eligible-node

Node.js bindings for Eligible APIs (https://eligible.com). Eligible is built for developers needing HIPAA compliant connectivity to health insurance companies.

You can request an account at https://eligible.com/request-access

• Documentation
• Requirements
• Installation
• Usage
  • Create instance
  • Test Mode
  • Example
  • Coverage
    • Retrieve Coverage
    • Retrieve Medicare
    • Retrieve Cost Estimates
  • Payment
    • Payment Status
  • Claim
    • Create a Claim
    • Retrieve Single Claim Acknowledgements
    • Retrieve Multiple Claims Acknowledgements
    • Retrieve Single Claim Payment Report
    • Retrieve Specific Claim Payment Report
    • Retrieve Multiple Claim Payment Report
    • Realtime Adjudication & Estimate
  • Payer
    • List All Payers
    • View a Payer
    • Search Options
    • Search Options of a Payer
  • Customer
    • Create a Customer
    • Update a Customer
    • View a Customer
    • List Customers
  • Enrollment
    • Create an Enrollment
    • Update an Enrollment
    • Retrieve an Enrollment
    • List Enrollments
    • Received PDF
      • View Received PDF
      • Download Received PDF
    • Original Signature PDF
      • Create Original Signature PDF
      • Update Original Signature PDF
      • View Original Signature PDF
      • Delete Signature PDF
      • Download Signature PDF
  • Referral
    • Referral Inquiry
    • Create A Referral
  • Precertification
    • Precertification Inquiry
    • Create A Precertification
  • x12
    • Simple Post
    • MIME Post
  • Tickets
    • Create a Ticket
    • View a Ticket
    • Update a Ticket
    • List Tickets
    • Create a Ticket Comment
    • List Comments for a Ticket
• Errors
• Testing
• Developing
• Support Forums

Documentation

Refer to https://eligible.com/rest for full documentation on Eligible APIs, their request parameters and expected response formats.

Requirements

Node.js 0.12 and above

Installation

npm install eligible-node --save

Usage

Create instance

First create an Eligible object by passing your api key. You can pass the api key directly or as an object. You may also load your api key from environment variables.

var Eligible = require('eligible-node');

// Get values from environment variables if nothing is passed in arguments
// available env variables: ELIGIBLE_API_KEY, ELIGIBLE_IS_TEST
var eligible = Eligible();

//or, pass them as object:
var eligible = Eligible({
    apiKey: 'foobar',
    isTest: true
});

//or, pass Config object
var config = new Eligible.Config;
config.setApiKey('foobar')
config.setTest(true);
var eligible = Eligible(config);

Test Mode

To make the Eligible as explorable as possible, accounts have test-mode as well as live-mode. See above example to enable test mode on any of your requests and hit the sandbox.

Example

Complete example on how to use the library:

var Eligible = require('eligible-node');
var eligible = Eligible({
    apiKey: 'n5Cddnj2KST6YV9J2l2ztQQ2VrdPfzA4JPbn',
    isTest: true
});

// Retrieve a payer and it's search options

eligible.Payer.retrieve('62308')
  .then(function(payer){
    console.log(payer.payer_id);
    return payer.searchOptions(); //retrieve search options
  })
  .then(function(searchOptions){
    console.log(searchOptions)
  })
  .catch(Eligible.APIConnectionError, function(e){
    console.log('Connection Error');
  })
  .catch(Eligible.AuthenticationError, function(e){
      console.log('Authentication Error', e.message, e.code, e.response);
  })
  .catch(Eligible.InvalidRequestError, function(e){
      console.log('InvalidRequestError', e.message, e.code, e.response);
  })
  .catch(function(e){
    console.log(e);
  });

See Errors for a list of Error types.

Coverage

Retrieve Coverage

eligible.Coverage.all({
  payer_id: '00001',
  provider_last_name: 'Doe',
  provider_first_name: 'John',
  provider_npi: '0123456789',
  member_id: 'ZZZ445554301',
  member_first_name: 'IDA',
  member_last_name: 'FRANKLIN',
  member_dob: '1701-12-12',
  service_type: '30',
})
.then(function(coverage) {
  console.log(coverage)
})
.catch(function(e) {
  //
});

Retrieve Medicare

eligible.Coverage.medicare({
  provider_npi: '0123456789',
  member_id: 'ZZZ445554301',
})
.then(function(medicare) {
  console.log(medicare);
})
.catch(function(e) {
  //
});

Retrieve Cost Estimates

eligible.Coverage.costEstimates({
  provider_npi: '0123456789',
  provider_price: '1500.50',
  service_type: '1',
  network: 'IN',
})
.then(function(costEstimates) {
  console.log(costEstimates);
})
.catch(function(e) {
  //
});

Payment

Payment Status

eligible.Payment.status({
  payer_id: '00001',
  provider_last_name: 'Doe',
  provider_first_name: 'John',
  provider_npi: '0123456789',
  member_id: 'ZZZ445554301',
  member_first_name: 'IDA',
  member_last_name: 'FRANKLIN',
  member_dob: '1701-12-12',
  payer_control_number: 123123123,
  charge_amount: 125.00,
  start_date: '2010-06-15',
  end_date: '2010-06-15',
  trace_number: 'BHUYTOK98IK',
})
.then(function(payment) {
  console.log(payment)
})
.catch(function(e) {

});

Claim

Create a Claim

eligible.Claim.create(params)  // example params can be found in the REST document of this endpoint
  .then(function(claim) { // returns a claim instance
    console.log(claim);
    return claim.acknowledgements(); // get acknowledgements for this claim
  })
  .then(function(acknowledgements){
    console.log(acknowledgements);
  })
  .catch(function(e){
    //
  });

Retrieve Single Claim Acknowledgements

eligible.Claim.getAcknowledgements('12121212')
  .then(function(data) {
    console.log(data);
  })

or, using claim instance either created manually or returned by Claim.create() method

var claim = new eligible.Claim({'reference_id': '12121212'});
claim.acknowledgements()
  .then(function(data) {
    console.log(data);
  })

Retrieve Multiple Claims Acknowledgements

eligible.Claim.queryAcknowledgements(query)
  .then(function(data) {
  })

Retrieve Single Claim Payment Report

eligible.Claim.getPaymentReport('BDA85HY09IJ')
	.then(function(payment) {
	})

or, using claim instance either created manually or returned by Claim.create() method

var claim = new eligible.Claim({'reference_id': 'BDA85HY09IJ'});
claim.paymentReports()
  .then(function(payment_report) {
    console.log(payment_report);
  })

Retrieve Specific Claim Payment Report

eligible.Claim.getPaymentReport('BDA85HY09IJ', 'ABX45DGER44')
	.then(function(payment) {
	})

or, using claim instance either created manually or returned by Claim.create() method

var claim = new eligible.Claim({'reference_id': 'BDA85HY09IJ'});
claim.paymentReports('ABX45DGER44')
  .then(function(payment_report) {
    console.log(payment_report);
  })

Retrieve Multiple Claim Payment Report

eligible.Claim.queryPaymentReports(query)
	.then(function(data) {
	})

Realtime Adjudication & Estimate

eligible.Claim.realtime(params) // example params can be found in the REST document of this endpoint
  .then(function(data) {
  })
  .catch(function(e){
  });

Payer

List All Payers

eligible.Payer.all({
    endpoint: 'coverage',
  })
  .then(function(payers) {
    console.log(payers);
  })

View a Payer

eligible.Payer.retrieve('62308')
	.then(function(payer) {
	  return payer.searchOptions()
	})
	//retrieve search options for this payer
	.then(function(searchOptions){
	   console.log(searchOptions)
	})
	.catch()

Search Options

eligible.Payer.searchOptions()
	.then(function(searchOptions) {
	  console.log(searchOptions)
	})

Search Options of a Payer

eligible.Payer.searchOptions('62308')
	.then(function(searchOptions) {
	})

or, using payer instance either:

var payer = new eligible.Payer({payer_id: '62308'});
payer.searchOptions()
  .then(function(searchOptions) {
    console.log(searchOptions);
  })

Customer

Create a Customer

eligible.Customer.create({
    customer: {
      name: 'ABC company',
    },
  })
  .then(function(customer) {
    console.log(customer.id);
  })
  .catch();

Update a Customer

eligible.Customer.update('TN344YY67HH09KK', {
    customer: {
      name: 'XYZ company',
    },
  })
  .then(function(customer) {
    console.log(customer.id);
  })
  .catch(done);

View a Customer

eligible.Customer.get('TN344YY67HH09KK')
  .then(function(customer) {
    console.log(customer.id);
  })
  .catch();

List Customers

eligible.Customer.all({
    page: 1,
  })
  .then(function(data) {
    console.log(data.customers);
  })
  .catch();

Enrollment

Create an Enrollment

eligible.Enrollment.create(params) // example params can be found in the REST document of this endpoint
  .then(function(enrollment) {
    console.log(enrollment);
  })
  .catch();

Update an Enrollment

eligible.Enrollment.update(params) // example params can be found in the REST document of this endpoint
  .then(function(enrollment) {
    console.log(enrollment);
  })
  .catch();

Retrieve an Enrollment

eligible.Enrollment.get(123)
  .then(function(enrollment) {
    console.log(enrollment);
  })
  .catch();

List Enrollments

eligible.Enrollment.all({
    page: 1,
  })
  .then(function(data) {
    console.log(data.enrollment_npis);
  })
  .catch();

View Received PDF

eligible.Enrollment.viewReceivedPDF('123')
  .then(function(receivedPDF) {
    console.log(receivedPDF.download_url);
  })
  .catch();

Download Received PDF

Returns a readable stream when successful

eligible.Enrollment.downloadReceivedPDF('123')
  .then(function(pdf) {
    pdf.pipe(fs.createWriteStream('./received_pdf.pdf'))
  })
  .catch();

Create Original Signature PDF

You can either pass a path to PDF or a readable stream of the pdf file:

eligible.Enrollment.createOriginalSignaturePDF('123', {
  file: './upload.pdf',
})
.then(function(originalSignaturePDF) {
  console.log(originalSignaturePDF.download_url);
})
.catch();

Update Original Signature PDF

You can either pass a path to PDF or a readable stream of the pdf file:

eligible.Enrollment.updateOriginalSignaturePDF('123', {
  file: './upload.pdf',
})
.then(function(originalSignaturePDF) {
  console.log(originalSignaturePDF.download_url);
})
.catch();

View Original Signature PDF

eligible.Enrollment.viewOriginalSignaturePDF('123')
  .then(function(originalSignaturePDF) {
    console.log(originalSignaturePDF.download_url);
  })
  .catch();

Delete Signature PDF

eligible.Enrollment.deleteOriginalSignaturePDF('123')
  .then(function(response) {
    console.log(response.message);
  })
  .catch(done);

Download Signature PDF

Returns a readable stream when successful

eligible.Enrollment.downloadOriginalSignaturePDF('123')
  then(function(pdf) {
    pdf.pipe(fs.createWriteStream('./original_signature_pdf.pdf'))
  })
  .catch();

Referral

Referral Inquiry

eligible.Referral.inquiry({
  payer_id: '60054',
  payer_name: 'Aetna',
  provider_type: 'attending',
  provider_last_name: 'Doe',
  provider_first_name: 'John',
  provider_npi: '0123456789',
  provider_phone_number: '1234567890',
  provider_taxonomy_code: '291U00000X',
  member_id: 'ZZZ445554301',
  member_first_name: 'IDA',
  member_last_name: 'FRANKLIN',
  member_dob: '1701-12-12',
  from_date: '2014-01-01',
  to_date: '2015-01-01',
})
.then(function(referral) {
})
.catch(done);

Create A Referral

eligible.Referral.create(params) // example params can be found in the REST document of this endpoint
  .then(function(referral) {
  })
  .catch(done);

Precertification

Precertification Inquiry

eligible.Precertification.inquiry({
  payer_id: '60054',
  payer_name: 'Aetna',
  provider_type: 'attending',
  provider_last_name: 'Doe',
  provider_first_name: 'John',
  provider_npi: '0123456789',
  provider_phone_number: '1234567890',
  provider_taxonomy_code: '291U00000X',
  member_id: 'ZZZ445554301',
  member_first_name: 'IDA',
  member_last_name: 'FRANKLIN',
  member_dob: '1701-12-12',
  from_date: '2014-01-01',
  to_date: '2015-01-01',
})
.then(function(precert) {
})
.catch(done);

Create A Precertification

eligible.Precertification.create(params) // example params can be found in the REST document of this endpoint
  .then(function(precert) {
  })
  .catch(done);

x12

Simple Post

eligible.config.setApiVersion('v1.1');
eligible.X12.post(params)//
  .then(function(x12) {
  })
  .catch(done);

MIME Post

eligible.config.setApiVersion('v1.1');
eligible.X12.mimePost(params)//
  .then(function(x12) {
  })
  .catch(done);

Tickets

Create a Ticket

eligible.Ticket.create(params)
  .then(function(ticket) {

  })
  .catch();

View a Ticket

eligible.Ticket.retrieve('123')
  .then(function(ticket) {

  })
  .catch();

Update a Ticket

eligible.Ticket.update('123', params)
  .then(function(ticket) {

  })
  .catch();

List Tickets

eligible.Ticket.list()
  .then(function(data) {

  })
  .catch();

Create a Ticket Comment

eligible.Ticket.createComment('123', params)
  .then(function(comment) {

  })
  .catch();

List Comments for a Ticket

eligible.Ticket.comments('123')
  .then(function(comments) {

  })
  .catch();

Errors

The library throws following error objects.

• Eligible.APIConnectionError
• Eligible.APIResponseError
• Eligible.APIError
• Eligible.AuthenticationError
• Eligible.InvalidRequestError

The following table describes the properties of the error object.

Property	Type	Description
message	string	The error message
code	number	When the error occurs during an HTTP request, the HTTP status code.
response	object or string	HTTP response as JSON, if JSON not available raw response is stored

To catch individual errors, use bluebird catch syntax.

Testing

Use the following commands to run tests or test coverage:

ELIGIBLE_API_KEY=API_KEY npm test
ELIGIBLE_API_KEY=API_KEY npm run coverage

Note that, by default running above commands will mock HTTP requests using nock library. To disable mocking and make actaul calls against eligible server, pass NOCK_OFF=true enviroment variable:

NOCK_OFF=true npm test

To filter tests, update grep field in test/mocha.opts.

Developing

To work on the library:

1. Fork it
2. Create your feature branch (git checkout -b my-new-feature)
3. Install dependencies: npm install
4. Fix bugs or add features. Make sure the changes pass the coding guidelines by runing: npm run lint or npm run watch
5. Write tests for your new features. For HTTP mocking nock library is used. Nock definitions are saved in test/fixtures directory
6. Run test by npm test or npm run coverage
7. If all tests are passed, push to the branch (git push origin my-new-feature)
8. Create new Pull Request

Support Forums

If you find an issue with in the client library we would appricate you Send an email to [e-mail] or add an issue in the Issue tracker for bug reports.