See API Specification

See Insurance Categories for additional information.

CovCats GET (single)

Version Added: 23.3.8

Gets a single covcat.

Parameters:

CovCatNum: Required in the URL.

Example Request:
GET /covcats/1

Example Response:

{
"CovCatNum": 1,
"Description": "General",
"DefaultPercent": -1,
"CovOrder": 0,
"IsHidden": "false",
"EbenefitCat": "General"
}

200 OK
404 NotFound (with explanation)

CovCats GET (multiple)

Version Added: 23.3.8

Gets a list of covcats.

Example Request:
GET /covcats

Example Response:

[
{
"CovCatNum": 1,
"Description": "General",
"DefaultPercent": -1,
"CovOrder": 0,
"IsHidden": "false",
"EbenefitCat": "General"
},
{
"CovCatNum": 2,
"Description": "Diagnostic",
"DefaultPercent": 100,
"CovOrder": 1,
"IsHidden": "false",
"EbenefitCat": "Diagnostic"
},
{
"CovCatNum": 3,
"Description": "Preventive",
"DefaultPercent": 100,
"CovOrder": 3,
"IsHidden": "false",
"EbenefitCat": "RoutinePreventive"
},
etc.
]

200 OK

CovCats POST (create)

Version Added: 24.1.24

Creates a covcat. Do not alter Insurance Categories without a full understanding of what this does as insurance categories are global and changes may affect all plans.

One of each Electronic Benefit Category (EbenefitCat) must be assigned to a corresponding coverage category. There can be no duplicates and no missing categories in order for Open Dental Benefit Processing and Electronic Eligibility and Benefits to function properly.

Description: Required. Description of this category.
DefaultPercent: Optional. Coverage percentage assigned to category when creating a new Insurance Plan. Integer between -1 and 100. Specifying -1 will not apply a percentage. Default -1.
IsHidden: Optional. Either "true" or "false". Default "false".
EbenefitCat: Optional. Either "None", "General", "Diagnostic", "Periodontics", "Restorative", "Endodontics", "MaxillofacialProsth", "Crowns", "Accident", "Orthodontics", "Prosthodontics", "OralSurgery", "RoutinePreventive", "DiagnosticXRay", or "Adjunctive". Default "None".

Example Request:
POST /covcats

{
"Description": "Implants",
"DefaultPercent": 80,
"IsHidden": "false",
"EbenefitCat": "None"
}

Example Response:
{
"CovCatNum": 25,
"Description": "Implants",
"DefaultPercent": 80,
"CovOrder": 16,
"IsHidden": "false",
"EbenefitCat": "None"
}

201 Created
400 BadRequest (with explanation)
404 NotFound (with explanation)

CovCats PUT (update)

Version Added: 24.1.24

Updates a covcat. This does affect all benefits that are currently tied to this CovCat.

CovOrder is important as multiple benefits can apply to a single procedure code. If some benefits are of the same type, there is a hierarchy to determine which benefits affect insurance estimates. See the Benefit Hierarchy section for more information.

CovCatNum: Required in the URL.

Description: Description of this category.
DefaultPercent: Coverage percentage assigned to category when creating a new Insurance Plan. Integer between -1 and 100. Specifying -1 will not apply a percentage.
CovOrder: The order in which the categories are displayed. CovCats with a lower CovOrder are more general, while CovCats with a higher CovOrder will have priority and override the lower categories.
IsHidden: Either "true" or "false".
EbenefitCat: Either "None", "General", "Diagnostic", "Periodontics", "Restorative", "Endodontics", "MaxillofacialProsth", "Crowns", "Accident", "Orthodontics", "Prosthodontics", "OralSurgery", "RoutinePreventive", "DiagnosticXRay", or "Adjunctive".

Example Request:
PUT /covcats/34

{
"Description": "Sealants",
"DefaultPercent": 80,
"CovOrder": 17,
"IsHidden": "false",
"EbenefitCat": "None"
}

Example Response:
{
"CovCatNum": 34,
"Description": "Sealants",
"DefaultPercent": 80,
"CovOrder": 17,
"IsHidden": "false",
"EbenefitCat": "None"
}

200 OK
400 BadRequest (with explanation)
404 NotFound (with explanation)