Sample Individual Membership Read Request and Response in XML Format
Using the below example, you can do the following:
-
View the details of an individual membership with the membership Id is 018627581362534
| Person Name | Person Type | Membership ID | Policy Number | Main Subscriber |
|---|---|---|---|---|
|
REPC_BEN, REPC_WOAKES |
PERSON | 018627581362534 | REPC_BEN_POL1 | Yes |
<schema>
<responseDetails>
<membershipId>018627581362534</membershipId>
<responseStatus>SUCCESS</responseStatus>
<message></message>
</responseDetails>
<simulationSw>Y</simulationSw>
<action></action>
<readFilters>
<dateFilter>
<startDate>2021-01-01</startDate>
<endDate>2021-12-31</endDate>
</dateFilter>
<priceItemFilter>
<priceItemList>
<priceItemCode>LEP</priceItemCode>
</priceItemList>
</priceItemFilter>
<responseType>DT</responseType>
</readFilters>
<person>
<personData>
<sequence>1</sequence>
<personType>P</personType>
<personName>
<sequence>1</sequence>
<entityName>REPC_BEN,REPC_WOAKES</entityName>
<nameType>PRIM</nameType>
</personName>
<identifiers>
<idType>WEB</idType>
<idValue>REPC_BEN</idValue>
<isPrimary>Y</isPrimary>
</identifiers>
<division>HC</division>
<birthDate>1982-07-07</birthDate>
<sinceDate>2020-01-01</sinceDate>
<collectionClass></collectionClass>
<postponeCreditReviewUntil></postponeCreditReviewUntil>
<lastCreditReviewDate></lastCreditReviewDate>
<dragDays></dragDays>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositLevel></advanceDepositLevel>
<address>
<addressEffDate>2020-01-01</addressEffDate>
<addressType>MAIN</addressType>
<mailingName>BENJAMIN WOAKES</mailingName>
<address1>THE WOAKES FINS SYSTEMS</address1>
<address2>7773-K SOUTH WEST PARK</address2>
<address3>SCOTTSDALE(WEST)</address3>
<address4>ARIZONA</address4>
<city>SCOTTSDALE</city>
<state>ARIZONA</state>
<zip>80255</zip>
<country>USA</country>
<houseType>RANCH</houseType>
<streetNumber1>270TH MAIN STREET</streetNumber1>
<streetNumber2>CENTRAL ROAD</streetNumber2>
<inCityLimit>Y</inCityLimit>
<taxVendorGeographicalCode>2020</taxVendorGeographicalCode>
<county>MARICOPA</county>
<addressStatus></addressStatus>
</address>
<email>repc_ben_woakes@osfs.com</email>
<overrideMailingName1>
repc_ben_woakes@osfs.com
</overrideMailingName1>
<overrideMailingName2>
repc_ben_woakes@osfs.com
</overrideMailingName2>
<overrideMailingName3>
repc_ben_woakes@osfs.com
</overrideMailingName3>
<phones>
<phoneType>BUSN</phoneType>
<phoneValue>+1.623.555.6100</phoneValue>
<extension>1041</extension>
</phones>
<phones>
<phoneType>HOME</phoneType>
<phoneValue>+1.663.555.3457</phoneValue>
<extension></extension>
</phones>
<relatedPersons>
<idType>WEB</idType>
<idValue>REPC_BEN_C1</idValue>
<personRelationshipType>CHILD</personRelationshipType>
<startDate>2020-01-01</startDate>
<endDate>2020-12-31</endDate>
<financialRelationshipSw>FALSE</financialRelationshipSw>
<parentOrChild>P</parentOrChild>
<relatedPersonsCharacteristicsList>
<characteristic>
<characteristicType>RP-GAMBL</characteristicType>
<characteristicValue>DRCT</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</relatedPersonsCharacteristicsList>
</relatedPersons>
<personCharacteristicList>
<characteristic>
<characteristicType>ZZ-BLAGM</characteristicType>
<characteristicValue>DRCT</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</personCharacteristicList>
<accountData>
<accountType>ZZS</accountType>
<customerClass>HC</customerClass>
<billCycle>AUT</billCycle>
<billLeadDays></billLeadDays>
<division>HC</division>
<currency>USD</currency>
<setUpDate></setUpDate>
<acctUsageFlg></acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass>HC</collectionClass>
<billRouteType>EMAIL</billRouteType>
<billAddressSource>ACCT</billAddressSource>
<accountIdentifiers>
<idType>ACCTNM</idType>
<idValue>REPC_BEN_ACCT1</idValue>
<isPrimary>TRUE</isPrimary>
</accountIdentifiers>
<characteristics>
<characteristicsList>
<characteristicType>C1OFFRST</characteristicType>
<characteristicValue>1</characteristicValue>
<effectiveDate>2021-01-01</effectiveDate>
</characteristicsList>
<characteristicsList>
<characteristicType>ZZBLRULE</characteristicType>
<characteristicValue>TESTMT5</characteristicValue>
<effectiveDate>2021-01-01</effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
</personData>
</person>
<membership>
<sourceSystem>ZZPRIME</sourceSystem>
<policyNumber>REPC_BEN_POL1</policyNumber>
<planNumber>REPC_BEN_POL1_P1</planNumber
<healthPlanCode>HLPNFSTEST145</healthPlanCode>
<startDate>2021-01-01</startDate>
<endDate>2021-12-31</endDate>
<boStatusCd></boStatusCd>
<paidThroughDate>2021-01-01</paidThroughDate>
<membershipType>MDCR</membershipType>
<mainSubscriber>
<mainSubsIdType>WEB</mainSubsIdType>
<mainSubsIdValue>REPC_BEN</mainSubsIdValue>
<membershipType>MDCR</membershipType>
</mainSubscriber>
<autoRenew>N</autoRenew>
<associatedMemberIdentifierType>
AADHR
</associatedMemberIdentifierType>
<associatedMemberIdentifier>
HLPN022
</associatedMemberIdentifier>
<exchangeFlag>ON</exchangeFlag>
<exchangeId>HLPNFSTEST145</exchangeId>
<binderLiabilityAmount>1500.00</binderLiabilityAmount>
<binderPayApplicability>Y</binderPayApplicability>
<binderPayGraceDays>30</binderPayGraceDays>
<binderPayThreshold>1000</binderPayThreshold>
<holdBilling>N</holdBilling>
<membershipRenewalDate>2022-01-01</membershipRenewalDate>
<contractPeriod>0</contractPeriod>
<repriceAfterDate></repriceAfterDate>
<membershipIdentifierList>
<membershipIdentifier>
<membershipIdentifierType>
AADHR
</membershipIdentifierType>
<membershipIdentifierValue>
HLPN022
</membershipIdentifierValue>
</membershipIdentifier>
</membershipIdentifierList>
<membershipCharacteristicList>
<characteristic>
<characteristicType>
BILL_LVL1
</characteristicType>
<characteristicValue>
FINS_MDPSCR_AGRT005_IN1_PARAM1
</characteristicValue>
<effectiveDate>
2021-01-01
</effectiveDate>
</characteristic>
</membershipCharacteristicList>
<membershipRateGuarantee>
<membershipRateGuaranteeList>
<rateGuaranteeStartDate>
2021-01-01
</rateGuaranteeStartDate>
<rateGuaranteeEndDate>
2021-12-31
</rateGuaranteeEndDate>
<rateGuaranteeStatus>
ACTIVE
</rateGuaranteeStatus>
</membershipRateGuaranteeList>
</membershipRateGuarantee>
<memberDataList>
<memberData>
<memberIdType>WEB</memberIdType>
<memberIdValue>REPC_BEN</memberIdValue>
<enrollmentStartDate>2021-01-01</enrollmentStartDate>
<enrollmentEndDate>2021-12-31</enrollmentEndDate>
<memberRelationship>OWNER</memberRelationship>
<membershipPersonStatus>ACTV</membershipPersonStatus>
<membershipPersonstatusReason>
</membershipPersonstatusReason>
<memberId>REPC_BEN_M1</memberId>
<financeRespFlag>Y</financeRespFlag>
<isMemberSw>Y</isMemberSw>
<externalMedicareBeneficiaryId>
FINS_SD001_P2
</externalMedicareBeneficiaryId>
<memberCharacteristicList>
<characteristic>
<characteristicType>C1SMOKER</characteristicType>
<characteristicValue>Y</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</memberCharacteristicList>
<benefitData>
<benefitDataList>
<sequence>1</sequence>
<startDate>2020-02-01</startDate>
<endDate>2020-10-31</endDate>
<benefitStatus>ACTIVE</benefitStatus>
<benefitSourceFlag>ST</benefitSourceFlag>
<benefitSubTypeFlag>LEP</benefitSubTypeFlag>
<planBenefitPackageId>
MDCR078_P1
</planBenefitPackageId>
<benefitAmount>1500.00</benefitAmount>
<benefitCharacteristicsList>
<characteristic>
<characteristicType>
GENDER
</characteristicType>
<characteristicValue>
MALE
</characteristicValue>
<effectiveDate>
2020-01-01
</effectiveDate>
</characteristic>
</benefitCharacteristicsList>
<benefitDataList>
</benefitData>
</memberData>
</memberDataList>
<premiumCalculationDetails>
<premiumCalculation>
<priceItemCd>LEP</priceItemCd>
<startDt>2021-01-01</startDt>
<endDt>2021-12-31</endDt>
<calcAmt>1500.00</calcAmt>
<distAmt>0</distAmt>
<currencyCd>USD</currencyCd>
<acctIdType>ACCT_NM</acctIdType>
<acctIdVal>REPCBEN1011IN10519S1</acctIdVal>
<accountId>6573747915</accountId>
<billableChgId>753035850030</billableChgId>
<pricingRuleId>181910202193698</pricingRuleId>
<priceAsgnId>8220029141</priceAsgnId>
<premiumCalcLineDetails>
<premiumCalcLines>
<proFactor>1</proFactor>
<calcAmt>1500.00</calcAmt>
<distAmt>0</distAmt>
<month>0</month>
<totalCalcAmt>1500.00</totalCalcAmt>
<currencyCd>USD</currencyCd>
<entityTypeFlg>PERS</entityTypeFlg>
<entityId>5055198762</entityId>
<referenceIdType>WEB</referenceIdType>
<referenceIdValue>
REPC_BEN_MAINSUB
</referenceIdValue>
<pricingParameters>DRUGGIST</pricingParameters>
<description></description>
</premiumCalcLines>
</premiumCalcLineDetails>
</premiumCalculation>
</premiumCalculationDetails>
</membership>
<accountBalance>
<accountBalanceData>
<accountIdentifierType>ACCT_NM</accountIdentifierType>
<accountNumber>REPCBEN1011IN10519S1</accountNumber>
<accountId>6573747915</accountId>
<division>HC</division>
<sourceSystem>ZZPRIME</sourceSystem>
<c1ExternalTransactionId></c1ExternalTransactionId>
<externalSourceId></externalSourceId>
<accountInfoDtls>
<currentBalance>3000.00</currentBalance>
<lastBillAmount>1500.00</lastBillAmount>
<statusCd>SUCCESS</statusCd>
<messageText></messageText>
</accountInfoDtls>
</accountBalanceData>
</accountBalance>
</schema>
Note: We have given the above sample
to illustrate how the tags should be nested while sending an individual
membership read request from the external system. However, you should
not seamlessly use this sample in your environment because the required
pre-requisite data may not be available in your environment. In such
case, the system will give erroneous results.