CMS ACCESS Model API
0.9.0 - ci-build

CMS ACCESS Model API - Local Development build (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## OperationDefinition: Check Eligibility Request

Official URL: https://globalalliantinc.com/access/OperationDefinition/CheckEligibility | Version: 0.9.0
Active as of 2026-03-06 | Computable Name: CheckEligibility

The $check-eligibility operation allows a participant to submit basic information on a patient who they believe will be a good candidate for the ACCESS model and who wants to be part of the ACCESS Model. The participant can use this API to do a quick check on which patients may be eligible before officially submitting the patient's information for consideration and inclusion in the ACCESS Model.

URL: [base]/Patient/$check-eligibility

Input parameters Profile:ACCESS Check Eligibility Request Parameters

### Parameters

Use | Name | Scope | Cardinality | Type | Binding | Documentation
IN | participantID |  | 1..1 | Identifier |  | ACCESS participant identifier. Must follow the pattern ACCESS#### where #### represents exactly 4 digits (e.g., ACCESS0001, ACCESS1234).
IN | payerID |  | 1..1 | Identifier |  | Payer ID for the patient.
IN | patient |  | 1..1 | Patient |  | Patient information. It SHOULD contain the Medicare Beneficiary Identifier (MBI).
IN | track |  | 1..1 | CodeableConcept | ACCESS Model Tracks Value Set (Required) | ACCESS track for which eligibility is being checked.
IN | condition |  | 0..* | Condition |  | Patient's conditions.