AuthReview

::: tip Description An Authorization Review Request is generated when a provider requests authorization for a referral from a payer or other third party. 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/authreview.

Async REST API Endpoint to call the API: https://{base_url}/api/v1/endpoint.

Data Model JSON for AuthReview

AuthReview - Sample Payload

{
   "Meta": {
      "DataModel": "Referral",
      "EventType": "AuthReview",
      "EventDateTime": "2022-08-16T14:21:20.733Z",
      "Test": true,
      "Source": {
         "ID": "c3a4c989-3f50-46d1-bde2-d273cc64b31d",
         "Name": "EHR Bridge Dev Tools"
      },
      "Destinations": [
         {
            "ID": "c22b3f8f-80a6-4b88-a010-2fe5c439a426",
            "Name": "Destinations EMR"
         }
      ],
      "Logs": [
         {
            "ID": "2014d305-87c5-4b98-9e53-db3c071b6aff",
            "AttemptID": "7a93a3f8-5be1-4158-ae46-9099b846280f"
         }
      ],
      "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
   },
   "Authorization": {
      "Request": {
         "ID": "4356789876",
         "IDType": null
      },
      "AlternateID": "2133311",
      "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": [],
      "Diagnoses": [],
      "Notes": [],
      "Services": [
         {
            "Code": "400500400",
            "Codeset": "CPT4",
            "Description": "Therapy Referral",
            "RevenueCode": null,
            "Quantity": {
               "Value": "1",
               "Units": "Visit"
            },
            "Modifiers": [],
            "ServiceDate": null,
            "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": "500 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": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
            "IDType": "EHRID"
         },
         {
            "ID": "a1d4ee8aba494ca",
            "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": "+18088675301",
            "Office": null,
            "Mobile": null
         },
         "EmailAddresses": [],
         "Language": "en",
         "Citizenship": [],
         "Address": {
            "StreetAddress": "1223 Hill Street",
            "City": "San Jose"",
            "State": "CA",
            "ZIP": "53566",
            "County": "Santa Clara",
            "Country": "USA"
         }
      },
      "Notes": [],
      "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": "+18089541123"
            },
            "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
               }
            }
         }
      ]
   }
}