> ## Documentation Index
> Fetch the complete documentation index at: https://docs.api.dental/llms.txt
> Use this file to discover all available pages before exploring further.

# Request Eligibility Verification

> Submit a real-time eligibility and benefits verification request for a dental insurance subscriber. Returns coverage details, deductibles, maximums, and benefit information from the payer.



## OpenAPI

````yaml openapi.json post /Eligibility
openapi: 3.1.0
info:
  title: API Dental
  description: >-
    Dental eligibility verification, payer lookup, and ClearCoverage APIs.
    Access real-time dental insurance data through REST or GraphQL.
  version: 1.0.0
  contact:
    email: support@api.dental
    url: https://api.dental
servers:
  - url: https://wg.api.dental/rest
    description: Production REST API
security:
  - apiKey: []
  - bearerAuth: []
paths:
  /Eligibility:
    post:
      tags:
        - Eligibility
      summary: Request Eligibility Verification
      description: >-
        Submit a real-time eligibility and benefits verification request for a
        dental insurance subscriber. Returns coverage details, deductibles,
        maximums, and benefit information from the payer.
      operationId: requestEligibility
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/EligibilityRequest'
            example:
              payer:
                id: '52133'
              provider:
                npi: '1447364856'
                tax_id: '270872579'
              subscriber:
                first_name: John
                last_name: Smith
                member_id: '123456789'
                dob: 01/15/1990
                group_number: GRP001
              version: v2
      responses:
        '200':
          description: Eligibility verification results
          content:
            application/json:
              schema:
                type: object
                description: >-
                  Eligibility response containing coverage details, benefits,
                  deductibles, and payer information. Response structure varies
                  by payer.
        '400':
          description: >-
            Bad request — invalid payer ID, missing required fields, or upstream
            payer error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/UpstreamError'
              example:
                error:
                  statusCode: 400
                  message: 'Invalid payer ID: INVALID_PAYER'
                  upstream:
                    message: >-
                      Invalid payer ID: INVALID_PAYER, please check
                      https://developers.onederful.co/ for valid payer IDs
                    code: invalid_payer_id
                    primaryReason: Invalid payer ID
        '401':
          description: Authentication required — invalid or missing API key
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ApiError'
        '402':
          description: Payment required — no active subscription or payment method
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ApiError'
        '403':
          description: Forbidden — API key is disabled
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ApiError'
        '429':
          description: Rate limit exceeded
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ApiError'
components:
  schemas:
    EligibilityRequest:
      type: object
      required:
        - payer
        - provider
        - subscriber
        - version
      properties:
        payer:
          type: object
          required:
            - id
          properties:
            id:
              type: string
              description: Payer ID from the Payer List endpoint
        provider:
          type: object
          required:
            - npi
            - tax_id
          properties:
            npi:
              type: string
              description: Provider's National Provider Identifier (10 digits)
            tax_id:
              type: string
              description: Provider's Tax Identification Number (9 digits)
        subscriber:
          type: object
          required:
            - first_name
            - last_name
            - member_id
            - dob
            - group_number
          properties:
            first_name:
              type: string
              description: Subscriber's first name
            last_name:
              type: string
              description: Subscriber's last name
            member_id:
              type: string
              description: Subscriber's insurance member ID
            dob:
              type: string
              description: Date of birth in MM/DD/YYYY format
            group_number:
              type: string
              description: Insurance group number
        dependent:
          type: object
          description: Optional dependent information for dependent eligibility checks
          properties:
            first_name:
              type: string
            last_name:
              type: string
            member_id:
              type: string
            dob:
              type: string
              description: MM/DD/YYYY format
            group_number:
              type: string
        version:
          type: string
          description: API version. Use "v2".
          example: v2
    UpstreamError:
      type: object
      description: Error response when the upstream payer service returns an error
      properties:
        error:
          type: object
          properties:
            statusCode:
              type: integer
              description: HTTP status code from the upstream payer service
            message:
              type: string
              description: Human-readable error summary
            upstream:
              description: >-
                Full error response body from the upstream payer service (object
                or string)
              oneOf:
                - type: object
                - type: string
    ApiError:
      type: object
      properties:
        error:
          type: object
          properties:
            statusCode:
              type: integer
            message:
              type: string
  securitySchemes:
    apiKey:
      type: apiKey
      in: header
      name: X-Token-API
      description: Your API Dental API key. Found in the Dashboard under API Keys.
    bearerAuth:
      type: http
      scheme: bearer
      description: >-
        Alternatively, pass your API key as a Bearer token in the Authorization
        header.

````

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