{ "$schema": "https://ui.shadcn.com/schema/registry-item.json", "name": "insurance-eligibility-checker", "title": "Insurance Eligibility Checker", "type": "registry:block", "files": [ { "path": "packages/registry-react/blocks/insurance-eligibility-checker/InsuranceEligibilityChecker.tsx", "content": "'use client'\n\nimport * as React from 'react'\nimport {\n Activity,\n AlertCircle,\n Building2,\n CheckCircle2,\n CreditCard,\n FileCheck,\n FileText,\n Hospital,\n Info,\n Pill,\n RefreshCw,\n ShieldCheck,\n Stethoscope,\n User,\n} from 'lucide-react'\nimport { cn } from '@/lib/utils'\nimport { Badge } from '@/components/ui/badge'\nimport { Button } from '@/components/ui/button'\nimport { Card, CardContent, CardDescription, CardHeader, CardTitle } from '@/components/ui/card'\nimport { Progress } from '@/components/ui/progress'\nimport { Separator } from '@/components/ui/separator'\nimport { Table, TableBody, TableCell, TableHead, TableHeader, TableRow } from '@/components/ui/table'\n\nexport function InsuranceEligibilityChecker({ className }: { className?: string }) {\n const [isVerifying, setIsVerifying] = React.useState(false)\n const [lastVerifiedText, setLastVerifiedText] = React.useState('Active Coverage · Verified Today at 09:15 AM')\n\n const handleReverify = () => {\n if (isVerifying) return\n setIsVerifying(true)\n setTimeout(() => {\n setIsVerifying(false)\n const now = new Intl.DateTimeFormat('en-US', {\n hour: '2-digit',\n minute: '2-digit',\n second: '2-digit',\n hour12: true,\n }).format(new Date())\n setLastVerifiedText(`Active Coverage · Verified Real-time at ${now}`)\n }, 750)\n }\n\n return (\n \n {/* Header: Patient Demographics & Real-time Eligibility Status */}\n
\n
\n {/* Top Row: Title & Real-time Action */}\n
\n
\n
\n
\n \n
\n

\n Insurance Eligibility & Benefits Verifier\n

\n
\n

\n Real-time EDI 270/271 electronic benefit eligibility inquiry, deductible accumulators, and coverage\n limits.\n

\n
\n\n
\n \n \n {isVerifying ? 'Verifying EDI 270...' : 'Re-verify Real-time'}\n \n
\n
\n\n \n\n {/* Patient & Primary Payer Profile Details */}\n
\n {/* Patient Demographics */}\n
\n
\n \n Patient Name & DOB\n
\n

David Chen

\n

DOB: 1978-10-14 (48 yrs · Male)

\n
\n\n {/* Primary Payer / Plan */}\n
\n
\n \n Insurance Payer & Plan\n
\n

BlueCross BlueShield

\n

PPO - Choice Plus Network

\n
\n\n {/* Member & Group ID */}\n
\n
\n \n Member & Policy ID\n
\n

#BCBS-98421094

\n

Group: GRP-88204-01 · Plan #902

\n
\n\n {/* Verification Status Badge */}\n
\n
\n \n Verification Status\n
\n
\n \n \n {lastVerifiedText}\n \n
\n

\n Trace: EDI-271-99842 · Effective: Jan 01, 2026 – Dec 31, 2026\n

\n
\n
\n
\n
\n\n {/* 4 Primary Benefit Cards */}\n
\n {/* Card 1: Individual Deductible */}\n \n \n
\n \n Individual Deductible\n \n \n In-Network\n \n
\n
\n
\n $1,200.00\n / $2,500.00 met\n
\n \n $1,300.00 remaining in plan year\n \n
\n \n \n
\n
\n Accumulator Met\n 48%\n
\n \n

\n Family Deductible: $2,400.00 / $5,000.00 met (48%)\n

\n
\n \n \n\n {/* Card 2: Out-of-Pocket Maximum */}\n \n \n
\n \n Out-of-Pocket Maximum\n \n \n Annual Max\n \n
\n
\n
\n $2,800.00\n / $6,000.00 met\n
\n \n $3,200.00 until 100% plan\n liability\n \n
\n \n \n
\n
\n Accumulator Met\n 46%\n
\n \n

\n Includes deductibles, copays & Rx coinsurance\n

\n
\n \n \n\n {/* Card 3: Primary Care Copay */}\n \n \n
\n \n Primary Care Copay\n \n \n No Deductible\n \n
\n
\n
\n $25.00\n copay\n
\n No deductible required prior to copay benefit\n
\n \n \n
\n
\n \n Designated PCP In-Network\n
\n

$0.00 copay for annual preventive wellness checkups

\n
\n \n \n\n {/* Card 4: Specialist Copay */}\n \n \n
\n \n Specialist Copay\n \n \n PA Required\n \n
\n
\n
\n $50.00\n copay\n
\n Prior authorization required for select procedures\n
\n \n \n
\n
\n \n Direct Specialist Access\n
\n

No primary care physician (PCP) referral required

\n
\n \n \n
\n\n {/* Detailed Coverage Category Breakdown Table */}\n \n \n
\n
\n
\n \n Detailed Coverage Category Breakdown\n
\n \n Schedule of in-network vs out-of-network patient cost-sharing, authorization rules, and annual benefit\n limits.\n \n
\n \n Updated via ANSI 835/271\n \n
\n \n \n
\n \n \n \n Service Category\n In-Network Coverage\n Out-of-Network Coverage\n Prior Authorization (PA)\n Annual Limits & Copay\n \n \n \n {/* Row 1: Preventive Care */}\n \n \n
\n
\n \n
\n
\n

Preventive Care

\n

\n Annual wellness exams, biometric screenings, routine adult & pediatric immunizations,\n mammograms.\n

\n
\n
\n \n \n
\n 100% covered\n \n $0 Deductible & Copay\n \n
\n \n \n
\n 60% of UCR\n

Subject to out-of-network deductible

\n
\n \n \n
\n \n Not Required\n
\n

Direct access without pre-certification

\n \n \n
\n

$0.00 copay

\n

Unlimited annual wellness visits

\n
\n \n \n\n {/* Row 2: Specialist Visits */}\n \n \n
\n
\n \n
\n
\n

Specialist Visits

\n

\n Cardiology, neurology, physical & occupational therapy, diagnostic imaging, and outpatient\n consultations.\n

\n
\n
\n \n \n
\n 80% after deductible\n

$50.00 office visit copay

\n
\n \n \n
\n 60% of UCR\n

Balance billing applies above UCR

\n
\n \n \n
\n \n Required for Procedures\n
\n

PA required for MRI, CT scans & surgery

\n \n \n
\n

$50.00 copay

\n

Max 30 PT visits / calendar year

\n
\n \n \n\n {/* Row 3: Urgent Care & ER */}\n \n \n
\n \n
\n
\n

Urgent Care & ER

\n

\n Emergency department trauma evaluation, hospital triage, advanced imaging, and walk-in urgent\n clinics.\n

\n
\n \n \n
\n 100% after copay\n

$100 Urgent / $350 ER + 20%

\n
\n \n \n
\n \n Emergency: In-Network Rate\n \n

Prudent Layperson Standard (ACA)

\n
\n \n \n
\n \n Exempt for Emergency\n
\n

Notification requested within 48h

\n \n \n
\n

$100.00 / $350.00

\n

ER copay waived if admitted

\n
\n \n \n\n {/* Row 4: Prescription Drug Tiers */}\n \n \n
\n
\n \n
\n
\n

Prescription Drug Tiers

\n

\n Tier 1 Generic, Tier 2 Preferred Brand, Tier 3 Non-Preferred Brand, Tier 4 Specialty\n Biologics.\n

\n
\n
\n \n \n
\n Tier 1–3 Copay / T4 20%\n

T1: $10 · T2: $35 · T3: $70

\n
\n \n \n
\n Not Covered\n

Participating retail & mail order only

\n
\n \n \n
\n \n Step Therapy / PA\n
\n

Mandatory PA for Tier 4 Specialty

\n \n \n
\n

$10.00 – $70.00

\n

$3,500.00 Rx Annual OOP Max

\n
\n \n \n \n
\n
\n \n \n\n {/* Secondary Insurance / Coordination of Benefits (COB) Card */}\n \n \n
\n
\n
\n \n \n Secondary Insurance & Coordination of Benefits (COB)\n \n
\n \n Medicare secondary payor rules and automated electronic crossover claims coordination.\n \n
\n \n Automatic Crossover Active\n \n
\n \n \n
\n {/* Secondary Payer */}\n
\n

Secondary Payer

\n

Medicare Part B (CMS)

\n

Medical Insurance

\n
\n\n {/* Policy & HICN Number */}\n
\n

Secondary Policy / MBI

\n

#MED-9023411-B

\n

Coordination: Secondary Payor

\n
\n\n {/* Part B Deductible */}\n
\n

Medicare Part B Deductible

\n

$240.00 / $240.00 met

\n

100% Deductible Satisfied

\n
\n\n {/* Secondary Benefit Coverage */}\n
\n

Secondary Cost Sharing

\n

20% Coinsurance Balance

\n

Covers patient gap liability

\n
\n
\n\n {/* Coordination of Benefits EDI Advice Banner */}\n
\n \n
\n

Automated 837P / EDI-271 Crossover Agreement (COBA)

\n

\n Primary claims processed by BlueCross BlueShield automatically transmit to Medicare for secondary\n adjudication. No manual paper secondary submission is required for eligible in-network clinical\n encounters.\n

\n
\n
\n \n \n \n )\n}\n\nexport default InsuranceEligibilityChecker\n", "type": "registry:block", "target": "~/components/blocks/InsuranceEligibilityChecker.tsx" } ], "dependencies": [ "lucide-react" ], "devDependencies": [], "registryDependencies": [ "https://uipkge.dev/r/react/badge.json", "https://uipkge.dev/r/react/button.json", "https://uipkge.dev/r/react/card.json", "https://uipkge.dev/r/react/progress.json", "https://uipkge.dev/r/react/separator.json", "https://uipkge.dev/r/react/table.json" ], "description": "Real-time health insurance eligibility and benefits verification dashboard: patient member demographics, active payer status, individual deductible and out-of-pocket maximum progress trackers, primary care and specialist copay benefit cards, category-level coverage breakdown table with in/out-of-network rates, and Medicare secondary coordination of benefits.", "categories": [ "healthcare", "app" ] }