Visit types
Mapping your encounter types to visit_type, and the four different visit_type vocabularies one response contains.
visit_type is the field that decides which benefit the payer prices, so
getting it wrong does not produce an error, it produces a correct-looking answer
about the wrong benefit.
Two things make it harder than a lookup table. The mapping from your encounter
types is not one to one in either direction, and the word visit_type means
four different things in one response.
The mapping is not one to one
Which values a payer accepts is on the payer matrix and, for Daman, on payer-specific requirements. What those pages cannot tell you is how your own encounter types land on them.
One encounter, three values. An obstetric ultrasound is one procedure in most clinical systems. Daman prices it as three:
ULTRASOUND_FIRST_TRIMESTER
ULTRASOUND_SECOND_TRIMESTER
ULTRASOUND_THIRD_TRIMESTER{"id": "00000000-0000-4000-a000-000000000001","tenant_id": "yourorg","clinic_id": "00000000-0000-4000-a000-000000000002","created_at": "2026-09-08T04:49:47.439000","updated_at": "2026-09-08T04:50:56.001000","task_id": "00000000-0000-4000-a000-000000000001","status": "PROCESS_COMPLETE","request_dump": {"emirates_id": "784-0000-0000000-0","phone": "+971 50 000 0000","practice_id": "00000000-0000-4000-a000-000000000002","tpa_name": "INS026","id_type": "EMIRATESID","visit_type": "ULTRASOUND_THIRD_TRIMESTER","name": "Sample Patient","extra_args": {"title": "","value": "","is_pod": false,"is_maternity": true,"not_related_to_chief_complaint": false,"free_followup_or_extended_followup": false,"request_start_time": 1788842987.430109},"doctorName": "Sample Clinician","payerName": "","user_id": "00000000-0000-4000-a000-000000000003"},"interim_results": {"referral_documents": [{"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 Card Pdf","id": "member_eligibility_card_pdf","original_filename": "member-eligibility.png"},{"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","tag": "Schedule of Benefits Pdf","id": "schedule_of_benefits_pdf","original_filename": "member-eligibility.png"},{"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 Document","id": "member_eligibility","original_filename": "member-eligibility.png"}],"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","tpa_name": "INS026"},"is_search_all": false,"search_all_status": null,"created_by_user_id": null,"eligibility_result": {"id": "00000000-0000-4000-a000-000000000001:INS026","tenant_id": "yourorg","clinic_id": "00000000-0000-4000-a000-000000000002","created_at": "2026-09-08T04:50:55.994000","updated_at": "2026-09-08T04:50:55.994000","data_dump": {"status": "found","tpa": "INS026","data": {"patient_info": {"policy_holder_name": "Sample Policy Holder","patient_emirates_id": "784-0000-0000000-0","policy_primary_member_id": "MBR-0000000","eligibility_id": "REF-0000000","policy_primary_dha_member_id": "0000000000","policy_holder_dob": "1990-01-01"},"copay_analysis": {"waiting_period": "Not Specified","copay_details": [{"visit_type": "Dental","coverage_status": "Covered","copay_percentage": 20,"copay_amount": null,"copay_max_amount": null,"copay_currency": "AED","copay_max_scope": null,"coinsurance_percentage": null,"visit_setting": null,"remarks": "Citation: - **Coinsurance**: Dental : 20% | - **Dental**: Yes | - **LIMIT**: Dental : 3500","copay_aggregate_cap": "AED 3,500"},{"visit_type": "Maternity","coverage_status": "Covered","copay_percentage": null,"copay_amount": null,"copay_max_amount": null,"copay_currency": "AED","copay_max_scope": null,"coinsurance_percentage": null,"visit_setting": null,"remarks": "Covered"},{"visit_type": "Optical","coverage_status": "Not Covered","copay_percentage": null,"copay_amount": null,"copay_max_amount": null,"copay_currency": "AED","copay_max_scope": null,"coinsurance_percentage": null,"visit_setting": null,"remarks": "Not Covered"},{"visit_type": "Consultation","coverage_status": "Covered","copay_percentage": null,"copay_amount": 0,"copay_max_amount": null,"copay_currency": "AED","copay_max_scope": null,"coinsurance_percentage": null,"visit_setting": null,"remarks": "Includes: physician consultation\nCitation: - **Outpatient Deductible (Copay Amount)**: Physician Consultation : 0"}],"special_remarks": ["networkaborad: Abroad : Worldwide Excluding. US Canada Europe"],"new_version_of_copay_analysis": {"benefits": [{"service_category_standardized": "Dental","service_category_original": "dental","coverage_status": "Covered","cost_sharing": [{"visit_type": null,"visit_setting": null,"copay_percentage": 20,"copay_amount": null,"copay_maximum_amount": null}],"conditions": null,"limits": null,"remarks": "Citation: - **Coinsurance**: Dental : 20% | - **Dental**: Yes | - **LIMIT**: Dental : 3500"},{"service_category_standardized": "Maternity","service_category_original": "maternity","coverage_status": "Covered","cost_sharing": [{"visit_type": null,"visit_setting": null,"copay_percentage": null,"copay_amount": null,"copay_maximum_amount": null}],"conditions": null,"limits": null,"remarks": "Covered"},{"service_category_standardized": "Optical","service_category_original": "optical","coverage_status": "Not Covered","cost_sharing": [{"visit_type": null,"visit_setting": null,"copay_percentage": null,"copay_amount": null,"copay_maximum_amount": null}],"conditions": null,"limits": null,"remarks": "Not Covered"},{"service_category_standardized": "Consultation","service_category_original": "physician consultation","coverage_status": "Covered","cost_sharing": [{"visit_type": null,"visit_setting": null,"copay_percentage": null,"copay_amount": 0,"copay_maximum_amount": null}],"conditions": null,"limits": null,"remarks": "Includes: physician consultation\nCitation: - **Outpatient Deductible (Copay Amount)**: Physician Consultation : 0"}],"policy_info": {},"general_remarks": ["networkaborad: Abroad : Worldwide Excluding. US Canada Europe"]}},"policy_network": {"policy_plan_name": "Silver","payer_name_as_in_text": "Daman","sponsor_id": null,"payer_name": "Not Applicable","valid_upto": "2027-08-31","start_date": "2026-09-01","all_networks": [{"network_name_as_in_text": "Network Billing Reference: NW2","network": "NW2","network_value": "NW2","visit_type": "Not Specified","matched_plan_name": null,"network_code": null,"raw_plan_string": "DAMAN NETWORK-2-DXB","plan_code": "D003-DXB"}],"policy_authority": "MOH","is_general_physician_referral_required_for_specialist_referral": false,"is_gatekeeper": "Not Mentioned","is_vip": "Not Mentioned","waiting_period": null,"policy_holder_name": "Sample Policy Holder","work_site_covered": "Could not determine","package_name": null,"package": "Silver","card_network": "Supreme","network_billing_reference": "NW2"},"copay_details_to_fill": [{"name": "Outpatient","values_to_fill": {"CONSULTATION": {"deductible": "0.0","copay": "0","should_set_copay": true,"_copayAmount": "0.0","_copayMaxAmount": "0","_is_outpatient_fallback": false,"_deductibleLegacy": "0.0"},"LAB": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"RADIOLOGY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"PROCEDURE": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"DIAGNOSTICS": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"DENTAL CONSULTATION & PROCEDURE": {"deductible": "0","copay": "20.0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false,"_deductibleLegacy": "0"},"MEDICINES": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"PHYSIOTHERAPY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"OPTICAL": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false,"_deductibleLegacy": "0"}},"available_networks": [{"network_name_as_in_text": "Network Billing Reference: NW2","network": "NW2","network_value": "NW2","visit_type": "Not Specified","matched_plan_name": null,"network_code": null,"raw_plan_string": "DAMAN NETWORK-2-DXB","plan_code": "D003-DXB"}],"has_multiple_networks": false,"primary_network": {"network": "NW2","network_status": null,"matched_plan_name": null}},{"name": "Maternity","values_to_fill": {"CONSULTATION": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"LAB": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0","_maxDeductible": "0"},"RADIOLOGY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"PROCEDURE": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"DIAGNOSTICS": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"DENTAL CONSULTATION & PROCEDURE": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"MEDICINES": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"PHYSIOTHERAPY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"OPTICAL": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"}},"available_networks": [{"network_name_as_in_text": "Network Billing Reference: NW2","network": "NW2","network_value": "NW2","visit_type": "Not Specified","matched_plan_name": null,"network_code": null,"raw_plan_string": "DAMAN NETWORK-2-DXB","plan_code": "D003-DXB"}],"has_multiple_networks": false,"primary_network": {"network": "NW2","network_status": null,"matched_plan_name": null}},{"name": "Specialization","values_to_fill": {"CONSULTATION": {"deductible": "0.0","copay": "0","should_set_copay": true,"_copayAmount": "0.0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0.0"},"LAB": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true},"RADIOLOGY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true},"PROCEDURE": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true},"DIAGNOSTICS": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true},"DENTAL CONSULTATION & PROCEDURE": {"deductible": "0","copay": "20.0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"},"MEDICINES": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true},"PHYSIOTHERAPY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true},"OPTICAL": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": true,"_deductibleLegacy": "0"}},"available_networks": [{"network_name_as_in_text": "Network Billing Reference: NW2","network": "NW2","network_value": "NW2","visit_type": "Not Specified","matched_plan_name": null,"network_code": null,"raw_plan_string": "DAMAN NETWORK-2-DXB","plan_code": "D003-DXB"}],"has_multiple_networks": false,"primary_network": {"network": "NW2","network_status": null,"matched_plan_name": null}},{"name": "Inpatient","values_to_fill": {"CONSULTATION": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"LAB": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"RADIOLOGY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"PROCEDURE": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"DIAGNOSTICS": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"DENTAL CONSULTATION & PROCEDURE": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"MEDICINES": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"PHYSIOTHERAPY": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false},"OPTICAL": {"deductible": "0","copay": "0","should_set_copay": true,"_copayAmount": "0","_copayMaxAmount": "0","_is_outpatient_fallback": false}},"available_networks": [{"network_name_as_in_text": "Network Billing Reference: NW2","network": "NW2","network_value": "NW2","visit_type": "Not Specified","matched_plan_name": null,"network_code": null,"raw_plan_string": "DAMAN NETWORK-2-DXB","plan_code": "D003-DXB"}],"has_multiple_networks": false,"primary_network": {"network": "NW2","network_status": null,"matched_plan_name": null}}],"policy_holder_name": "Sample Policy Holder","policy_holder_emirates_id": "784-0000-0000000-0","eligibility_id": "REF-0000000","policy_holder_dob": "1990-01-01","is_eligible": true,"failure_reason": null,"adjusted_tpa_name": "INS026","is_maternity": true,"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","referral_documents": [{"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 Card Pdf","id": "member_eligibility_card_pdf","original_filename": "member-eligibility.png"},{"s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","tag": "Schedule of Benefits Pdf","id": "schedule_of_benefits_pdf","original_filename": "member-eligibility.png"},{"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 Document","id": "member_eligibility","original_filename": "member-eligibility.png"}],"payer_id": "INS026","warning_messages": [],"was_identified_by_aggregator": false}},"search_id": "0000-0000-0000-0000","tpa_name": "INS026","task_id": "00000000-0000-4000-a000-000000000001","user_id": null,"status": "found"}}
Highlighted on request_dump: tpa_name, id_type, visit_type. The rest of the keys are documented on Results.
The encounter does not say which one. Gestational age does, and that lives in
your system, not in the appointment type. Any mapping table that turns
"obstetric ultrasound" into a single visit_type is wrong two thirds of the
time.
One of your types, several payers' values. A follow-up for a long-term
condition is OUTPATIENT almost everywhere and CHRONIC_OUT at Nextcare:
{"id": "00000000-0000-4000-a000-000000000001","tenant_id": "yourorg","clinic_id": "00000000-0000-4000-a000-000000000002","created_at": "2026-09-09T20:12:44.265000","updated_at": "2026-09-09T20:18:18.762000","task_id": "00000000-0000-4000-a000-000000000001","status": "PROCESS_COMPLETE","request_dump": {"doctorName": "Sample Clinician","emirates_id": "784-0000-0000000-0","extra_args": {"title": "","value": "","request_start_time": 1788984764.258263},"id_type": "EMIRATESID","payor": "","phone": "+971 50 000 0000","practice_id": "00000000-0000-4000-a000-000000000002","tpa_name": "TPA002","visit_type": "CHRONIC_OUT","user_id": "00000000-0000-4000-a000-000000000003"},"interim_results": null,"is_search_all": false,"search_all_status": null,"created_by_user_id": null,"eligibility_result": {"id": "00000000-0000-4000-a000-000000000001:TPA002","tenant_id": "yourorg","clinic_id": "00000000-0000-4000-a000-000000000002","created_at": "2026-09-09T20:18:18.755000","updated_at": "2026-09-09T20:18:18.755000","data_dump": {"tpa": "TPA002","message": "`This beneficiary is Invalid` was seen","screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","error_type": "MemberNotFoundError","status": "member_not_found","data": {"is_eligible": false,"show_data": false,"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","payer_id": "TPA002","was_identified_by_aggregator": false}},"search_id": "0000-0000-0000-0000","tpa_name": "TPA002","task_id": "00000000-0000-4000-a000-000000000001","user_id": null,"status": "member_not_found"}}
Highlighted on request_dump: tpa_name, id_type, visit_type. The rest of the keys are documented on Results.
So the mapping is per payer, not global. Build it as a function of
(your encounter type, tpa_name), and default to the common value when the pair
is not in your table.
Nothing rejects a wrong value
create-task does not validate visit_type against the payer. A value the payer does not accept
returns 200, creates a task, and comes back minutes later as a failure or as an answer about a
different benefit. See payer-specific requirements.
Four vocabularies, one response
This catches people who assume the visit_type they sent is the visit_type
they will read back. These are all from the samples in this section.
| Where | Vocabulary | Values seen |
|---|---|---|
request_dump.visit_type | What you sent | OUTPATIENT, MATERNITY, CHRONIC_OUT, ULTRASOUND_THIRD_TRIMESTER |
policy_network.all_networks[].visit_type | The portal's setting label | OP (Out Patient), IP (In Patient), Out Mat, SP (Specialist Physician) Referral, Not Specified |
new_version_of_copay_analysis.benefits[].cost_sharing[].visit_type | Normalised setting | Outpatient, Maternity, Both |
copay_analysis.copay_details[].visit_type | Free-text benefit description | Consultation - Other Hospitals or Clinics - Dubai, Dental - Northern Emirates (NE), Inpatient Psychiatric |
Only the first is the enum you sent. The second is what to match on when you pick a network; the third is a small and fairly stable set that is safe to compare; the fourth is prose to display and never to branch on.
{"id": "00000000-0000-4000-a000-000000000001","tenant_id": "yourorg","clinic_id": "00000000-0000-4000-a000-000000000002","created_at": "2026-02-13T20:32:17.525000","updated_at": "2026-02-13T21:08:09.214000","task_id": "00000000-0000-4000-a000-000000000001","status": "PROCESS_COMPLETE","request_dump": {"phone": "+971 50 000 0000","id_type": "EMIRATESID","tpa_name": "INS010","payerName": "AXA INSURANCE - GULF","doctorName": "Sample Clinician","extra_args": {"title": "LocationGroup","value": "OPTICAL"},"visit_type": "OPTICAL","emirates_id": "784-0000-0000000-0","practice_id": "00000000-0000-4000-a000-000000000002","is_special_location": true,"user_id": "00000000-0000-4000-a000-000000000003","name": null,"dob": null,"mode": "prod","test_mode": false},"interim_results": {"tpa_name": "INS010","screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z","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"}]},"is_search_all": false,"search_all_status": null,"created_by_user_id": null,"eligibility_result": {"id": "00000000-0000-4000-a000-000000000001:INS010","tenant_id": "yourorg","clinic_id": "00000000-0000-4000-a000-000000000002","created_at": "2026-02-13T21:08:09.754000","updated_at": "2026-02-13T21:08:09.754000","data_dump": {"tpa": "INS010","data": {"payer_id": "INS010","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: CONSULTATION:20% MAX AED 75 | \n\n ","visit_type": "Consultation - 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Highlighted on every entry of eligibility_result.data_dump.data.policy_network.all_networks: network, plan_code, visit_type. The rest of the keys are documented on Results.
Sending MATERNITY does not filter the response
The response carries the whole benefit schedule regardless of what you asked about. visit_type
on the request decides what the payer prices and which portal flow runs; it does not trim
benefits down to the one you named. Select the benefit you care about yourself.
What your code has to do
Key your mapping on the pair, not the encounter alone. (encounter type, tpa_name), with the common value as the fallback.
Carry the extra clinical facts into the mapping where the payer needs them. Gestational age is the worked example; without it the three ultrasound values cannot be told apart.
Do not compare a response visit_type against the enum you sent. Match
all_networks[].visit_type against the portal labels, and treat
copay_details[].visit_type as display text.
Select the benefit you asked about from the full schedule. The response does not do it for you.
Where to go next
Not found, then found
The same patient, checked twice, answering differently: when a member_not_found is worth retrying and when it is a real answer.
Documents and warnings
The files a check produces and the notices it raises: two arrays whose shapes vary by payer, and one field pair that contradicts itself.