AuthResponse
Description
An Authorization Review Response is generated by a payer or other third party after reviewing an authorization request. Note that the Referral object is deprecated and the Authorization object is now preferred for authorization-related information.
API endpoints for
Sync REST API Endpoint to call the API: https://{base_url}/api/v1/referral/authresponse.
Async REST API Endpoint to call the API: https://{base_url}/api/v1/endpoint.
Data Model JSON for AuthResponse
AuthResponse - Sample Payload
{
"Meta": {
"DataModel": "Referral",
"EventType": "AuthResponse",
"EventDateTime": "2022-08-16T14:21:20.733Z",
"Test": true,
"Source": {
"ID": "e0839a82-0862-4307-954a-bd3d436f739e",
"Name": "EHR Bridge Dev Tools"
},
"Destinations": [
{
"ID": "b0b9ea2b-5f25-4b81-832c-8b3281843d3a",
"Name": "Destinations EMR"
}
],
"Logs": [
{
"ID": "00313f27-7840-422a-82b7-e87f0bf61fbe",
"AttemptID": "bb752ad1-6dec-4fcb-b3d6-9f1e2bd233e0"
}
],
"Message": {
"ID": 5565
},
"Transmission": {
"ID": 12414
},
"FacilityCode": null
},
"Referral": {
"ID": null,
"IDType": null,
"AlternateID": null,
"Type": null,
"Category": null,
"Priority": null,
"Status": null,
"DateTime": null,
"ExpirationDateTime": null,
"ProcessDateTime": null,
"Reason": null,
"ProviderSpecialty": null,
"DepartmentSpecialty": null,
"Notes": [],
"Authorization": {
"Plan": {
"ID": null,
"IDType": null,
"Name": null
},
"Company": {
"ID": null,
"IDType": null,
"Name": null
},
"DateTime": null,
"ExpirationDateTime": null,
"Number": null,
"ReimbursementLimit": null,
"RequestedTreatmentCount": null,
"RequestedTreatmentUnits": null,
"AuthorizedTreatmentCount": null,
"Notes": []
},
"Diagnoses": [],
"Procedures": [],
"Providers": [],
"Visit": {
"VisitNumber": null
},
"ServiceLocation": null,
"RequestType": null,
"RelatedCause": null,
"StatusReason": null
},
"Authorization": {
"Request": {
"ID": "4356789876",
"IDType": null
},
"AlternateID": "2133311",
"Number": "AB668876",
"Type": "Professional",
"Category": "Procedure",
"CertificationCode": "Initial",
"ServiceType": "Medical Care",
"ServiceLocation": "On Campus - Outpatient Hospital",
"RelatedCause": null,
"ServiceLevel": null,
"EventDate": "2021-05-25",
"Quantity": {
"Value": "1",
"Units": "Visit"
},
"AdmissionSource": null,
"AdmissionType": null,
"AdditionalDates": [],
"Decision": "Certified",
"DecisionReason": null,
"IssueDate": null,
"EffectiveDate": "2021-05-01",
"ExpirationDate": "2021-07-01",
"Diagnoses": [],
"Notes": [],
"Services": [
{
"Code": "400500400",
"Codeset": "CPT4",
"Description": "Therapy Referral",
"RevenueCode": null,
"Quantity": {
"Value": "1",
"Units": "Visit"
},
"Modifiers": [],
"ServiceDate": null,
"AuthorizationNumber": "VVS12345",
"Decision": "Certified",
"DecisionReason": null,
"IssueDate": null,
"EffectiveDate": "2021-05-01",
"ExpirationDate": "2021-07-01",
"Notes": []
}
],
"Providers": [
{
"ID": "4236464757",
"IDType": "NPI",
"FirstName": "John",
"LastName": "Marker",
"Credentials": [
"DO"
],
"Address": {
"StreetAddress": "500 First St.",
"City": "San Jose"",
"State": "CA",
"ZIP": "63105",
"County": "Santa Clara",
"Country": "USA"
},
"EmailAddresses": [],
"PhoneNumber": {
"Office": null
},
"Type": "Referring Provider",
"ContactInfo": null,
"Location": {
"Type": null,
"Facility": null,
"Department": null,
"Room": null
}
},
{
"ID": "4236567757",
"IDType": "NPI",
"FirstName": null,
"LastName": "East Street Hospital",
"Credentials": [],
"Address": {
"StreetAddress": "400 First St.",
"City": "San Jose"",
"State": "CA",
"ZIP": "63105",
"County": "Santa Clara",
"Country": "USA"
},
"EmailAddresses": [],
"PhoneNumber": {
"Office": null
},
"Type": "Service Facility",
"ContactInfo": null,
"Location": {
"Type": null,
"Facility": null,
"Department": null,
"Room": null
}
}
]
},
"Patient": {
"Identifiers": [
{
"ID": "0000000001",
"IDType": "MR"
},
{
"ID": "8ec2cb43-d536-43cc-82cf-3a82b1311169",
"IDType": "EHRID"
},
{
"ID": "c1a91dad-01c3-4c0a-84dc-7162a1b89d7f",
"IDType": "NIST"
}
],
"Demographics": {
"FirstName": "John",
"MiddleName": "F",
"LastName": "Marker",
"DOB": "2008-01-06",
"SSN": "101-01-0001",
"Sex": "Male",
"Race": "White",
"IsHispanic": null,
"Religion": null,
"MaritalStatus": "Single",
"IsDeceased": null,
"DeathDateTime": null,
"PhoneNumber": {
"Home": "+18067675301",
"Office": null,
"Mobile": null
},
"EmailAddresses": [],
"Language": "en",
"Citizenship": [],
"Address": {
"StreetAddress": "2345 Hill Street",
"City": "San Jose"",
"State": "CA",
"ZIP": "53566",
"County": "Santa Clara",
"Country": "USA"
}
},
"Notes": [],
"Contacts": [
{
"FirstName": "Gracy",
"MiddleName": null,
"LastName": "Marker",
"Address": {
"StreetAddress": "4762 Hill Street",
"City": "San Jose"",
"State": "CA",
"ZIP": "53566",
"County": "Santa Clara",
"Country": "USA"
},
"PhoneNumber": {
"Home": "+18078675303",
"Office": "+170907543758",
"Mobile": "+19165368865"
},
"RelationToPatient": "Mother",
"EmailAddresses": [
"gracy.marker@test.net"
],
"Roles": [
"Emergency Contact"
]
}
],
"Insurances": [
{
"Plan": {
"ID": "31572",
"IDType": "Payor ID",
"Name": "HMO Plan",
"Type": null
},
"MemberNumber": null,
"Company": {
"ID": "60054",
"IDType": null,
"Name": "aetna (60054 0131)",
"Address": {
"StreetAddress": "PO Box 14080",
"City": "San Jose"",
"State": "CA",
"ZIP": "40512-4079",
"County": "Santa Clara",
"Country": "USA"
},
"PhoneNumber": "+18789541123"
},
"GroupNumber": "847025-024-0009",
"GroupName": "Digitech Labs",
"EffectiveDate": "2015-01-01",
"ExpirationDate": "2020-12-31",
"PolicyNumber": "9140860055",
"Priority": null,
"AgreementType": null,
"CoverageType": null,
"Insured": {
"Identifiers": [],
"LastName": null,
"MiddleName": null,
"FirstName": null,
"SSN": null,
"Relationship": null,
"DOB": null,
"Sex": null,
"Address": {
"StreetAddress": null,
"City": null,
"State": null,
"ZIP": null,
"County": null,
"Country": null
}
}
}
]
}
}