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API integration

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API integration

Uploaded by

amazein.tracking
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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To integrate with MetLife Gulf's API for insurance claim processing in Dubai, follow these

steps to ensure a smooth and secure integration.

Step 1: Get API Access from MetLife Gulf


📄 Contact MetLife Gulf

 Reach out to MetLife Gulf’s IT or API integration team to request API access.
 Submit a formal application detailing:
o Your company’s profile and services.
o The purpose of the integration (e.g., claim submission, status tracking, etc.).
o Security and compliance adherence (especially to DHA and eClaimLink
regulations).

Step 2: Obtain API Credentials


Upon approval, MetLife will provide:

 API Base URL: Sandbox and Production URLs.


 Client ID & Secret Key: For OAuth 2.0 authentication.
 API Key (if applicable): For additional security.

Step 3: API Authentication with OAuth 2.0


MetLife’s APIs generally use OAuth 2.0 for secure authentication.

✅ Get Access Token

 Endpoint: /oauth/token
 Method: POST
 Headers:

{
"Content-Type": "application/json",
"Authorization": "Basic <base64(client_id:client_secret)>"
}

 Request Body:
{
"grant_type": "client_credentials"
}

 Response:

{
"access_token": "eyJhbGciOiJIUzI1NiIs...",
"expires_in": 3600
}

✅ Store the access_token securely and use it for all API requests.

Step 4: API Endpoints for Claim Processing


📋 1. Submit Claim API

 Endpoint: /claims/submit
 Method: POST
 Headers:

{
"Content-Type": "application/json",
"Authorization": "Bearer <access_token>"
}

 Request Body Example:

{
"patient_id": "P12345",
"policy_number": "DUB-987654",
"claim_type": "outpatient",
"provider_id": "HOSP123",
"invoice_details": [
{
"service_code": "LAB001",
"amount": 500,
"currency": "AED"
}
],
"documents": [
{
"file_name": "lab_report.pdf",
"file_type": "application/pdf",
"file_data": "<base64_encoded_file>"
}
]
}
 Response:

{
"status": "success",
"claim_id": "CLM12345",
"message": "Claim submitted successfully"
}

2. Check Claim Status API

 Endpoint: /claims/status
 Method: GET
 Query Parameters:

claim_id=CLM12345

 Headers:

{
"Authorization": "Bearer <access_token>"
}

 Response:

{
"claim_id": "CLM12345",
"status": "approved",
"amount_approved": 450,
"currency": "AED",
"processing_stage": "finalized"
}

3. Pre-Authorization API (if required)

For high-cost treatments, pre-authorization may be necessary.

 Endpoint: /claims/preauthorize
 Method: POST
 Request Body:

{
"patient_id": "P12345",
"policy_number": "DUB-987654",
"procedure_code": "SURG001",
"estimated_cost": 10000,
"provider_id": "HOSP123"
}
 Response:

{
"status": "approved",
"authorization_id": "AUTH456",
"valid_until": "2025-03-31"
}

Step 5: Integrate with eClaimLink for Regulatory


Compliance
Since all health claims in Dubai must comply with DHA (Dubai Health Authority) regulations,
they need to be submitted through eClaimLink.

eClaimLink API Steps:

1. Apply for eClaimLink API Access:


o Contact the DHA and register as a provider or TPA.
2. Get API Credentials:
o Receive credentials to access eClaimLink.
3. Map JSON to XML:
o eClaimLink accepts XML format for claim submissions.
4. Submit Claims via eClaimLink:
o Use MetLife’s API to submit claims and forward the claim details to eClaimLink.

Step 6: Testing in Sandbox Environment


1. Test API Endpoints:
o Submit test claims using MetLife’s sandbox URL.
o Validate all success and error scenarios.
2. Error Handling:
o Handle response codes:
 200 OK – Success.
 400 Bad Request – Invalid data.
 401 Unauthorized – Invalid token.
 500 Internal Server Error – Retry mechanism.

Step 7: Deploy and Monitor in Production


1. Switch to Production URL:
o Migrate from sandbox to live API.
o Update credentials with production keys.
2. Real-time Monitoring:
o Use logging and monitoring tools to track API health and claim statuses.

MetLife API Workflow Diagram


[Client App] --> [OAuth 2.0 Auth Request] --> [MetLife API Gateway] --> [Token
Issued]
[Client App] --> [Claim Submission API] --> [MetLife Claims System]
[MetLife Claims System] --> [eClaimLink] --> [DHA Approval]
[Client App] --> [Claim Status API] --> [MetLife Claims System]

Tech Stack Recommendations


 Backend: Python (Flask/Django), Node.js, or Java (Spring Boot)
 Frontend (if required): React / Angular
 Security: OAuth 2.0, JWT, HTTPS
 Database: MongoDB / PostgreSQL (for storing claim data locally)

Pro Tip:
If you’re integrating with multiple insurers/TPAs, consider creating a middleware API to
handle different API formats and endpoints.

API Documentation Request:


To get MetLife Gulf’s API documentation, email:

 📧 Email: [MetLife Gulf Customer Support or IT Department]


 📞 Contact: Reach out through their business helpline.

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