Payer Enrollment¶

The SDK provides full coverage of the Assured Payer Enrollment subsystem — health plan lookups, enrollment requests, active enrollment management, and adding existing provider enrollments.

Health Plans¶

List available health plans with optional search and state filtering:

# Get all health plans
plans = await client.payer_enrollment.list_health_plans_all()

# Search by name
plans = await client.payer_enrollment.list_health_plans_all(search="Anthem")

# As a DataFrame
df = await client.payer_enrollment.list_health_plans_df()

Enrollment Requests¶

Create and track enrollment requests:

from assured.models.payer_enrollment import ProviderEnrollmentRequestCreate

# Create an enrollment request
request = ProviderEnrollmentRequestCreate(
    provider="provider-uuid",
    health_plan="health-plan-uuid",
    practice_location="location-uuid",
    tax_entity="tax-entity-uuid",
    effective_date="2025-01-01",
)
result = await client.payer_enrollment.create_provider_enrollment(request)

# List all enrollment requests
requests = await client.payer_enrollment.list_enrollment_requests_all()

Active Enrollments¶

Query existing active enrollments:

# List all active enrollments
active = await client.payer_enrollment.list_active_enrollments_all()

# As a DataFrame for analysis
df = await client.payer_enrollment.list_active_enrollments_df()

Adding Existing Provider Enrollments¶

When a provider already has an active enrollment with a payer (established outside the platform), you can record it using add_existing_provider_enrollment:

from assured.models.payer_enrollment import ExistingProviderEnrollmentCreate

enrollment = ExistingProviderEnrollmentCreate(
    provider="provider-uuid",
    tax_entity="tax-entity-uuid",
    state="IN",
    health_plan="health-plan-uuid",
    lobs=["Traditional Medicaid"],
    primary_practice_location="location-uuid",
    par_status="LINKED",
    new_health_plan_id="300017810",
    effective_date="2024-12-01",
    no_re_validation_date=True,
    no_proof_of_enrollment=True,
    notes="BCBA",
)

result = await client.payer_enrollment.add_existing_provider_enrollment(enrollment)
print(f"Created enrollment: {result.id}")

Payload Fields¶

Field	Type	Description
`provider`	`str`	Provider account UUID
`tax_entity`	`str`	Tax entity UUID
`state`	`str`	Two-letter state code
`health_plan`	`str`	Health plan UUID
`lobs`	`list[str]`	Lines of business (e.g., `["Traditional Medicaid"]`)
`primary_practice_location`	`str`	Primary practice location UUID
`par_status`	`str`	Participation status (e.g., `"LINKED"`)
`effective_date`	`str`	Effective date in `YYYY-MM-DD` format
`new_health_plan_id`	`str`	The payer-assigned provider ID
`no_re_validation_date`	`bool`	Whether re-validation date is not applicable
`no_proof_of_enrollment`	`bool`	Whether proof of enrollment is not available
`notes`	`str`	Free-text notes

Group Enrollment Requests¶

For group-level enrollments:

from assured.models.payer_enrollment import GroupEnrollmentRequestCreate

group = GroupEnrollmentRequestCreate(
    health_plan="health-plan-uuid",
    practice_location="location-uuid",
    tax_entity="tax-entity-uuid",
    effective_date="2025-01-01",
)
result = await client.payer_enrollment.create_group_enrollment(group)