Why am I still receiving an error on my eligibility request after my NPI submission has been completed?
For eligibility transactions, there can be two different ‘layers’ of NPI requirements. The first…
Support Tag: Eligibility
How do I check eligibility for a past date?
In order to request eligibility for a prior date, utilize the parameter member.plan_start_date. It…
Why am I not seeing deductible or other benefit information in an eligibility response?
PokitDok returns the available eligibility and benefit information provided by the trading partner in…
Why am I getting unable_to_respond_now on a X12 transaction response?
A response of unable_to_respond_now indicates the trading partner system is unable to provide a…
What does PokitDok do with data gathered from eligibility checks?
Internal and external legal counsel have verified that everything we do with the data…
What commercial pharmacy benefit plans am I able to check?
The X12 270/271 medical eligibility request may return limited pharmacy benefits if available. Please…
How can we use X12 APIs?
The X12 APIs allow communication to trading partners via a simple programmatic interface. It…
Where can I find a listing of health care service type codes for use in an eligibility request?
Health Care Service Type Codes supported by the PokitDok API can be retrieved by…
With which Medicare Advantage plans is PokitDok connected?
PokitDok is connected to every traditional Medicare Advantage plan for eligibility (this does not…
What happens when a trading partner returns multiple reject reasons?
There are certain instances where a single transaction results in multiple rejections from a…
Why do I see coverage active: false when I receive a reject_reason?
The active indicator under coverage is false when membership information could not be returned…
Why don’t I see an expected value returned in an eligibility response?
All trading partners who transact via EDI are required to support an eligibility request…
How is the summary section of the eligibility response calculated?
The summary section is computed based on the detailed deductible and out of pocket…