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The benefit verification flow determines medication coverage and whether a prior authorization is required. It has one event type: benefit_verification.status_change. See Webhooks to configure an endpoint and understand the shared delivery envelope, signature verification, retries, and processing guidance.

When webhooks are sent

benefit_verification.status_change

This event represents the terminal customer-facing result, not every attempt made to obtain it. Inspect:
  • data.status;
  • data.error when the verification failed;
  • data.drugs for coverage, PA requirements, and cost-sharing results;
  • data.patient_coverage_status; and
  • data.pharmacy_benefit_manager_name, data.patient_plan_fund_source, and data.patient_coverage_type when available.
The webhook’s data object matches the resource returned in the data field of GET /benefit-verification/. Use that endpoint to retrieve the latest complete benefit verification.