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Status States

The system recognizes five benefits check statuses:
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REQUESTED
status
Initial state
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AWAITING_SILNA
status
Silna is working on the benefits check
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AWAITING_PROVIDER
status
There is an open escalation on a benefits check which requires provider action
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COMPLETE
status
Finished, allows API response retrieval (terminal)
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WITHDRAWN
status
The benefits check will no longer be worked on (terminal)

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Lifecycle Flow

New benefits checks automatically progress from REQUESTED to AWAITING_SILNA. Successful completion moves to COMPLETE status. If issues arise, escalations trigger AWAITING_PROVIDER state, returning to AWAITING_SILNA once resolved. Providers may withdraw checks by moving them to WITHDRAWN status.

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New Patient Process

Creating benefits checks requires these steps:
  1. Patient creation
  2. Patient plan creation using the returned patient ID
  3. Benefits check creation using the patient plan ID
  4. Poll the status via the Get Benefits Check API
Terminal states are COMPLETE and WITHDRAWN, which may take up to days to achieve. Once complete, retrieve the PDF report using the Get Benefits Check Report API, then the Get File API.

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Existing Patient Process

Update existing patient information as needed, then create a new benefits check for either a new or existing plan. Use appropriate APIs based on whether the current system state is known.

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Real-Time Benefits

Contacts must create realtime templates. Pass the template_id to the Post Benefits Checks API. It usually takes a few seconds for a Silna realtime benefits check to complete, but you should be prepared for it to take up to a minute in some cases.