Search-all response structure
The flat list a search-all returns, the four kinds of entry in it, and the two status fields that disagree about whether the sweep is finished.
A search-all asks every payer your clinic has credentials for, and the body it
returns is not a bigger version of a single-payer result. It has no
eligibility_result key at all. The answer is aggregated_results, one flat
array of six-key entries, and in production a single sweep produces between 15
and 19 of them.
Nothing here is nested, so the difficulty is not finding a value. It is that most of the list is not the answer, in four different ways that a client has to tell apart before it renders anything.
The card below is the whole envelope. Select any field to see the path it lives at, its type, and the thing that catches people out.
Select any field on the card. Nothing here calls the API: the layout is illustrative and the values are one real captured sweep, with the member’s identifiers replaced.
Which envelope
is_search_allboolean
The discriminator between the two shapes this endpoint returns. When it is true there is no eligibility_result key anywhere in the body, and the per-payer answers are in aggregated_results instead. Branch on it before you read anything else.
Code that reaches straight for eligibility_result.data_dump.data.is_eligible gets undefined on every search-all, and in most languages that renders as a patient who is not covered.
The two statuses do not agree
The body carries two fields that both look like "is the sweep finished", and they are computed differently.
status is the task's own lifecycle state, written by the worker. It reaches
SEARCH_ALL_COMPLETE when the task finishes. This is the field to poll on.
search_all_status is recomputed from the entries on every read, and the rule
that produces it says complete when there are at least seventeen entries.
Seventeen is a hard-coded constant. It is not the size of the pool that was
swept, which is around 19 and varies with what your clinic has credentials for.
So a sweep that finishes with fewer than seventeen entries reads
SEARCH_ALL_PROCESSING for ever, on a task that is already done. Two of the
eleven captured production sweeps on this site are exactly that: one with 15
entries and one with 2, both on a finished task, both still reporting
SEARCH_ALL_PROCESSING.
Never use search_all_status as a loop condition
A client that polls until search_all_status is SEARCH_ALL_COMPLETE hangs until its own timeout
on those checks, then reports a failure for a sweep that answered correctly minutes earlier. Poll
status, and read search_all_status only as a hint about how much of the pool reported.
{"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": "BOTH","doctorName": "Sample Clinician","extra_args": {"title": "LocationGroup","value": "MATERNITY","request_start_time": 1779205696.599499},"visit_type": "MATERNITY","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},"is_search_all": true,"search_all_status": "SEARCH_ALL_PROCESSING","aggregated_results": [{"tpa_name": "INS038","status": "failed","data": null,"created_at": "2026-05-19T16:15:34.492000","message": "Something went wrong","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": "2026-05-19T16:15:51.756000","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": "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": "2026-05-19T16:15:17.984000","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": "TPA003","status": "member_not_found","data": {"payer_id": "TPA003","is_eligible": false,"patient_info": {"patient_emirates_id": "784-0000-0000000-0","policy_primary_member_id": "MBR-0000000","policy_primary_dha_member_id": "0000000000"},"copay_analysis": {"copay_details": [],"waiting_period": "Not Specified","special_remarks": [],"new_version_of_copay_analysis": {"benefits": [],"policy_info": {"waiting_period": "Not Specified","policy_period_end": null,"policy_jurisdiction": "Not Specified","policy_period_start": null,"beneficiary_start_date": null},"general_remarks": null,"abbreviations_defined": null}},"failure_reason": "The document explicitly indicates NOT ELIGIBLE with 'Invalid Emirates ID' and lacks any positive eligibility details.","policy_network": {"is_vip": "Not Mentioned","payer_name": "Could not determine","sponsor_id": null,"start_date": null,"valid_upto": null,"all_networks": [],"package_name": null,"is_gatekeeper": "Not Mentioned","waiting_period": null,"policy_authority": "Not Mentioned","policy_plan_name": null,"work_site_covered": "Could not determine","policy_holder_name": null,"payer_name_as_in_text": null,"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","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"}],"copay_details_to_fill": [],"policy_holder_emirates_id": "784-0000-0000000-0","was_identified_by_aggregator": false},"created_at": "2026-05-19T16:15:34.586000","message": null,"screenshot_url": null},{"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": "2026-05-19T16:16:59.957000","message": "Member not eligible (portal): Not Eligible","screenshot_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z"},{"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": "2026-05-19T16:15:14.017000","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": "2026-05-19T16:15:26.338000","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": "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": "2026-05-19T16:15:30.388000","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"},{"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": "2026-05-19T16:15:41.335000","message": "`1216: Provider not within the Agreed Network` 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": "INS012","status": "failed","data": null,"created_at": "2026-05-19T16:26:03.730000","message": "Oman portal has not responded with the eligibility status after 500 seconds","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": "2026-05-19T16:15:50.050000","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": "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": "2026-05-19T16:16:20.414000","message": "Member not eligible (portal): Not Eligible","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": {"payer_id": "INS015","is_eligible": false,"patient_info": {"patient_emirates_id": null,"policy_primary_dha_member_id": "0000000000"},"copay_analysis": {"copay_details": [],"waiting_period": "Not Specified","special_remarks": [],"new_version_of_copay_analysis": {"benefits": [],"policy_info": {"waiting_period": "Not Specified","policy_period_end": null,"policy_jurisdiction": "Not Specified","policy_period_start": null,"beneficiary_start_date": null},"general_remarks": [],"abbreviations_defined": []}},"failure_reason": "The content is merely a provider portal navigation page without any actual insurance details or eligibility information. It does not provide any explicit indicators that the patient is eligible, hence the determination is False.","policy_network": {"is_vip": "Not Mentioned","payer_name": "Not Applicable","sponsor_id": null,"start_date": null,"valid_upto": null,"all_networks": [],"package_name": null,"is_gatekeeper": "Not Mentioned","waiting_period": null,"policy_authority": "Not Mentioned","policy_plan_name": null,"work_site_covered": "Could not determine","policy_holder_name": null,"payer_name_as_in_text": null,"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","referral_documents": [],"copay_details_to_fill": [],"policy_holder_emirates_id": null,"was_identified_by_aggregator": false},"created_at": "2026-05-19T16:16:00.465000","message": null,"screenshot_url": null},{"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": "2026-05-19T16:16:42.850000","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": "INS026","status": "failed","data": null,"created_at": "2026-05-19T16:16:39.027000","message": "Both credentials failed. Primary: Error during API submission for primary: Eligibility Request failed for primary: Doctor with license 'Sample Clinician' not found in the system. Please verify the doctor license ID.; Secondary: Error during API submission for secondary: Eligibility Request failed for secondary: Doctor with license 'Sample Clinician' not found in the system. Please verify the doctor license ID.","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": 15,"found_results": 0,"created_at": "2026-05-19T15:48:16.609000","updated_at": "2026-05-19T16:45:46.472000"}
Highlighted: search_all_status. Every other key on the response is documented on Results.
Fifteen entries, so the seventeen test fails. The task's own status, the
second key in the same document, reads SEARCH_ALL_COMPLETE.
Every entry is the same six keys
There is no variation in the shape. Across all 181 entries captured from
production for this site, every one carries exactly tpa_name, status,
data, created_at, message and screenshot_url, and nothing else.
{"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": 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Highlighted: aggregated_results.8. Every other key on the response is documented on Results.
What varies is which of them are populated, and that follows status.
| Key | On a match | On a real negative | On a non-answer |
|---|---|---|---|
tpa_name | payer code | payer code | payer code, or a label |
status | found, member_found | member_not_found | six other values |
data | object | object, occasionally null | null |
created_at | set | set | set |
message | always null | text on two thirds | text |
screenshot_url | sometimes a signed link | sometimes a signed link | null |
Three of those rows are the ones that break clients.
data is null, not empty. On failed, error, backoff,
invalid_credentials and delegated_to_search_all_pool the key is null
outright, so entry.data.is_eligible throws or reads undefined on about one
entry in six. It is also null on a few member_not_found entries: 3 of
the 128 captured.
message is null on every match. It is portal-derived text explaining a
non-answer, so it is set on every failed, error, backoff,
invalid_credentials and tpa_not_configured entry, and on 83 of the 128
captured member_not_found entries. A UI that renders the message as the reason
has nothing to show on the other 45.
screenshot_url exists, on 86 of the 181 captured entries. It is a signed
link to the payer page the entry was read from. The endpoint re-signs it on
every read, so do not cache the URL: cache the result and ask again when you
need the link.
tpa_name is not always a payer
Two of the 21 distinct tpa_name values in the captures are routing
bookkeeping rather than payers: DHPO / Riayati and search_all_pool. They
carry status: "delegated_to_search_all_pool" and a null data, and they
report how the check was routed.
{"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": 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"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": 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"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 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"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.0. Every other key on the response is documented on Results.
delegated_to_search_all_pool is not in the status enum
It is absent from the result status table and appears on essentially
every sweep. A client that switches exhaustively on status and throws on the default hits an
unhandled branch on every search-all it ever runs. Ignore statuses you do not recognise; never
fail the response on one.
What the list does not tell you
Two things are lost before the array reaches you, and neither leaves a marker.
A payer that reported without an internal key is dropped. The aggregation
reads the payer code from one place in the stored response and skips any row
that does not carry it. Those rows are not in aggregated_results and are not
counted in total_tpas_checked, so the count cannot tell you anything went
missing.
Only one entry survives per payer. When two responses arrive under the same
tpa_name, the later one replaces the earlier. A member holding two cards at
one payer therefore loses a policy here, silently. See Daman
multi-card for what that looks like.
So total_tpas_checked is the number of entries present. It is not the number
of payers asked, and the absence of a payer is not evidence that the payer was
not asked.
Reading one
The order is response latency, so the first entry is not the answer. Partition
the list by status before reading any other field.
const MATCHED = new Set(['found', 'member_found']);
function readSearchAll(result: SearchAllResult) {
if (!result.is_search_all) throw new Error('not a search-all body');
const entries = result.aggregated_results;
// Partition first. `data` is null on every non-answer, so anything that
// reaches for `data.is_eligible` before this point breaks on a real sweep.
const matched = entries.filter((e) => MATCHED.has(e.status));
const negatives = entries.filter((e) => e.status === 'member_not_found');
const unreachable = entries.filter(
(e) => !MATCHED.has(e.status) && e.status !== 'member_not_found',
);
const eligible = matched.filter((e) => e.data?.is_eligible === true);
return {
// Present every one of these and let a human choose. Do not pick, and do
// not rank on created_at.
eligible,
// A found member whose policy has lapsed. Still worth showing.
matchedButNotEligible: matched.filter((e) => e.data?.is_eligible !== true),
checkedAndNotFound: negatives.length,
// Routing entries land here too, which is correct: they are not payers
// and they are not answers.
couldNotReach: unreachable.length,
};
}Report the non-answers separately
"No cover found at 15 payers, 3 payers could not be reached" is the honest rendering of a sweep
with three broken entries. "Not covered" is not: a payer your clinic has no credentials for
reports tpa_not_configured with data.is_eligible: false, and collapsing that into the
negatives turns a configuration problem into a clinical answer.
Note that Daman is never part of a search-all. A patient with Daman cover and nothing else produces a sweep in which nobody found anything.
Where to go next
Search-all in production
Four real sweeps: the status spread, two eligible policies, and the check where nobody found anything.
Eligible response structure
The other envelope, and the ten fields a front desk acts on inside it.
Polling
Which field to poll, and what a client-side timeout should do.
Daman multi-card
What happens when the two policies are at the same payer, and one of them disappears.