True Eligibility Transform

Premium add-on that transforms basic eligibility responses into comprehensive, developer-ready data with 100+ transformation rules.

True Eligibility is a premium add-on that transforms raw eligibility responses into comprehensive, standardized data with 100+ transformation rules. Save countless hours of data processing work.

Pricing

Monthly Cost	$300/month
Transform Rules	100+
Time Saved	Hours per day

True Eligibility is available as an add-on to any API Dental plan. Contact [e-mail] or visit the Dashboard to enable it.

What You Get

Complete Patient Demographics

Full patient and subscriber information including addresses, DOB, member IDs, and contact details.

Detailed Coverage Breakdown

Precise coverage percentages for diagnostics, preventive care, restorative work, crowns, orthodontics, and more.

Comprehensive Benefit Details

Deductibles, maximums, remaining benefits, effective dates, and policy information.

Procedure Limitations & Rules

Detailed limitations by procedure code, frequency restrictions, age limits, and coverage disclaimers.

Payer Information

Complete payer details including names, IDs, phone numbers, and addresses when available.

Enhanced Response Format

When True Eligibility is enabled, a true_eligibility field is added to your eligibility responses:

{
  "true_eligibility": {
    "Status": "active",
    "EffectiveDate": "01/01/2025",
    "ExpiryDate": "12/31/2025",
    "PolicyType": "ppo",
    "Deductible_Standard_Individual": "50.00",
    "Deductible_Standard_Individual_Remaining": "50.00",
    "Deductible_Standard_Family": "150.00",
    "GroupNumber_Response": "GRP123456",
    "GroupName_Response": "ACME HEALTHCARE DENTAL",
    "PayerName_Response": "ACME DENTAL INSURANCE",
    "PatientFirstName_Response": "JOHN",
    "PatientLastName_Response": "DOE",
    "PatientDOB_Response": "01/15/1985",
    "Diagnostic_Coverage": "100",
    "Preventive_Coverage": "100",
    "Basic_Restorative_Coverage": "80",
    "Crowns_Coverage": "50",
    "Orthodontics_Coverage": "50",
    "// ...": "100+ additional enriched fields"
  }
}

How It Works

1. Your eligibility request is processed normally
2. The raw payer response is captured
3. The True Eligibility transform engine applies 100+ rules to normalize and enrich the data
4. The standardized true_eligibility object is added to your response

Developer Time Savings

Instead of writing complex parsing logic for dozens of different payer response formats, get standardized, enriched data ready for your application. Focus on building features, not data transformation.

True Eligibility works with both the standard Eligibility API and the ClearCoverage API. The transform is applied automatically when enabled on your account.