Athena Fetch patient insurances

POSThttps://api.ontross.com/api/integrations/athena/fetch-patient-insurances

input.org_id

integer

required

Athena practice ID.

Example

32817

input.department_id

integer

required

Active department ID.

Example

4

input.patient_id

integer

required

Practice patient ID.

Example

1133

auth_id

string

required

Saved connection to run this operation through, from the Authentication page. It decides which practice and login the call uses.

Example

"00000000-0000-4000-8000-000000000000"

patient_id

string

Requested practice patient ID.

Example

"1133"

coverages

array

Coverages in Athena's banner order.

coverages[].id

string

Patient insurance record ID.

Example

"684927"

coverages[].sequence

string

Coverage order (1=primary, 2=secondary, ...).

Example

"1"

coverages[].package_id

string

Insurance package ID.

Example

"57382"

coverages[].package_name

string

Insurance package / payer name.

Example

"Example Health PPO"

coverages[].long_name

string

Full payer/plan name.

Example

"Example Health Preferred Provider Organization"

coverages[].label

string

Display label for the coverage.

Example

"Primary: Example Health PPO"

coverages[].member_id

string

Member/insurance ID number.

Example

"XHP987654321"

coverages[].insured_id

string

Insured's ID number, when distinct from member.

Example

"XHP98765432101"

coverages[].expiration_date

string

Coverage expiration date, if set.

Example

"2026-12-31"

coverages[].package_expiration_date

string

Package expiration date, if set.

Example

"2027-12-31"

coverages[].eligibility_status

string

Eligibility status reported by Athena.

Example

"Eligible"

coverages[].eligibility_last_checked

string

When eligibility was last checked.

Example

"2026-10-14T09:15:00-04:00"

coverages[].eligibility_message

string

Eligibility message, if any.

Example

"Active coverage confirmed for the requested service date."

coverages[].case_policy_name

string

Case policy name, for case/injury coverage.

Example

"Example Workers Compensation Policy"

coverages[].non_insurance_type_name

string

Non-insurance type (e.g. self-pay), if applicable.

Example

"Self-pay"

coverages[].override_name

string

Insurance override name, if set.

Example

"Example Health Employer Plan"

coverages[].sliding_fee_plan_name

string

Sliding-fee plan name, if applicable.

Example

"Income-based discount plan"

coverages[].sliding_fee_program_name

string

Sliding-fee program name, if applicable.

Example

"Community care assistance"

coverages[].cancelled

boolean

Whether the coverage is cancelled.

Example

false

coverages[].created

string

Coverage creation timestamp.

Example

"2026-03-10T09:15:00-04:00"

total

integer

Number of coverages returned.

Example

1

curl --request POST \
  --url https://api.ontross.com/api/integrations/athena/fetch-patient-insurances \
  --header 'X-API-Key: REPLACE_KEY_VALUE' \
  --header 'content-type: application/json' \
  --data '{"input":{"department_id":4,"org_id":32817,"patient_id":1133},"auth_id":"auth_uuid_here"}'

Request BODY

{
  "input": {
    "department_id": 4,
    "org_id": 32817,
    "patient_id": 1133
  },
  "auth_id": "auth_uuid_here"
}

Response BODY

{
  "id": "string",
  "workflow_id": "string",
  "auth_id": "string",
  "status": "string",
  "input": {},
  "output": {
    "patient_id": "1133",
    "coverages": [
      {
        "id": "684927",
        "sequence": "1",
        "package_id": "57382",
        "package_name": "Example Health PPO",
        "long_name": "Example Health Preferred Provider Organization",
        "label": "Primary: Example Health PPO",
        "member_id": "XHP987654321",
        "insured_id": "XHP98765432101",
        "expiration_date": "2026-12-31",
        "package_expiration_date": "2027-12-31",
        "eligibility_status": "Eligible",
        "eligibility_last_checked": "2026-10-14T09:15:00-04:00",
        "eligibility_message": "Active coverage confirmed for the requested service date.",
        "case_policy_name": "Example Workers Compensation Policy",
        "non_insurance_type_name": "Self-pay",
        "override_name": "Example Health Employer Plan",
        "sliding_fee_plan_name": "Income-based discount plan",
        "sliding_fee_program_name": "Community care assistance",
        "cancelled": false,
        "created": "2026-03-10T09:15:00-04:00"
      }
    ],
    "total": 1
  },
  "files": null,
  "created_at": "2019-08-24T14:15:22Z",
  "started_at": "2019-08-24T14:15:22Z",
  "completed_at": "2019-08-24T14:15:22Z"
}