Sample Member Person Creation Read Request and Response in XML Format
Using the below example, you can do the following:
-
Create a member person for a membership
| Person Name | Person Type | Membership ID | Policy Number | Main Subscriber |
|---|---|---|---|---|
|
REPC_ANDY, REPC_WILLIAMS |
PERSON | 998162301690408 | REPC_ANDY_POL1 | Yes |
<schema>
<responseDetails>
<membershipId>998162301690408</membershipId>
<responseStatus>SUCCESS</responseStatus>
<message></message>
</responseDetails>
<simulationSw>N</simulationSw>
<action></action>
<readFilters>
<dateFilter>
<startDate>2020-01-01</startDate>
<endDate>2020-12-31</endDate>
</dateFilter>
<priceItemFilter>
<priceItemList>
<priceItemCode>AGEBASED_PROD2_INLOC</priceItemCode>
</priceItemList>
</priceItemFilter>
<responseType>DT</responseType>
</readFilters>
<person>
<personData>
<sequence></sequence>
<personType></personType>
<personName>
<sequence></sequence>
<entityName></entityName>
<nameType></nameType>
</personName>
<identifiers>
<idType></idType>
<idValue></idValue>
<isPrimary></isPrimary>
</identifiers>
<division>HC</division>
<birthDate></birthDate>
<sinceDate></sinceDate>
<collectionClass></collectionClass>
<postponeCreditReviewUntil></postponeCreditReviewUntil>
<lastCreditReviewDate></lastCreditReviewDate>
<dragDays></dragDays>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositLevel></advanceDepositLevel>
<address>
<addressEffDate></addressEffDate>
<addressType></addressType>
<mailingName></mailingName>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<state></state>
<zip></zip>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<addressStatus></addressStatus>
</address>
<email></email>
<overrideMailingName1></overrideMailingName1>
<overrideMailingName2></overrideMailingName2>
<overrideMailingName3></overrideMailingName3>
<phones>
<phoneType></phoneType>
<phoneValue></phoneValue>
<extension></extension>
</phones>
<relatedPersons>
<idType></idType>
<idValue></idValue>
<personRelationshipType></personRelationshipType>
<startDate></startDate>
<endDate></endDate>
<financialRelationshipSw></financialRelationshipSw>
<parentOrChild></parentOrChild>
<relatedPersonsCharacteristicsList>
<characteristic>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristic>
</relatedPersonsCharacteristicsList>
</relatedPersons>
<personCharacteristicList>
<characteristic>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristic>
</personCharacteristicList>
<accountData>
<accountType></accountType>
<customerClass></customerClass>
<billCycle></billCycle>
<billLeadDays></billLeadDays>
<division></division>
<currency></currency>
<setUpDate></setUpDate>
<acctUsageFlg></acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType></billRouteType>
<billAddressSource></billAddressSource>
<accountIdentifiers>
<idType></idType>
<idValue></idValue>
<isPrimary></isPrimary>
</accountIdentifiers>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
</personData>
</person>
<membership>
<sourceSystem>ZZ_LOC_PRIME</sourceSystem>
<policyNumber>REPC_ANDY_POL1</policyNumber>
<planNumber>REPC_ANDY_POL1_PLN1</planNumber>
<healthPlanCode></healthPlanCode>
<startDate>2023-01-01</startDate>
<endDate>2023-12-31</endDate>
<boStatusCd></boStatusCd>
<paidThroughDate></paidThroughDate>
<membershipType>MDCR</membershipType>
<mainSubscriber>
<mainSubsIdType>WEB</mainSubsIdType>
<mainSubsIdValue>REPC_ANDY</mainSubsIdValue>
<membershipType>MDCR</membershipType>
</mainSubscriber>
<autoRenew></autoRenew>
<associatedMemberIdentifierType>
</associatedMemberIdentifierType>
<associatedMemberIdentifier>
</associatedMemberIdentifier>
<exchangeFlag></exchangeFlag>
<exchangeId></exchangeId>
<binderLiabilityAmount></binderLiabilityAmount>
<binderPayApplicability></binderPayApplicability>
<binderPayGraceDays></binderPayGraceDays>
<binderPayThreshold></binderPayThreshold>
<holdBilling></holdBilling>
<membershipRenewalDate></membershipRenewalDate>
<contractPeriod></contractPeriod>
<repriceAfterDate></repriceAfterDate>
<membershipIdentifierList>
<membershipIdentifier>
<membershipIdentifierType>
</membershipIdentifierType>
<membershipIdentifierValue>
</membershipIdentifierValue>
</membershipIdentifier>
</membershipIdentifierList>
<membershipCharacteristicList>
<characteristic>
<characteristicType>C1SRCSYS</characteristicType>
<characteristicValue>ZZPRIME</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</membershipCharacteristicList>
<membershipRateGuarantee>
<membershipRateGuaranteeList>
<rateGuaranteeStartDate></rateGuaranteeStartDate>
<rateGuaranteeEndDate></rateGuaranteeEndDate>
<rateGuaranteeStatus></rateGuaranteeStatus>
</membershipRateGuaranteeList>
</membershipRateGuarantee>
<memberDataList>
<memberData>
<memberIdType>WEB</memberIdType>
<memberIdValue>REPC_ANDY_0090_P1</memberIdValue>
<enrollmentStartDate>2023-01-01</enrollmentStartDate>
<enrollmentEndDate>2023-12-31</enrollmentEndDate>
<memberRelationship>OWNER</memberRelationship>
<membershipPersonStatus>ACTIVE</membershipPersonStatus>
<membershipPersonstatusReason>
ZZNW
</membershipPersonstatusReason>
<memberId>REPC_ANDY_0099_M1</memberId>
<financeRespFlag>Y</financeRespFlag>
<isMemberSw>Y</isMemberSw>
<externalMedicareBeneficiaryId>
REPC_ANDY_0090_P1
</externalMedicareBeneficiaryId>
<memberCharacteristicList>
<characteristic>
<characteristicType>SMOKER</characteristicType>
<characteristicValue>Y</characteristicValue>
<effectiveDate>2023-01-01</effectiveDate>
</characteristic>
</memberCharacteristicList>
<benefitData>
<benefitDataList>
<sequence>1</sequence>
<startDate>2023-02-01</startDate>
<endDate>2023-10-31</endDate>
<benefitStatus>ACTIVE</benefitStatus>
<benefitSourceFlag>CMS</benefitSourceFlag>
<benefitSubTypeFlag>LEP</benefitSubTypeFlag>
<planBenefitPackageId>
MDCR078_P1
</planBenefitPackageId>
<benefitAmount>1000.00</benefitAmount>
<benefitCharacteristicsList>
<characteristic>
<characteristicType>
GENDER
</characteristicType>
<characteristicValue>
MALE
</characteristicValue>
<effectiveDate>
2023-01-01
</effectiveDate>
</characteristic>
</benefitCharacteristicsList>
<benefitDataList>
</benefitData>
</memberData>
</memberDataList>
<premiumCalculationDetails>
<premiumCalculation>
<priceItemCd></priceItemCd>
<startDt></startDt>
<endDt></endDt>
<calcAmt></calcAmt>
<distAmt></distAmt>
<currencyCd></currencyCd>
<acctIdType></acctIdType>
<acctIdVal></acctIdVal>
<accountId></accountId>
<billableChgId></billableChgId>
<pricingRuleId></pricingRuleId>
<priceAsgnId></priceAsgnId>
<premiumCalcLineDetails>
<premiumCalcLines>
<proFactor></proFactor>
<calcAmt></calcAmt>
<distAmt></distAmt>
<month></month>
<totalCalcAmt></totalCalcAmt>
<currencyCd></currencyCd>
<entityTypeFlg></entityTypeFlg>
<entityId></entityId>
<referenceIdType></referenceIdType>
<referenceIdValue></referenceIdValue>
<pricingParameters></pricingParameters>
<description></description>
</premiumCalcLines>
</premiumCalcLineDetails>
</premiumCalculation>
</premiumCalculationDetails>
</membership>
<accountBalance>
<accountBalanceData>
<accountIdentifierType></accountIdentifierType>
<accountNumber></accountNumber>
<accountId></accountId>
<division></division>
<sourceSystem></sourceSystem>
<c1ExternalTransactionId></c1ExternalTransactionId>
<externalSourceId></externalSourceId>
<accountInfoDtls>
<currentBalance></currentBalance>
<lastBillAmount></lastBillAmount>
<statusCd></statusCd>
<messageText></messageText>
</accountInfoDtls>
</accountBalanceData>
</accountBalance>
</schema>
Note: We have given the above sample
to illustrate how the tags should be nested while sending a member
person creation 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.