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Initial Configuration

On-demand eligibility verification requires pre-configuration of verification templates specific to your organization’s needs. Contact your dedicated Spike Care representative to establish the appropriate template for your use case. Your representative will provide the template name needed for API integration.

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API Implementation Steps

To perform an on-demand eligibility verification through the Spike Care API:
  1. Retrieve Template ID: Query the Get Benefit Verification Templates API using the template name provided by your Spike Care representative. The response will include the template_id required for verification requests.
  2. Create Verification Request: Call the Create Benefit Verification API, including the template_id parameter in your request payload. This initiates the eligibility check process.
  3. Monitor Completion: Poll the Get Benefit Verification API to track the verification status until it reaches a terminal state (COMPLETE or WITHDRAWN).
The verification request follows the same lifecycle as standard benefit verifications, progressing through REQUESTED → AWAITING_SPIKE_CARE → COMPLETE status transitions.

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Accessing Verification Results

Completed eligibility verifications are accessible through multiple channels: API Access: Retrieve verification details programmatically using the Get Benefit Verification API once the status reaches COMPLETE. Web Portal Access: Navigate to the patient record in the Spike Care web application and access the benefit verifications section to view the eligibility check results and associated documentation.

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Required API Endpoints

Implementing on-demand eligibility verification requires integration with these endpoints:
  • Get Benefit Verification Templates API: Template lookup and ID retrieval
  • Create Benefit Verification API: Eligibility verification request submission (with template_id parameter)
  • Get Benefit Verification API: Status monitoring and result retrieval
Ensure your integration properly handles all verification status states and includes appropriate error handling for API failures or timeout scenarios.