This endpoint enables the establishment of rules governing medical aid packages, offering additional context regarding eligible claims within the package. Note you must provide a unique policy_id to create a new schema, using an already existing one will return an error.policy_id creation rules
Must not contain any special characters except for _
Must not start with character _
Must be in lowercase
Users can define specific criteria, restrictions, and allowances for claims, ensuring adherence to policy guidelines and facilitating efficient processing of medical claims within the package. This endpoint empowers administrators to configure comprehensive schemas tailored to the requirements and coverage scope of each medical aid package, enhancing clarity, transparency, and compliance in claim processing.
Request
Body Params application/json
policy_id
string
Policy Id
required
Policy ID
policy_name
string
Policy Name
required
Policy name
grades
array[string]
Grades
required
Contains hospital grades covered under plan eg ['A','B'] -ONLY GRADES A and B are covered
Allowed values:
ABCDEF
annual_limit
number
Annual Limit
required
Annual benefits total amount claimable per period
limits
object(Limits)
required
Breakdown of claimable amount for individual benefits
hospitalization
number
Hospitalization
required
Maximum claimable amount for hospitalization per period/annually
pathology
number
Pathology
required
Maximum claimable amount for pathology per period/annually
radiology
number
Radiology
required
Maximum claimable amount for radiology per period/annually
physiotherapy
number
Physiotherapy
required
Maximum claimable amount for physiotherapy per period/annually
dental
number
Dental
required
Maximum claimable amount for dental per period/annually
optical
number
Optical
required
Maximum claimable amount for optical per period/annually
drugs
number
Drugs
required
Maximum claimable amount for drugs per period/annually
anesthetic
number
Anesthetic
required
Maximum claimable amount for anesthetic per period/annually
consultation
number
Consultation
required
Maximum claimable amount for consultation per period/annually
gynaecology
number
Gynaecology
required
Maximum claimable amount for gynaecology per period/annually
maternity
number
Maternity
required
Maximum claimable amount for maternity per period/annually
hearing_aids
number
Hearing Aids
required
Maximum claimable amount for hearing aids per period/annually
rules
array[string]
Rules
required
Additional rules you would want to enforce to further process claims
