Results

GET /eligibility-result/{task_id}: the envelope, and one section per outcome with a sample response.

GET /eligibility-result/{task_id}

The same request you have been polling. Once its status is PROCESS_COMPLETE, the body you are already holding is the answer: there is no further call to make.

The envelope

Prop

Type

status is the specific lifecycle state

EXTRACTING_DATA and the other in-flight states appear here verbatim. Treat anything other than PROCESS_COMPLETE, CANCELLED and FAILED as still running; see when to stop.

data_dump

Prop

Type

So the two fields you branch on are nested like this:

eligibility_result.status                    ← what happened
eligibility_result.data_dump.data.is_eligible ← the answer

Outcomes

eligibility_result.status is the discriminator. Each section below is one value it can take.

Eligible

status: "found", is_eligible: true. The member was found and is covered for the visit_type you asked about.

Sample not captured yet

eligibility-result/eligible will be filled in once the sample capture pass has run against a completed production task.

For where each field a front desk acts on lives in that body, see eligible response structure.

Screenshot pending. The payer portal showing an active policy, with numbered callouts mapping each region of the page to the field it becomes in the JSON result.

Not eligible

status: "found", is_eligible: false. The member exists, but is not covered: lapsed policy, benefit excluded, or the visit type not on the plan. The reason is in failure_reason.

Sample not captured yet

eligibility-result/not-eligible will be filled in once the sample capture pass has run against a completed production task.

This is a determination, not an error. Do not retry automatically: the answer reflects the policy as the payer holds it, so an immediate re-check returns the same outcome. Re-check only after the underlying policy is expected to have changed, for example once a renewal has been processed.

Member not found

status: "member_not_found", is_eligible: false, show_data: false. The portal has no member matching that identifier.

Sample not captured yet

eligibility-result/member-not-found will be filled in once the sample capture pass has run against a completed production task.

The most common causes, in order: the patient is with a different payer; the Emirates ID is not yet linked at this payer, in which case retry with CARDNUMBER; the identifier contains a typo. was_identified_by_aggregator indicates whether an aggregator directed the check to this payer.

Invalid credentials

status: "invalid_credentials". Your clinic's payer credentials were rejected. This is a configuration problem, not a determination about the patient.

Sample not captured yet

eligibility-result/invalid-credentials will be filled in once the sample capture pass has run against a completed production task.

Display the credential error to the user and contact Mantys support at kriti@mantys.io or sudhanshu@mantys.io. Do not retry in a loop: repeated failures cause the payer to lock the account, and unlocking it requires manual intervention.

Failed, error, backoff, tpa_not_configured

The remaining values eligibility_result.status can take.

`status`	Meaning	Retry?
`failed`	The check ran and did not complete.	Yes, once.
`error`	An unexpected error occurred while running the check.	Yes, once.
`backoff`	Too many recent credential failures for this payer; the check was not attempted.	No, wait.
`tpa_not_configured`	Your clinic has no credentials for this payer.	No.

Sample not captured yet

eligibility-result/failed will be filled in once the sample capture pass has run against a completed production task.

failed, error, backoff and invalid_credentials carry no data block at all. Read error_type for the class of failure and message for the text to put in front of a human. Code that reaches straight for data_dump.data.is_eligible finds nothing on these four, and in most languages that reads as false: a check that broke then renders as a patient who is not covered.

is_eligible is null, not false, on a config error

tpa_not_configured never reached the portal, so no determination was made. null means "we do not know"; false means "we asked and the answer was no". Do not collapse the two.

Cancelled

status on the task is CANCELLED. Someone stopped the check before it finished. There is no result to read.

Sample not captured yet

eligibility-result/cancelled will be filled in once the sample capture pass has run against a completed production task.

Search all

A search-all result has a completely different envelope: no eligibility_result, an aggregated_results array instead.

Sample not captured yet

eligibility-result/search-all-complete will be filled in once the sample capture pass has run against a completed production task.

Handling multiple matching payers

Filter aggregated_results to entries whose status is found or member_found.
Of those, keep the ones whose data.is_eligible is true.
If more than one remains, present them to the user and let them choose. A patient may genuinely hold more than one active policy, and the response does not say which one they are presenting at reception.
If none are found, no matching coverage was found in the returned payer results. Note that Daman is not among the payers a search-all covers.

Do not rank matches by created_at

created_at on an entry records when that payer responded to this check, not when the policy was issued or renewed. It carries no information about which policy the patient intends to use, so it is not a basis for choosing between two active policies.

Sample not captured yet

eligibility-result/search-all-complete at aggregated_results.0 will be filled in once the sample capture pass has run against a completed production task.

aggregated_results may be incomplete

The list holds only payers that have already responded, and a response missing an internal tpa key is omitted from it. It is the best available record of what was checked, but search-all completion does not guarantee a response from every configured payer. Handle the returned results as potentially incomplete; see how completion is decided.

Daman multi-card

A Daman member can hold several packages, each on its own network. The check runs once per card and the result carries card_index and multi_card_total. The same fields arrive from Nextcare (TPA002), so do not gate on the payer.

The multi-card fields

.json

{
"id": "00000000-0000-4000-a000-000000000001",
"tenant_id": "yourorg",
"clinic_id": "00000000-0000-4000-a000-000000000002",
"created_at": "2026-09-07T08:31:45.646000",
"updated_at": "2026-09-07T08:32:55.298000",
"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": "CARDNUMBER",
"visit_type": "OUTPATIENT",
"name": "Sample Patient",
"extra_args": {
"title": "",
"value": "",
"is_pod": false,
"is_maternity": false,
"not_related_to_chief_complaint": false,
"free_followup_or_extended_followup": false,
"request_start_time": 1788769905.639303
},
"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:card2",
"tenant_id": "yourorg",
"clinic_id": "00000000-0000-4000-a000-000000000002",
"created_at": "2026-09-07T08:32:55.284000",
"updated_at": "2026-09-07T08:32:55.284000",
"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": "Consultation - Outside Abu Dhabi",
"coverage_status": "Covered",
"copay_percentage": 10,
"copay_amount": null,
"copay_max_amount": 75,
"copay_currency": "AED",
"copay_max_scope": null,
"coinsurance_percentage": null,
"visit_setting": null,
"remarks": "Includes: physician consultation\nCitation: - **Coinsurance**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10% | - **Out Of Pocket Limit**: Physician Consultation : 75     Diagnostics : 150",
"scope": {
"benefit": "Consultation - Outside Abu Dhabi",
"network": null,
"location": "UAE",
"visit_setting": null,
"qualifiers": [
"Outside Abu Dhabi"
],
"is_default": false,
"label": "Outside Abu Dhabi | UAE"
}
},
{
"visit_type": "Pharmacy",
"coverage_status": "Covered",
"copay_percentage": 10,
"copay_amount": null,
"copay_max_amount": null,
"copay_currency": "AED",
"copay_max_scope": null,
"coinsurance_percentage": null,
"visit_setting": null,
"remarks": "Includes: pharmaceuticals\nCitation: - **Coinsurance**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10%",
"scope": {
"benefit": "Pharmacy",
"network": null,
"location": "UAE",
"visit_setting": null,
"qualifiers": [
],
"is_default": true,
"label": "UAE"
}
},
{
"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**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10% | - **Dental**: Yes | - **LIMIT**: Dental : 3500",
"copay_aggregate_cap": "AED 3,500",
"scope": {
"benefit": "Dental",
"network": null,
"location": "UAE",
"visit_setting": null,
"qualifiers": [
],
"is_default": true,
"label": "UAE"
}
},
{
"visit_type": "Diagnostics",
"coverage_status": "Covered",
"copay_percentage": 10,
"copay_amount": null,
"copay_max_amount": 150,
"copay_currency": "AED",
"copay_max_scope": null,
"coinsurance_percentage": null,
"visit_setting": null,
"remarks": "Citation: - **Coinsurance**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10% | - **Out Of Pocket Limit**: Physician Consultation : 75     Diagnostics : 150",
"scope": {
"benefit": "Diagnostics",
"network": null,
"location": "UAE",
"visit_setting": null,
"qualifiers": [
],
"is_default": true,
"label": "UAE"
}
},
{
"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",
"scope": {
"benefit": "Optical",
"network": null,
"location": "UAE",
"visit_setting": null,
"qualifiers": [
],
"is_default": true,
"label": "UAE"
}
},
{
"visit_type": "Consultation - Abu Dhabi",
"coverage_status": "Covered",
"copay_percentage": null,
"copay_amount": 50,
"copay_max_amount": 75,
"copay_currency": "AED",
"copay_max_scope": null,
"coinsurance_percentage": null,
"visit_setting": null,
"remarks": "Includes: physician consultation\nCitation: - **Outpatient Deductible (Copay Amount)**: Physician Consultation : 50 | - **Out Of Pocket Limit**: Physician Consultation : 75     Diagnostics : 150",
"scope": {
"benefit": "Consultation",
"network": null,
"location": "Abu Dhabi",
"visit_setting": null,
"qualifiers": [
],
"is_default": false,
"label": "Abu Dhabi"
}
},
{
"visit_type": "Maternity",
"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",
"scope": {
"benefit": "Maternity",
"network": null,
"location": "UAE",
"visit_setting": null,
"qualifiers": [
],
"is_default": true,
"label": "UAE"
}
}
],
"special_remarks": [
"networknotes: For Physician Consultation : Deductible applicable in Abu Dhabi / Co-ins applicable outside Abu Dhabi",
"networkaborad: Abroad : Worldwide Excluding. US Canada"
],
"new_version_of_copay_analysis": {
"benefits": [
{
"service_category_standardized": "Consultation - Outside Abu Dhabi",
"service_category_original": "physician consultation",
"coverage_status": "Covered",
"cost_sharing": [
{
"visit_type": null,
"visit_setting": null,
"copay_percentage": 10,
"copay_amount": null,
"copay_maximum_amount": 75
}
],
"conditions": null,
"limits": null,
"remarks": "Includes: physician consultation\nCitation: - **Coinsurance**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10% | - **Out Of Pocket Limit**: Physician Consultation : 75     Diagnostics : 150"
},
{
"service_category_standardized": "Pharmacy",
"service_category_original": "pharmaceuticals",
"coverage_status": "Covered",
"cost_sharing": [
{
"visit_type": null,
"visit_setting": null,
"copay_percentage": 10,
"copay_amount": null,
"copay_maximum_amount": null
}
],
"conditions": null,
"limits": null,
"remarks": "Includes: pharmaceuticals\nCitation: - **Coinsurance**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10%"
},
{
"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**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10% | - **Dental**: Yes | - **LIMIT**: Dental : 3500"
},
{
"service_category_standardized": "Diagnostics",
"service_category_original": "diagnostics",
"coverage_status": "Covered",
"cost_sharing": [
{
"visit_type": null,
"visit_setting": null,
"copay_percentage": 10,
"copay_amount": null,
"copay_maximum_amount": 150
}
],
"conditions": null,
"limits": null,
"remarks": "Citation: - **Coinsurance**: Physician Consultation : 10%  Pharmaceuticals : 10%  Dental : 20%   Diagnostics : 10% | - **Out Of Pocket Limit**: Physician Consultation : 75     Diagnostics : 150"
},
{
"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 - Abu Dhabi",
"service_category_original": "physician consultation",
"coverage_status": "Covered",
"cost_sharing": [
{
"visit_type": null,
"visit_setting": null,
"copay_percentage": null,
"copay_amount": 50,
"copay_maximum_amount": 75
}
],
"conditions": null,
"limits": null,
"remarks": "Includes: physician consultation\nCitation: - **Outpatient Deductible (Copay Amount)**: Physician Consultation : 50 | - **Out Of Pocket Limit**: Physician Consultation : 75     Diagnostics : 150"
},
{
"service_category_standardized": "Maternity",
"service_category_original": "maternity",
"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"
}
],
"policy_info": {
},
"general_remarks": [
"networknotes: For Physician Consultation : Deductible applicable in Abu Dhabi / Co-ins applicable outside Abu Dhabi",
"networkaborad: Abroad : Worldwide Excluding. US Canada"
]
}
},
"policy_network": {
"policy_plan_name": "Gold",
"payer_name_as_in_text": "Daman",
"sponsor_id": "INS026",
"payer_name": "Not Applicable",
"valid_upto": "2027-01-31",
"start_date": "2026-02-01",
"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": "DHA",
"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": "Gold",
"card_network": "Royal",
"network_billing_reference": "NW2"
},
"copay_details_to_fill": [
{
"name": "Outpatient",
"values_to_fill": {
"CONSULTATION": {
"deductible": "0",
"copay": "10.0",
"should_set_copay": true,
"_copayAmount": "0",
"_copayMaxAmount": "75.0",
"_is_outpatient_fallback": false,
"_deductibleLegacy": "75.0"
},
"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": "10.0",
"should_set_copay": true,
"_copayAmount": "0",
"_copayMaxAmount": "150.0",
"_is_outpatient_fallback": false,
"_deductibleLegacy": "0"
},
"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": "10.0",
"should_set_copay": true,
"_copayAmount": "0",
"_copayMaxAmount": "0",
"_is_outpatient_fallback": false,
"_deductibleLegacy": "0"
},
"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",
"copay": "10.0",
"should_set_copay": true,
"_copayAmount": "0",
"_copayMaxAmount": "75.0",
"_is_outpatient_fallback": true,
"_deductibleLegacy": "75.0"
},
"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": "10.0",
"should_set_copay": true,
"_copayAmount": "0",
"_copayMaxAmount": "150.0",
"_is_outpatient_fallback": true,
"_deductibleLegacy": "0"
},
"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": "10.0",
"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
},
"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",
"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,
"card_index": 2,
"card_number": "MBR-0000000",
"package_name": "Gold",
"card_network": "NW UAE: Royal",
"multi_card_total": 2
}
},
"search_id": "0000-0000-0000-0000",
"tpa_name": "INS026",
"task_id": "00000000-0000-4000-a000-000000000001",
"user_id": null,
"status": "found"
}
}

Highlighted on eligibility_result.data_dump.data: card_index, multi_card_total, card_number, package_name, card_network, is_eligible. The rest of the keys are documented on Results.

This endpoint returns one card, and which one is not a stable choice: it is whichever result row came back first, so card_index varies between otherwise identical checks. There is no array of cards and no way to ask for the others through this endpoint, so multi_card_total is how you know you are looking at part of the picture. Show the user how many packages the member holds and which one is displayed. See Daman multi-card for the whole case.

all_cards is not on this endpoint

An internal response shape for the same situation carries is_multi_card: true and an all_cards array. GET /eligibility-result emits neither key. Do not write code that waits for them.

Warnings

data.warning_messages is an array of objects, one per notice raised while the check ran. Each entry carries message, the text to put in front of a person, screenshot, a signed link to the portal at that moment which is usually null, and warning, a boolean that is true on every entry and so carries no information. Severity is message_type, "warning" or "information", and it is present on some entries and absent on others in the same response: when it is missing, treat the entry as a warning.

What lands here is portal-derived and unstructured: claim-form outcomes, a prior approval request and its id, a doctor or service the portal did not list, and rules configured for your clinic. Display message as it stands; the wording changes with the portal, so do not parse it or match on it.

warning_messages

.json

{
"id": "00000000-0000-4000-a000-000000000001",
"tenant_id": "yourorg",
"clinic_id": "00000000-0000-4000-a000-000000000002",
"created_at": "2026-04-23T04:15:44.832000",
"updated_at": "2026-04-23T04:16:20.953000",
"task_id": "00000000-0000-4000-a000-000000000001",
"status": "PROCESS_COMPLETE",
"request_dump": {
"name": "Sample Patient",
"phone": "+971 50 000 0000",
"id_type": "CARDNUMBER",
"tpa_name": "TPA002",
"payerName": "",
"doctorName": "Sample Clinician",
"extra_args": {
"title": "",
"value": "",
"request_start_time": 1776917744.8226814
},
"visit_type": "OUTPATIENT",
"emirates_id": "784-0000-0000000-0",
"practice_id": "00000000-0000-4000-a000-000000000002",
"user_id": "00000000-0000-4000-a000-000000000003",
"dob": null,
"mode": "prod",
"test_mode": false
},
"interim_results": {
"tpa_name": "TPA002",
"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": "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"
}
]
},
"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": "2026-04-23T04:16:21.691000",
"updated_at": "2026-04-23T04:16:21.691000",
"data_dump": {
"tpa": "TPA002",
"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": "Laboratory",
"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": "Radiology",
"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
},
{
"remarks": "Citation: Deductible Excess: 50 AED Per Claim | \n\n ",
"visit_type": "Consultation",
"copay_amount": 50,
"cost_sharing": {
"visit_type": "Outpatient",
"copay_amount": 50,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": null,
"copay_maximum_scope": "Per Claim",
"copay_maximum_amount": null,
"coinsurance_percentage": null
},
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_max_scope": "Per Claim",
"copay_max_amount": null,
"copay_percentage": "None",
"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": "Laboratory",
"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": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Radiology",
"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": 10,
"copay_maximum_scope": null,
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Pharmacy",
"service_category_standardized": "Pharmacy"
},
{
"limits": null,
"remarks": null,
"conditions": null,
"cost_sharing": [
{
"visit_type": "Outpatient",
"copay_amount": 50,
"visit_setting": "Outpatient",
"copay_currency": "AED",
"copay_percentage": null,
"copay_maximum_scope": "Per Claim",
"copay_maximum_amount": null,
"coinsurance_percentage": null
}
],
"coverage_status": "Covered",
"service_category_original": "Consultation",
"service_category_standardized": "Consultation"
}
],
"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": 2025
}
},
"general_remarks": [
],
"abbreviations_defined": [
]
}
},
"failure_reason": null,
"policy_network": {
"is_vip": "No",
"payer_name": "DUBAI INSURANCE COMPANY - INS005",
"sponsor_id": "INS005",
"start_date": "2026-01-01",
"valid_upto": "2027-06-30",
"all_networks": [
{
"network": "PCP",
"plan_code": "P267",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "PCP",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "OP@PCP"
},
{
"network": "RN3",
"plan_code": "P267",
"visit_type": "SP (Specialist Physician) Referral",
"network_code": null,
"network_value": "RN3",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "SpRef@RN3"
}
],
"package_name": null,
"is_gatekeeper": "Not Mentioned",
"waiting_period": null,
"policy_authority": "MOH",
"policy_plan_name": null,
"work_site_covered": "Could not determine",
"policy_holder_name": "Sample Policy Holder",
"payer_name_as_in_text": "INS005 - Dubai Insurance",
"is_general_physician_referral_required_for_specialist_referral": true
},
"screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z",
"warning_messages": [
{
"message": "WARNING: GP referral is required for specialist referral.\n\"Gatekeeper: Yes\"\n\"This Policy is a Referral Policy* which requires a Referral from the assigned Gatekeeper**.\"",
"warning": true,
"screenshot": null
}
],
"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": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"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": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0"
},
"DIAGNOSTICS": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "50.0",
"_copayAmount": "50.0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "50.0"
},
"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": "PCP",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "PCP",
"plan_code": "P267",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "PCP",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "OP@PCP"
},
{
"network": "RN3",
"plan_code": "P267",
"visit_type": "SP (Specialist Physician) Referral",
"network_code": null,
"network_value": "RN3",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "SpRef@RN3"
}
],
"has_multiple_networks": true
},
{
"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
},
"DIAGNOSTICS": {
"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": "PCP",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "PCP",
"plan_code": "P267",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "PCP",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "OP@PCP"
},
{
"network": "RN3",
"plan_code": "P267",
"visit_type": "SP (Specialist Physician) Referral",
"network_code": null,
"network_value": "RN3",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "SpRef@RN3"
}
],
"has_multiple_networks": true
},
{
"name": "Specialization",
"values_to_fill": {
"LAB": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_maxDeductible": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0",
"_is_outpatient_fallback": true
},
"MEDICINES": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0",
"_is_outpatient_fallback": true
},
"PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_is_outpatient_fallback": true
},
"RADIOLOGY": {
"copay": "10.0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "0",
"_is_outpatient_fallback": true
},
"DIAGNOSTICS": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_is_outpatient_fallback": true
},
"CONSULTATION": {
"copay": "0",
"deductible": "50.0",
"_copayAmount": "50.0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_deductibleLegacy": "50.0",
"_is_outpatient_fallback": true
},
"PHYSIOTHERAPY": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_is_outpatient_fallback": true
},
"DENTAL CONSULTATION & PROCEDURE": {
"copay": "0",
"deductible": "0",
"_copayAmount": "0",
"_copayMaxAmount": "0",
"should_set_copay": true,
"_is_outpatient_fallback": true
}
},
"primary_network": {
"network": "PCP",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "PCP",
"plan_code": "P267",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "PCP",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "OP@PCP"
},
{
"network": "RN3",
"plan_code": "P267",
"visit_type": "SP (Specialist Physician) Referral",
"network_code": null,
"network_value": "RN3",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "SpRef@RN3"
}
],
"has_multiple_networks": true
},
{
"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
},
"DIAGNOSTICS": {
"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": "PCP",
"network_status": null,
"matched_plan_name": null
},
"available_networks": [
{
"network": "PCP",
"plan_code": "P267",
"visit_type": "OP (Out Patient)",
"network_code": null,
"network_value": "PCP",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "OP@PCP"
},
{
"network": "RN3",
"plan_code": "P267",
"visit_type": "SP (Specialist Physician) Referral",
"network_code": null,
"network_value": "RN3",
"raw_plan_string": "DUBAI INSURANCE COMPANY(NEXTCARE) - SHJ",
"matched_plan_name": null,
"network_name_as_in_text": "SpRef@RN3"
}
],
"has_multiple_networks": true
}
],
"policy_holder_emirates_id": "784-0000-0000000-0",
"was_identified_by_aggregator": false
},
"status": "found"
},
"search_id": "0000-0000-0000-0000",
"tpa_name": "TPA002",
"task_id": "00000000-0000-4000-a000-000000000001",
"user_id": null,
"status": "found"
}
}

Highlighted: eligibility_result.data_dump.data.warning_messages. Every other key on the response is documented on Results.

For the shapes that vary and the gatekeeper contradiction, see documents and warnings.

The gatekeeper rule is not in here

policy_network.is_gatekeeper is the only place the response reports whether a GP referral gates specialist visits, so a client that renders warning_messages and nothing else drops it entirely. See gatekeeper.

Documents and screenshots

screenshot_key, and the s3_url on every entry in referral_documents, are signed links with a limited lifetime. This endpoint re-signs them on every read, so a stale link is always fixable by asking again.

Do not cache the URLs. Cache the result and re-request the links when you need them.

On this page