{ "task_id": "00000000-0000-4000-a000-000000000001", "status": "SEARCH_ALL_COMPLETE", "request_dump": { "emirates_id": "784-0000-0000000-0", "phone": "+971 50 000 0000", "practice_id": "00000000-0000-4000-a000-000000000002", "tpa_name": "BOTH", "id_type": "EMIRATESID", "visit_type": "OUTPATIENT", "extra_args": { "title": "LocationGroup", "value": "OUTPATIENT", "request_start_time": 1785026728.8002584 }, "doctorName": "Sample Clinician", "payerName": "ARAB GULF HEALTH SERVICES (NEXTCARE)", "user_id": "00000000-0000-4000-a000-000000000003" }, "is_search_all": true, "search_all_status": "SEARCH_ALL_PROCESSING", "aggregated_results": [ { "tpa_name": "TPA011", "status": "member_not_found", "data": { "is_eligible": false, "show_data": false, "screenshot_key": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z", "payer_id": "TPA011", "was_identified_by_aggregator": true }, "created_at": "2026-07-26T00:48:00.428000", "message": "Member not found - Adherent 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": "found", "data": { "patient_info": { "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", "policy_holder_dob": "1990-01-01" }, "copay_analysis": { "waiting_period": "Not Specified", "copay_details": [ { "visit_type": "Consultation", "copay_percentage": "10.0", "visit_setting": "Outpatient", "copay_amount": null, "copay_currency": "AED", "copay_max_amount": null, "copay_max_scope": null, "coinsurance_percentage": null, "remarks": "Citation: Co-Part: 10% | \n\n ", "cost_sharing": { "visit_type": "Outpatient", "visit_setting": "Outpatient", "copay_percentage": 10.0, "copay_amount": null, "copay_currency": "AED", "copay_maximum_amount": null, "copay_maximum_scope": null, "coinsurance_percentage": null } } ], "special_remarks": [], "new_version_of_copay_analysis": { "benefits": [ { "service_category_standardized": "Consultation", "service_category_original": "Consultation", "coverage_status": "Covered", "cost_sharing": [ { "visit_type": "Outpatient", "visit_setting": "Outpatient", "copay_percentage": 10.0, "copay_amount": null, "copay_currency": "AED", "copay_maximum_amount": null, "copay_maximum_scope": null, "coinsurance_percentage": null } ], "conditions": null, "limits": null, "remarks": null }, { "service_category_standardized": "Medical Checkup", "service_category_original": "Medical Checkup", "coverage_status": "Covered", "cost_sharing": [ { "visit_type": "Outpatient", "visit_setting": "Outpatient", "copay_percentage": null, "copay_amount": null, "copay_currency": "AED", "copay_maximum_amount": null, "copay_maximum_scope": null, "coinsurance_percentage": null } ], "conditions": null, "limits": null, "remarks": null } ], "policy_info": { "policy_period_start": { "DD": 1, "MM": 9, "YYYY": 2025 }, "policy_period_end": null, "beneficiary_start_date": { "DD": 1, "MM": 9, "YYYY": 2017 }, "waiting_period": "Not Specified", "policy_jurisdiction": "Not Specified" }, "general_remarks": [], "abbreviations_defined": [] } }, "policy_network": { "policy_plan_name": "A - Worldwide excluding USA", "payer_name_as_in_text": "INS008 - Orient Insurance PJSC Worldwide E-Rx", "sponsor_id": "INS008", "payer_name": "ORIENT INSURANCE PJSC - INS008", "valid_upto": "2026-08-31", "start_date": "2025-09-01", "all_networks": [ { "network_name_as_in_text": "AWC CN Excl. Iranian Hospital", "network": "CN", "visit_type": "OP (Out Patient)", "network_value": "CN", "matched_plan_name": null, "network_code": null, "raw_plan_string": "INS008 - ORIENT INSURANCE PJSC- NEXTCARE - CN - DXB", "plan_code": "NPDXB-430" } ], "policy_authority": "DHA", "is_general_physician_referral_required_for_specialist_referral": false, "is_gatekeeper": "No", "is_vip": "No", "waiting_period": null, "policy_holder_name": "Sample Policy Holder", "work_site_covered": "Could not determine", "package_name": null }, "copay_details_to_fill": [ { "name": "Outpatient", "values_to_fill": { "CONSULTATION": { "deductible": "0", "copay": "10.0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": false, "_deductibleLegacy": "0" }, "LAB": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": false }, "RADIOLOGY": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": false }, "PROCEDURE": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": false }, "DIAGNOSTICS": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": false }, "DENTAL CONSULTATION & PROCEDURE": { "deductible": "0", "copay": "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": "AWC CN Excl. Iranian Hospital", "network": "CN", "visit_type": "OP (Out Patient)", "network_value": "CN", "matched_plan_name": null, "network_code": null, "raw_plan_string": "INS008 - ORIENT INSURANCE PJSC- NEXTCARE - CN - DXB", "plan_code": "NPDXB-430" } ], "has_multiple_networks": false, "primary_network": { "network": "CN", "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": 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": "AWC CN Excl. Iranian Hospital", "network": "CN", "visit_type": "OP (Out Patient)", "network_value": "CN", "matched_plan_name": null, "network_code": null, "raw_plan_string": "INS008 - ORIENT INSURANCE PJSC- NEXTCARE - CN - DXB", "plan_code": "NPDXB-430" } ], "has_multiple_networks": false, "primary_network": { "network": "CN", "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": "0", "_is_outpatient_fallback": true, "_deductibleLegacy": "0" }, "LAB": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "RADIOLOGY": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "PROCEDURE": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "DIAGNOSTICS": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "DENTAL CONSULTATION & PROCEDURE": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "MEDICINES": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "PHYSIOTHERAPY": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true }, "OPTICAL": { "deductible": "0", "copay": "0", "should_set_copay": true, "_copayAmount": "0", "_copayMaxAmount": "0", "_is_outpatient_fallback": true } }, "available_networks": [ { "network_name_as_in_text": "AWC CN Excl. Iranian Hospital", "network": "CN", "visit_type": "OP (Out Patient)", "network_value": "CN", "matched_plan_name": null, "network_code": null, "raw_plan_string": "INS008 - ORIENT INSURANCE PJSC- NEXTCARE - CN - DXB", "plan_code": "NPDXB-430" } ], "has_multiple_networks": false, "primary_network": { "network": "CN", "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": "AWC CN Excl. Iranian Hospital", "network": "CN", "visit_type": "OP (Out Patient)", "network_value": "CN", "matched_plan_name": null, "network_code": null, "raw_plan_string": "INS008 - ORIENT INSURANCE PJSC- NEXTCARE - CN - DXB", "plan_code": "NPDXB-430" } ], "has_multiple_networks": false, "primary_network": { "network": "CN", "network_status": null, "matched_plan_name": null } } ], "policy_holder_name": "Sample Policy Holder", "policy_holder_emirates_id": "784-0000-0000000-0", "policy_holder_dob": "1990-01-01", "is_eligible": true, "failure_reason": null, "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": "Claim Form", "id": "claim_form" }, { "s3_url": "https://storage.example.com/eligibility/00000000-0000-4000-a000-000000000001/document.png?sig=PLACEHOLDER&se=2026-01-01T00%3A00%3A00Z", "tag": "Claim Form Image", "id": "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", "tag": "Table of Benefits", "id": "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", "tag": "Member Eligibility Document", "id": "member_eligibility_document" } ], "payer_id": "TPA002", "warning_messages": [ { "message": "Patient holds 2 NextCare policies; checking each of them...", "screenshot": null, "warning": true, "message_type": "warning" }, { "message": "Referral Details Dropdown does not have any options to select", "screenshot": null, "warning": true, "message_type": "warning" }, { "message": "Referral Details Dropdown does not have any options to select", "screenshot": null, "warning": true, "message_type": "warning" }, { "message": "Patient holds 2 NextCare policies; delivering 2 eligible as separate results: Sample Plan A, Sample Plan B", "screenshot": null, "warning": true, "message_type": "warning" }, { "message": "Medical check-up / wellness is covered under this policy", "screenshot": null, "warning": true, "message_type": "information" } ], "was_identified_by_aggregator": true, "card_index": 2, "card_number": "MBR-0000000", "package_name": "Orient Insurance PJSC Worldwide E-Rx", "card_network": null, "multi_card_total": 2 }, "created_at": "2026-07-26T00:54:31.010000", "message": null, "screenshot_url": null } ], "total_tpas_checked": 2, "found_results": 1, "created_at": "2026-07-26T00:45:28.808000", "updated_at": "2026-07-26T00:48:42.590000" }