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Business service APIs

Updated on February 1, 2022

Pega Foundation for Healthcare
  • Authorizations

    • Get Authorization by ID

    • Get Authorizations by Member Policy ID

  • Benefits

    • Get Benefit Coverage (in the context of member’s claim line)

  • Business Entities (Provider)

    • Get Provider Business Entity

  • Business Affiliations (Provider)

    • Get Provider Business Affiliation

  • Provider Contracts

    • Get Provider Contract

  • Claims

    • Get Claims History (for member)

  • Employer Group Contracts

    • Get Employer Group Contract

  • Members

    • Get Member

    • Get Member Policies

    • Get Member Networks

  • Networks

    • Get Network

  • Payers

    • Get Payer

  • Plan Networks

    • Get Plan Network

  • Policies

    • Get Policy

  • Providers

    • Get Provider

    • Get Provider Networks

  • Rate Sheets

    • Get Rate Sheets

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