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Patient on a telehealth video visit with his clinician
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Roles
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FOR PRODUCT & ENGINEERING

Build insurance intake with less payer logic to maintain

Sohar finds coverage, interprets benefits for the service you provide and checks network status, while your team controls the patient experience

96%
verification accuracy
15M+
eligibility requests a year
95%+
benefits accuracy
8x
ROI within twelve months
What Product & Engineering leaders are up against

Insurance logic is a product you never meant to build

Payer responses need interpretation before you can use them in a patient experience

Connecting Discovery, Verification and Network Status means managing several requests, their results and the exceptions between them

Payer changes, incomplete benefits and slow responses create ongoing maintenance for your engineering team

Testing, provider setup and security review all need to fit your launch plan

How Sohar helps Product & Engineering teams

Insurance answers through one integration

01

Insurance logic maintained by Sohar

Sohar handles payer interpretation for coverage, benefits and network status. Your team controls when requests run and how results appear

02

Relevant benefits

Retrieve eligibility and benefits for your specified specialty and care setting

03

Maintained payer rules

Reduce the routing, filtering and exception logic your team maintains

04

Connected workflows

Coordinate requests and define next steps when more information is needed

05

Clear result handling

Use webhook updates to distinguish pending requests, ineligible results and input errors

06

Recovery built into the service

Sohar manages retries and alternative connection routes where available, reducing recovery work for your team

Relevant solutions for Product & Engineering

Build with the pieces you need

01

Verification API

Check eligibility and benefits for the service you provide

Dashboard
Network Status
Flows
Payers
Payer Status
Analytics
Create Verification
7c41e2a9
J. RIVERA
Summit BlueCare
complete.eligible
Oct 6, 3:44 PM
6b0f13d4
M. OKAFOR
Harbor Health Plan
complete.eligible
Oct 6, 3:44 PM
5e88a0c7
D. LINDQVIST
Summit BlueCare
pending
Oct 6, 3:44 PM
4a19c6f2
S. PATEL
Northfield Mutual
complete.eligible
Oct 6, 3:44 PM
3d2b7e55
A. MORENO
Harbor Health Plan
complete.ineligible
Oct 6, 3:44 PM
2c90f1b8
K. NAKAMURA
Summit BlueCare
complete.eligible
Oct 6, 3:44 PM
1f7a44c3
T. BECKER
Northfield Mutual
complete.eligible
Oct 6, 3:44 PM
02

Discovery API

Search for coverage from patient details

J. RIVERA
complete.eligible
Detail
Benefits
Network
Copay
Coins.
Deductible left
In Network
$30.00
20%
$850.00
Out of Network
–
50%
$2,000.00
Place of service
02 · Telehealth
Resolved in
7.3s
03

Network Status

Check whether coverage is in network for the relevant provider context

No card needed
Discovery
Verified
Coverage found
Recovered after a failed request
Payer
Summit BlueCare
Matched from patient details
Member ID
•••• 4821
Network
In-network
Verified and ready to book
04

Cost Estimate

Estimate patient responsibility from benefits and your contracted rates

Shown before booking
Patient estimate
Verified
You owe $30
Therapy visit · In person
Estimate
$30.00
Copay applied, deductible met
Network
In-network
Coinsurance
0%
Customer stories for Product & Engineering

Results from teams like yours

Patient checking in on a tablet at a clinic front desk
Tava

Tava implemented Sohar in about three weeks of one engineer's time and reported a 90% reduction in engineering maintenance requirements. “They solve a very real and complex challenge that most businesses just don't need to waste time taking on as a core strategy.” Joe Wiggins, Head of Engineering, Tava

Read case study

Frequently asked questions

How long does integration take?

Integration time depends on your workflow, data and testing requirements. Tava implemented Sohar in about three weeks of one engineer's time. Start with a defined workflow, agree the inputs and result handling, and test it before adding more triggers. Work with Sohar on payer mapping, provider setup and how results connect to your patient or appointment records.

What does the API return?

Structured JSON for the API you call, such as discovered coverage, eligibility and benefits, or network status. Verification uses the specialty and care setting you specify to identify relevant benefits. Available fields depend on the endpoint and payer data.

Do we need to build our own payer connections?

No. Sohar maintains payer connectivity and insurance logic. Your team supplies the required inputs, handles results and decides what happens in your application.

Is Sohar HIPAA compliant?

Yes. Sohar is HIPAA compliant and has a SOC 2 Type II report. Sohar signs BAAs and handles PHI under HIPAA requirements.

Is there a sandbox?

Yes. Use sandbox credentials and documented test values to exercise supported outcomes before going live. Use production credentials for live requests.

What happens when a request cannot be completed immediately?

Your application can show that the request is still processing and receive an update when the result is ready. Use the returned status to decide whether to continue, request corrected information or route the case for review. Pending, ineligible and input error results need different handling.

What happens if Discovery does not find coverage?

Ask the patient for their insurance details or route the case for review.

How does Sohar check the accuracy of benefits data?

Where remittance data is available and can be matched to a verification, Sohar compares the returned benefits with the payer's adjudicated claim data. We use discrepancies to identify improvements to our payer rules. Benefits information is not a guarantee of the final claim outcome.

See how Sohar fits your intake flow

View API Docs / Book a Demo