038",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:17.068000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA026",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Document lacks concrete eligibility indicators (no policy number, no inception/expiry dates, no eligibility status). TPAs instructions exist but do not confirm eligibility for the patient due to missing data. The placeholder content and invalid credentials suggest this is not a valid eligibility record.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:23.730000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA001",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Policy status indicates expiration before the check date and explicitly states Not Eligible.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"tag": "Member Eligibility - Main Page",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Details Modal",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tag": "Member Eligibility - Alternative Screenshot",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:47:55.207000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS012",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The message indicates an invalid health card number and states the patient is ineligible, with no information suggesting active or valid coverage for the current service.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-02-24T10:49:22.788000",
"message": null,
"screenshot_url": null
}
],
"total_tpas_checked": 18,
"found_results": 2,
"created_at": "2026-02-24T10:33:49.196000",
"updated_at": "2026-02-24T10:47:36.229000"
}

Highlighted: aggregated_results.8. Every other key on the response is documented on Results.

Present both and let a human choose. Nothing in the response says which one the patient is presenting at reception.

Do not rank matches by created_at

created_at on an entry is when that payer finished answering this check. It orders the fan-out by response latency and carries no information about which policy is newer or which one applies.

Nobody found anything

Nineteen payers, nothing found

.json

{
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "SEARCH_ALL_COMPLETE",
"request_dump": {
"phone": "+971 50 000 0000",
"id_type": "EMIRATESID",
"tpa_name": "BOTH",
"payerName": "THE NATIONAL INSURANCE COMPANY (DAMAN) PJSC",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "LocationGroup",
"value": "OUTPATIENT",
"request_start_time": 1775868902.4697683
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"name": null,
"dob": null,
"mode": "prod",
"test_mode": false
},
"is_search_all": true,
"search_all_status": "SEARCH_ALL_COMPLETE",
"aggregated_results": [
{
"tpa_name": "INS020",
"status": "member_not_found",
"data": {
"payer_id": "INS020",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:16.396000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA004",
"status": "member_not_found",
"data": {
"payer_id": "TPA004",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:23.117000",
"message": "Member not found, Final page was not member not found page.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS010",
"status": "member_not_found",
"data": {
"payer_id": "INS010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:36:13.924000",
"message": "Member not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "search_all_pool",
"status": "member_not_found",
"data": null,
"created_at": "2026-04-11T02:20:18.002000",
"message": "Eligibility checks completed for all prioritized TPAs, no active policy found.",
"screenshot_url": null
},
{
"tpa_name": "TPA037",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA037",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:48.221000",
"message": "TPA `TPA037` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA008",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA008",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:58.065000",
"message": "TPA `TPA008` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA003",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "TPA003",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The insurance enrollment check shows an explicit message 'NOT ELIGIBLE' with the reason 'Invalid Emirates ID', therefore the insurance policy is not valid for the patient.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:04.038000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA029",
"status": "member_not_found",
"data": {
"payer_id": "TPA029",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:13.907000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS038",
"status": "member_not_found",
"data": {
"payer_id": "INS038",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:23.962000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS017",
"status": "member_not_found",
"data": {
"payer_id": "INS017",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:24.072000",
"message": "Member not eligible: Given Member ID/Emirates ID is invalid",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "DHPO / Riayati",
"status": "delegated_to_search_all_pool",
"data": null,
"created_at": "2026-04-11T01:02:55.314000",
"message": "Identification via DHPO / Riayati failed, triggering pool-based search_all.",
"screenshot_url": null
},
{
"tpa_name": "TPA002",
"status": "member_not_found",
"data": {
"payer_id": "TPA002",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:35.563000",
"message": "`This beneficiary is  Invalid ` was seen",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA001",
"status": "member_not_found",
"data": {
"payer_id": "TPA001",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:42.764000",
"message": "Member not found, Final page was not member not found page.",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA010",
"status": "member_not_found",
"data": {
"payer_id": "TPA010",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:55.128000",
"message": "Saw `No data found` for the given ID: 784-0000-0000000-0",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "TPA036",
"status": "member_not_found",
"data": {
"payer_id": "TPA036",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:34:39.508000",
"message": "Member with ID 784-0000-0000000-0 not found",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
},
{
"tpa_name": "INS015",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS015",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "The document is just a portal navigation page without any specific insurance details or eligibility indicators such as copay or policy dates. Therefore, we cannot confirm active insurance coverage.",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:46.180000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "INS012",
"status": "member_not_found",
"data": {
"network": null,
"payer_id": "INS012",
"show_data": false,
"payer_name": null,
"valid_upto": null,
"is_eligible": false,
"copay_details": null,
"other_details": null,
"failure_reason": "Ineligible - as indicated by the portal's transaction actions field",
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"coverage_details": null,
"is_policy_active": false,
"policy_holder_dob": null,
"policy_holder_name": null,
"referral_documents": [
{
"id": "member_eligibility_document",
"tag": "Member Eligibility Document",
"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"policy_holder_phone": null,
"policy_holder_gender": null,
"policy_holder_last_name": null,
"policy_holder_member_id": null,
"payer_eligibility_status": null,
"policy_holder_first_name": null,
"policy_holder_card_number": null,
"policy_holder_emirates_id": null,
"policy_holder_middle_name": null,
"policy_holder_relationship": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:36:02.515000",
"message": null,
"screenshot_url": null
},
{
"tpa_name": "TPA032",
"status": "tpa_not_configured",
"data": {
"payer_id": "TPA032",
"show_data": false,
"is_eligible": false,
"screenshot_key": null,
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:09.436000",
"message": "TPA `TPA032` is not configured for the practice.",
"screenshot_url": null
},
{
"tpa_name": "TPA026",
"status": "member_not_found",
"data": {
"payer_id": "TPA026",
"show_data": false,
"is_eligible": false,
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"was_identified_by_aggregator": false
},
"created_at": "2026-04-11T01:35:24.372000",
"message": "Member with ID 784-0000-0000000-0 not found or member is inactive. Notification:  member not found !!",
"screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"
}
],
"total_tpas_checked": 19,
"found_results": 0,
"created_at": "2026-04-11T00:55:02.478000",
"updated_at": "2026-04-11T02:20:18.216000"
}

Highlighted on every entry of aggregated_results: tpa_name, status, data.is_eligible. The rest of the keys are documented on Results.

Nineteen entries, zero found, three of them tpa_not_configured. This is a real and complete answer: no payer in the sweep holds a policy for that identifier. It is different from a sweep where three payers broke, and your UI should say so differently. Count the entries whose status is failed, error, backoff, invalid_credentials or tpa_not_configured and, when there are any, say that some payers could not be reached.

Note also that Daman is never part of a search-all. A patient with Daman cover and nothing else produces exactly this response.

What your code has to do

Partition aggregated_results by status before you read anything else. Matches are found and member_found. Real negatives are member_not_found. Everything else is a non-answer.

Filter matches on data.is_eligible === true. A found entry can be a lapsed policy.

Present every eligible match. Do not pick one, and do not rank on created_at.

Report the non-answers separately. "No cover found at 15 payers, 3 payers could not be reached" is the honest rendering of the response above. "Not covered" is not.

Ignore statuses you do not recognise rather than throwing. delegated_to_search_all_pool is already one of them.

What came back

The envelope

delegated_to_search_all_pool

data is null, not empty

The same problem, two different statuses

Two eligible policies

Nobody found anything

What your code has to do

Where to go next

Daman multi-card

Failures

How completion is decided

On this page