Errors in Care Cost Estimator API

Errors can occur under the following scenarios:

• Mandatory data not submitted
• Data is not in required format
• Authorization failed
• Internal server error

Please check the HTTP status code and description to get more details about the error. You can also refer to the OpenAPI spec for details on the structure of error responses.

Errors when creating an estimate of patient's out-of-pocket spending

• When the Care Cost Estimator API returns HTTP status code 500, it indicates that Care Cost Estimator API encounters unexpected condition that prevents the completion of your request. Please try to send the request again. If the issue still occurs after retry, contact our support team.
• When the Care Cost Estimator API returns HTTP status code 400 , it indicates that your request fails to pass the data validation or the request to get patient's eligibility benefits rejected by clearing house or payer. Please check the error description and correct the inputs.

An example of a failed data validation when the API request includes incorrect format of the patient's birthday is listed below. In this example, the API response includes HTTP status code 400 and also include error description, "Request.InsuranceInfo.DependentMemberInfo.DateOfBirth field is incorrectly formatted."

{
    "title": "Request validation failed",
    "status": 400,
    "detail": "There were missing or invalid data or parameters in the request.",
    "instance": "f0d918af-b9db-4587-959f-2d9952ca9df5",
    "errors": {
        "FCEST112": "Request.InsuranceInfo.DependentMemberInfo.DateOfBirth field is incorrectly formatted."
    },
    "traceId": "a07c1824-5428-6a59-de2f-87087d93037f"
}

An example of AAA error when the API request includes a provider NPI not enrolled to request patient's eligibility benefit from the payer, is listed below. In this example, the API response includes HTTP status code 400 and also includes error description to indicate AAA error, rejected reason, and the follow-up action.

{
    "title": "Patient eligibility transaction failed.",
    "status": 400,
    "detail": "The request to check patient's eligibility benefits was rejected. Check error details below.",
    "instance": "9bb6851e-c5cf-4810-b83b-2cb348207268",
    "errors": {
        "FCELIG300": "Field: AAA    Description: Transaction contained a AAA rejection TraceId: 9e7f176f-22b8-2e0f-632f-5c340fd5e767 ControlNumber: 367146001",
        "FCELIG314": "Provider Ineligible for Inquiries  Code: 50  Location: Loop 2100B Follow Up Action: Resubmission Not Allowed TraceId: 9e7f176f-22b8-2e0f-632f-5c340fd5e767 ControlNumber: 367146001"
    },
    "traceId": "eb91bf65-20f3-5bbe-970f-fd2d897507e0"
}

Errors when trying to get estimate details by estimate ID

• When the Care Cost Estimator API returns HTTP status code 404, it indicates that the API cannot find estimate based on the ID you provided. Please check the error description for more details. The example below shows that the estimate ID does not exist when the Care Cost Estimator API returns HTTP 404 status code.

{
    "title": "Estimate Not Found",
    "status": 404,
    "detail": "The estimate based on the given id could not be found, or has not completed.",
    "instance": "0a5cfe40-2d52-4773-9dd0-3f6bd6505f85",
    "errors": {
        "FCEST007": "Cannot find an estimate with the given id. Please verify the id."
    }
}

• When Care Cost Estimator API returns HTTP status code 410, it indicates that estimate of the given ID is expired. An estimate by default expires in 24 hours. Contact Change Healthcare support if you want to change the expiration time.
• When the Care Cost Estimator API returns HTTP status code 412, it indicates that Cost Estimator API can find the estimate ID however, the estimate of patient's out-of-pocket spending failed. This may happen when it takes Care Cost Estimator API longer than expected to get patient's benefit coverage to calculate patient's out-of-pocket spending and end with a failed estimate.