Eligibility API

Request real-time dental insurance eligibility and benefits verification across 200+ payers via REST, GraphQL, or SDK.

The Eligibility API provides real-time eligibility and benefits verification for dental insurance coverage across 200+ payers.

SDK

const response = await client.eligibility.request({
  payer: { id: '52133' },
  provider: { npi: '1447364856', tax_id: '270872579' },
  subscriber: {
    first_name: 'John',
    last_name: 'Smith',
    member_id: '123456789',
    group_number: 'GRP001',
    dob: '01/15/1990',
  },
  version: 'v2',
});

REST

Endpoint: POST https://wg.api.dental/rest/Eligibility

Headers:

• X-Token-API: your-api-key
• Content-Type: application/json

{
  "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"
}

GraphQL

Endpoint: POST https://graphql.api.dental/gql

Playground: https://graphql.api.dental/

mutation Api_RequestEligibility {
  api_RequestEligibility(
    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"
  )
}

Request Parameters

Parameter	Type	Required	Description
payer.id	string	Yes	Payer ID from the Payer List endpoint
provider.npi	string	Yes	Provider’s National Provider Identifier (10 digits)
provider.tax_id	string	Yes	Provider’s Tax Identification Number (9 digits)
subscriber.first_name	string	Yes	Subscriber’s first name
subscriber.last_name	string	Yes	Subscriber’s last name
subscriber.member_id	string	Yes	Insurance member ID
subscriber.dob	string	Yes	Date of birth (MM/DD/YYYY)
subscriber.group_number	string	Yes	Insurance group number
dependent	object	No	Same fields as subscriber, for dependent eligibility checks
version	string	Yes	API version — use "v2"

Error Responses

When the upstream payer service returns an error, the API passes through the full error details:

{
  "error": {
    "statusCode": 400,
    "message": "Invalid payer ID: INVALID_PAYER, please check https://developers.onederful.co/ for valid payer IDs",
    "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"
    }
  }
}

Field	Description
statusCode	HTTP status code from the upstream payer service
message	Human-readable error summary
upstream	Full error response body from the payer service (object or string)

Add the True Eligibility transform to automatically normalize raw payer responses into 100+ standardized fields.