{"schemaVersion":"1.0","sourceCommit":"f6e9f05f76d443b26ebd2369f67d3c3bd52257ca","sourceVisibility":"private","article":{"id":"api-mansoq-nhcx-insuranceplanbenefitviewset-ea7638c1","title":"Insurance Plan Benefit API reference · mansoq-nhcx","summary":"Static source contract for Insurance Plan Benefit: 6 declared or inherited operation mappings, schema/field evidence and authorization/refusal references. Deployment and behavioral review remain explicit.","module":"RCM & insurance","roles":["IT administrator","Developer","Integration engineer"],"facilities":["All configured facility types"],"kind":"reference","minutes":11,"prerequisites":["Use the API contract from the installed deployment and an authorized synthetic test environment.","Confirm facility/organization scope, action permissions and optional app enablement.","This reference is static source evidence; complete payload, authorization, failure and end-to-end review remains recorded as pending."],"steps":[],"sections":[{"title":"Declared route and availability","body":"This resource is declared in **mansoq-nhcx** at `/api/{installed_plugin_prefix}/insurance-plan-benefit/`. plugin/local mount; actual prefix and enablement require deployment verification A registered path and an indexed handler do not prove deployment availability, user permission or production readiness."},{"title":"Operation map","body":"| Method | Path | Action | Evidence |\n| --- | --- | --- | --- |\n| GET | `/api/{installed_plugin_prefix}/insurance-plan-benefit/` | list | declared/inherited method |\n| GET | `/api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/` | retrieve | declared/inherited method |\n| GET | `/api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/extensions/` | extensions | @action declaration |\n| GET | `/api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/requirements/` | requirements | @action declaration |\n| GET | `/api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/questionnaires/` | questionnaires | @action declaration |\n| POST | `/api/{installed_plugin_prefix}/insurance-plan-benefit/lookup/` | lookup | @action declaration |"},{"title":"list · GET","body":"**GET /api/{installed_plugin_prefix}/insurance-plan-benefit/** — action `list`. static contract extracted; runtime/permission/payload behavior review pending.\n\nPath and deployment-context parameters:\n\n| Location | Parameter | Type | Required |\n| --- | --- | --- | --- |\n| deployment mount | installed_plugin_prefix | deployment-selected mount prefix | true |\n\n**response: InsurancePlanBenefitListSpec**. Declared fields below; inherited fields are retained in the schema inventory.\n\n| Field | Type | Required | Constraints |\n| --- | --- | --- | --- |\n| meta | dict | false | No extra constraint extracted |\n| id | UUID4 \\| None | false | No extra constraint extracted |\n| type_code | str \\| None | false | No extra constraint extracted |\n| type_display | str \\| None | false | No extra constraint extracted |\n| coverage_type_code | str \\| None | false | No extra constraint extracted |\n| coverage_type_display | str \\| None | false | No extra constraint extracted |\n| plan_type_code | str \\| None | false | No extra constraint extracted |\n| plan_type_display | str \\| None | false | No extra constraint extracted |\n| plan_id | UUID4 \\| None | false | No extra constraint extracted |\n| specialty_category_code | str \\| None | false | No extra constraint extracted |\n| specialty_category_display | str \\| None | false | No extra constraint extracted |\n| min_cost | Decimal \\| None | false | No extra constraint extracted |\n| max_cost | Decimal \\| None | false | No extra constraint extracted |\n| max_limit_amount | Decimal \\| None | false | No extra constraint extracted |\n| cost_count | int \\| None | false | No extra constraint extracted |\n| qualifier_count | int \\| None | false | No extra constraint extracted |\n| authorization_required | bool \\| None | false | No extra constraint extracted |\n| is_day_care | bool \\| None | false | No extra constraint extracted |\n| implant_applicable | bool \\| None | false | No extra constraint extracted |\n| stratification_allowed | bool \\| None | false | No extra constraint extracted |\n| procedure_type | str \\| None | false | No extra constraint extracted |\n| has_stratification_qualifier | bool \\| None | false | No extra constraint extracted |\n| has_implant_qualifier | bool \\| None | false | No extra constraint extracted |\n| has_consumable_qualifier | bool \\| None | false | No extra constraint extracted |\n| has_questionnaire | bool \\| None | false | No extra constraint extracted |\n| requires_supporting_info | bool \\| None | false | No extra constraint extracted |\n| supporting_info_count | int \\| None | false | No extra constraint extracted |\n| condition_count | int \\| None | false | No extra constraint extracted |\n| exclusion_count | int \\| None | false | No extra constraint extracted |\n\n**Authorization:** no literal permission name was resolved in the bounded handler/helper traversal. Authentication, inherited policies, object/facility scoping and middleware still require review; this does not mean public access."},{"title":"retrieve · GET","body":"**GET /api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/** — action `retrieve`. static contract extracted; runtime/permission/payload behavior review pending.\n\nPath and deployment-context parameters:\n\n| Location | Parameter | Type | Required |\n| --- | --- | --- | --- |\n| deployment mount | installed_plugin_prefix | deployment-selected mount prefix | true |\n| path | external_id | router lookup string; semantic ID validation requires handler/schema review | true |\n\n**response: InsurancePlanBenefitDetailSpec**. Declared fields below; inherited fields are retained in the schema inventory.\n\n| Field | Type | Required | Constraints |\n| --- | --- | --- | --- |\n| meta | dict | false | No extra constraint extracted |\n| id | UUID4 \\| None | false | No extra constraint extracted |\n| type_code | str \\| None | false | No extra constraint extracted |\n| type_display | str \\| None | false | No extra constraint extracted |\n| coverage_type_code | str \\| None | false | No extra constraint extracted |\n| coverage_type_display | str \\| None | false | No extra constraint extracted |\n| plan_type_code | str \\| None | false | No extra constraint extracted |\n| plan_type_display | str \\| None | false | No extra constraint extracted |\n| plan_id | UUID4 \\| None | false | No extra constraint extracted |\n| specialty_category_code | str \\| None | false | No extra constraint extracted |\n| specialty_category_display | str \\| None | false | No extra constraint extracted |\n| min_cost | Decimal \\| None | false | No extra constraint extracted |\n| max_cost | Decimal \\| None | false | No extra constraint extracted |\n| max_limit_amount | Decimal \\| None | false | No extra constraint extracted |\n| cost_count | int \\| None | false | No extra constraint extracted |\n| qualifier_count | int \\| None | false | No extra constraint extracted |\n| authorization_required | bool \\| None | false | No extra constraint extracted |\n| is_day_care | bool \\| None | false | No extra constraint extracted |\n| implant_applicable | bool \\| None | false | No extra constraint extracted |\n| stratification_allowed | bool \\| None | false | No extra constraint extracted |\n| procedure_type | str \\| None | false | No extra constraint extracted |\n| has_stratification_qualifier | bool \\| None | false | No extra constraint extracted |\n| has_implant_qualifier | bool \\| None | false | No extra constraint extracted |\n| has_consumable_qualifier | bool \\| None | false | No extra constraint extracted |\n| has_questionnaire | bool \\| None | false | No extra constraint extracted |\n| requires_supporting_info | bool \\| None | false | No extra constraint extracted |\n| supporting_info_count | int \\| None | false | No extra constraint extracted |\n| condition_count | int \\| None | false | No extra constraint extracted |\n| exclusion_count | int \\| None | false | No extra constraint extracted |\n| coverage_id | UUID4 \\| None | false | No extra constraint extracted |\n| specific_cost_benefit_id | UUID4 \\| None | false | No extra constraint extracted |\n| coverage_benefit_fhir_ids | list[str] | false | No extra constraint extracted |\n| questionnaire_fhir_ids | list[str] | false | No extra constraint extracted |\n| costs | list[InsurancePlanCostSpec] | false | No extra constraint extracted |\n| limits | list[InsurancePlanCoverageBenefitLimitSpec] | false | No extra constraint extracted |\n| conditions | list[ClaimConditionSpec] | false | No extra constraint extracted |\n| exclusions | list[ClaimExclusionSpec] | false | No extra constraint extracted |\n| supporting_info_requirements | list[ClaimSupportingInfoRequirementSpec] | false | No extra constraint extracted |\n| questionnaires | list[InsurancePlanQuestionnaireListSpec] | false | No extra constraint extracted |\n\n**Authorization:** no literal permission name was resolved in the bounded handler/helper traversal. Authentication, inherited policies, object/facility scoping and middleware still require review; this does not mean public access."},{"title":"extensions · GET","body":"**GET /api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/extensions/** — action `extensions`. static contract extracted; runtime/permission/payload behavior review pending.\n\nPath and deployment-context parameters:\n\n| Location | Parameter | Type | Required |\n| --- | --- | --- | --- |\n| deployment mount | installed_plugin_prefix | deployment-selected mount prefix | true |\n| path | external_id | router lookup string; semantic ID validation requires handler/schema review | true |\n\n**Authorization:** no literal permission name was resolved in the bounded handler/helper traversal. Authentication, inherited policies, object/facility scoping and middleware still require review; this does not mean public access."},{"title":"requirements · GET","body":"**GET /api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/requirements/** — action `requirements`. static contract extracted; runtime/permission/payload behavior review pending.\n\nPath and deployment-context parameters:\n\n| Location | Parameter | Type | Required |\n| --- | --- | --- | --- |\n| deployment mount | installed_plugin_prefix | deployment-selected mount prefix | true |\n| path | external_id | router lookup string; semantic ID validation requires handler/schema review | true |\n\n**Authorization:** no literal permission name was resolved in the bounded handler/helper traversal. Authentication, inherited policies, object/facility scoping and middleware still require review; this does not mean public access."},{"title":"questionnaires · GET","body":"**GET /api/{installed_plugin_prefix}/insurance-plan-benefit/{external_id}/questionnaires/** — action `questionnaires`. static contract extracted; runtime/permission/payload behavior review pending.\n\nPath and deployment-context parameters:\n\n| Location | Parameter | Type | Required |\n| --- | --- | --- | --- |\n| deployment mount | installed_plugin_prefix | deployment-selected mount prefix | true |\n| path | external_id | router lookup string; semantic ID validation requires handler/schema review | true |\n\n**Authorization:** no literal permission name was resolved in the bounded handler/helper traversal. Authentication, inherited policies, object/facility scoping and middleware still require review; this does not mean public access."},{"title":"lookup · POST","body":"Resolve the priced benefit row by (insurance_plan, plan_tier?,\ncoverage_type_code?, type_code). When ``plan_tier`` is omitted on a\nmulti-plan IP the first match is returned.\n\n**POST /api/{installed_plugin_prefix}/insurance-plan-benefit/lookup/** — action `lookup`. static contract extracted; runtime/permission/payload behavior review pending.\n\nPath and deployment-context parameters:\n\n| Location | Parameter | Type | Required |\n| --- | --- | --- | --- |\n| deployment mount | installed_plugin_prefix | deployment-selected mount prefix | true |\n\n**decorator request: BenefitLookupBody**. Declared fields below; inherited fields are retained in the schema inventory.\n\n| Field | Type | Required | Constraints |\n| --- | --- | --- | --- |\n| insurance_plan | UUID4 | true | No extra constraint extracted |\n| plan_tier | UUID4 \\| None | false | No extra constraint extracted |\n| coverage_type_code | str \\| None | false | No extra constraint extracted |\n| type_code | str | true | No extra constraint extracted |\n\n**decorator responses: InsurancePlanBenefitDetailSpec**. Declared fields below; inherited fields are retained in the schema inventory.\n\nThe declared field table is shown at its first occurrence in this reference; this operation links the same schema.\n\n**Authorization:** no literal permission name was resolved in the bounded handler/helper traversal. Authentication, inherited policies, object/facility scoping and middleware still require review; this does not mean public access.\n\n**Explicit response statuses in observed code:** 404. Other branches/framework exception handling may differ."},{"title":"Integration review checklist","body":"Confirm the installed route and full schema; review authentication, organization/facility scoping, all accepted fields, value-state and date/time semantics, idempotency, pagination, response/exception branches and the allowed correction/reversal workflow. Test positive and negative cases with synthetic data. This source reference does not establish external certification or replace an illustrated user procedure."}],"troubleshooting":[{"problem":"A declared route is unavailable or a request is rejected","solution":"Compare the installed revision, actual API schema, optional plugin mount, HTTP-method restrictions and recorded validation/permission evidence. Do not bypass a refusal or send a production transaction to test 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