> ## Documentation Index > Fetch the complete documentation index at: https://docs.develophealth.ai/llms.txt > Use this file to discover all available pages before exploring further. # Retrieve Prior Authorization Retrieve details of a specific prior authorization request. ## Response handling Use `data.status` for the overall PA lifecycle and the activity, outcome, and nested fields for more specific signals. See [Prior Authorization Response Handling](/api-reference/prior-authorization/response-handling) for lifecycle states, activity semantics, request error codes, terminal exceptions, and recommended caller behavior. ## OpenAPI ````yaml get /prior-authorization/{id} openapi: 3.1.0 info: title: Develop Health Public API description: Develop Health Public API version: '1.0' servers: - url: https://api.develophealth.ai security: [] paths: /prior-authorization/{id}: get: tags: - public-api summary: Get Prior Auth Submission By Id operationId: get_prior_auth_submission_by_id_prior_authorization__id__get parameters: - name: id in: path required: true schema: type: string title: Id responses: '200': description: Successfully returned a prior authorization content: application/json: schema: $ref: '#/components/schemas/GetPriorAuthResponse' example: status: success data: id: pa_sdkfj3f object: prior_authorization url: >- https://platform.develophealth.ai/prior-authorizations/pa_sdkfj3f status: completed diagnoses: - code: E66.9 evidence: - content: bmi_value: 32 date_measured: '2023-11-10' date_created: '2023-11-10T10:15:00' title: BMI Chart - content: medication_name: Metformin response: No significant weight loss date_created: '2023-11-10T10:15:00' title: Previous Medication History patient: address: street: 123 Health St. city: Wellness state_province: CA zip_postal_code: '12345' country: USA date_of_birth: '1980-01-01' email: johndoe@email.com first_name: John last_name: Doe gender: male internal_id: '123456' phone: 123-456-7890 insurance: - scanned_content: client_name: Company group_number: '12345678' member_name: John Doe member_number: '12345678' payer_name: United plan_name: Plus Plan rx_bin: '123456' rx_group: ADV rx_pcn: FAC discrete_content: {} url: https://example.com/insurance_doc - scanned_content: error: Unable to extract information from card discrete_content: {} url: https://example.com/insurance_doc2 prescription: days_supply: 30 quantity: 2 directions: Inject subcutaneously once a week drug_name: Wegovy strength: 0.25 mg/0.5 mL (0.25 mg dose) dose_form: injectable route_of_administration: subcutaneous extra: prescribing_information: >- Prescribed for weight management in patients with obesity prescription_date: '2024-02-14T05:46:07.764000' provider: address: street: 456 Care Blvd. city: Healtown state_province: CA zip_postal_code: '67890' country: USA fax: 987-654-3211 first_name: Alice internal_id: provider_12345 last_name: Smith npi: '1234567890' phone: 987-654-3210 pharmacy: name: Walgreens address: street: 789 Pharmacy Ave. city: Medtown state_province: MD zip_postal_code: '12345' country: USA questionnaires: - questions: - answer: >- I usually eat a balanced diet and exercise 3 times a week. question: >- Please describe your current diet and exercise routine. - answer: >- Yes, I have tried metformin without significant results. question: >- Have you previously tried other weight loss medications? date_created: '2023-11-01T08:00:00' visit_notes: - content: >- Patient presents with a BMI of 32, indicating obesity. Recommended to start Wegovy for weight management. date_created: '2023-11-10T10:00:00' activity_log: - id: sent_fax__S4382DA created_at: '2024-02-14T02:01:02' type: sent_fax details: url: https://example.com/sent_fax - id: rec_fax__SJ34WX created_at: '2024-02-14T05:46:07' type: received_fax details: url: https://example.com/received_fax - id: pa_follow_up_call__BF9AJ56 created_at: '2024-02-14T05:50:10' type: follow_up_call details: notes: Called Example PBM and ... recording_url: https://example.com/follow_up_call_recording transcript: Hello, this is Example PBM ... submitted_by: first_name: John last_name: Doe email: johndoe@email.com reviewed_by: first_name: Jane last_name: Doe email: janedoe@email.com denial_reason_analysis: categories: - Preferred Products Not Tried First explanation: >- The prior authorization request for Zepbound (tirzepatide) was denied because the patient's health plan requires ... next_steps_code: other next_steps: Discuss with Provider next_steps_explanation: >- The denial was due to the requirement to try a primary covered drug, Wegovy, before Zepbound can be approved. The client should discuss with the provider ... is_appeal: false patient_consent_required: false outcome: detail: Step Therapy Criteria Not Met result: Denied detail_code: step_therapy_criteria_not_met '422': description: Validation Error content: application/json: schema: $ref: '#/components/schemas/HTTPValidationError' security: - FronteggJWTAuthentication: [] components: schemas: GetPriorAuthResponse: properties: status: anyOf: - type: string enum: - success - type: string enum: - error title: Status default: success error: $ref: '#/components/schemas/ApiError' data: allOf: - $ref: '#/components/schemas/GetPriorAuthResponseData' title: Data description: >- Contains the data from your prior authorization request, or None if an error occurred. type: object title: GetPriorAuthResponse description: >- Represents the response structure for a GET /prior-authorization/:id request. This class extends the generic ApiResponse, specifically tailored to handle responses related to prior authorizations. It primarily includes the data attribute, which holds detailed information about the benefit verification process and its results. HTTPValidationError: properties: detail: items: $ref: '#/components/schemas/ValidationError' type: array title: Detail type: object title: HTTPValidationError ApiError: properties: title: type: string title: Title description: type: string title: Description code: type: string title: Code type: object required: - title - description - code title: ApiError GetPriorAuthResponseData: properties: id: type: string title: Id description: The ID of this prior authorization object: type: string enum: - prior_authorization title: Object description: >- The type of object. This will always be 'prior_authorization', from this endpoint, but this can be helpful for differentiating between different types of objects when parsing webhook responses. default: prior_authorization url: type: string title: Url description: The URL where the Prior Authorization can be viewed. status: allOf: - $ref: '#/components/schemas/PriorAuthRequestStatus' description: The current status of the prior auth request. diagnoses: items: $ref: '#/components/schemas/Diagnosis' type: array title: Diagnoses description: Clinical diagnoses for the patient in ICD-10 format. i.e. 'E66.9' evidence: items: $ref: '#/components/schemas/ResponseEvidenceItem' type: array title: Evidence description: >- A collection of evidence items supporting the authorization request. Any other supporting evidence that doesn't fit into one of the explicitly declared fields above can be added here. patient: allOf: - $ref: '#/components/schemas/Patient' title: Patient description: Demographic information for the patient insurance: items: $ref: '#/components/schemas/InsuranceDocumentInfo' type: array title: Insurance description: Array of insurance documents. prescription: allOf: - $ref: '#/components/schemas/Prescription' title: Prescription description: >- Information regarding the prescription this prior authorization is being created for. provider: allOf: - $ref: '#/components/schemas/Provider' title: Provider description: Details of the healthcare provider who created the prescription. pharmacy: allOf: - $ref: '#/components/schemas/Pharmacy' title: Pharmacy description: >- Information about the pharmacy where the prescription will be filled. questionnaires: items: $ref: '#/components/schemas/Questionnaire' type: array title: Questionnaires description: >- List of questionnaires. This is the best place to send structured Q&A format data, such as intake forms, etc. visit_notes: items: $ref: '#/components/schemas/VisitNote' type: array title: Visit Notes description: List of visit notes. ndp_submission: allOf: - $ref: '#/components/schemas/PriorAuthRequestNDPSubmission' title: Ndp Submission description: >- Configuration for processing the prescription associated with this PA request. resubmission_info: allOf: - $ref: '#/components/schemas/PriorAuthRequestResubmissionInfo' title: Resubmission Info description: >- Information provided when resubmitting a prior authorization request. activity_log: items: oneOf: - $ref: '#/components/schemas/PriorAuthActivityLogSentFax' - $ref: '#/components/schemas/PriorAuthActivityLogReceivedFax' - $ref: '#/components/schemas/PriorAuthActivityLogFollowUpCall' discriminator: propertyName: type mapping: sent_fax: $ref: '#/components/schemas/PriorAuthActivityLogSentFax' received_fax: $ref: '#/components/schemas/PriorAuthActivityLogReceivedFax' follow_up_call: $ref: '#/components/schemas/PriorAuthActivityLogFollowUpCall' type: array title: Activity Log description: >- A list of activity log items for the prior authorization request. Note: additional item types will be added here in future, so please ensure that unknown types are ignored when parsing this array to avoid validation errors when new types are added. submitted_by: allOf: - $ref: '#/components/schemas/User' title: Submitted By description: The user who submitted the prior authorization request. reviewed_by: allOf: - $ref: '#/components/schemas/User' title: Reviewed By description: The user who reviewed the prior authorization request. eligibility_check_response: items: anyOf: - $ref: '#/components/schemas/EligibilityCheckResponseSuccessItem' - $ref: '#/components/schemas/EligibilityCheckResponseErrorItem' type: array minItems: 1 title: Eligibility Check Response description: >- Populated after the eligibility check has been made for the PA, if enabled real_time_benefits_check_response: allOf: - $ref: '#/components/schemas/RealTimeBenefitsCheckResponse' title: Real Time Benefits Check Response description: >- Populated after the real-time benefits check has been made for the PA, if enabled prescription_transfer: allOf: - $ref: '#/components/schemas/PrescriptionTransfer' title: Prescription Transfer description: Information about the prescription transfer status and attempts mock_result: anyOf: - $ref: '#/components/schemas/PriorAuthMockResultApproved' - $ref: '#/components/schemas/PriorAuthMockResultDenied' - $ref: '#/components/schemas/PriorAuthMockResultOther' - $ref: '#/components/schemas/PriorAuthMockResultNotSubmitted' title: Mock Result description: >- The mock result of the prior authorization request, if one was provided in the initial request out_of_pocket_costs: items: $ref: '#/components/schemas/CopayOption' type: array title: Out Of Pocket Costs description: >- List of copay options with amounts in cents and supply duration in days denial_reason_analysis: allOf: - $ref: '#/components/schemas/DenialReasonAnalysis' title: Denial Reason Analysis description: >- Analysis of the denial reason(s). Populated when the prior authorization request has been denied. message_thread: allOf: - $ref: '#/components/schemas/PlatformMessageThread' title: Message Thread description: >- Message thread for this prior authorization, including whether it is resolved and its messages. triggered_benefit_verification_id: type: string title: Triggered Benefit Verification Id description: >- The ID of the benefit verification triggered by this PA request, if one was configured. is_appeal: type: boolean title: Is Appeal description: >- Whether this prior authorization request is an appeal of a previously denied PA. default: false patient_consent_required: type: boolean title: Patient Consent Required description: >- Whether the payer currently requires verbal patient consent for this prior authorization. default: false outcome: oneOf: - $ref: '#/components/schemas/PriorAuthSubmissionApprovalOutcome' - $ref: '#/components/schemas/PriorAuthSubmissionDenialOutcome' - $ref: '#/components/schemas/PriorAuthSubmissionOtherOutcome' - $ref: '#/components/schemas/PriorAuthSubmissionPendingOutcome' - $ref: '#/components/schemas/PriorAuthSubmissionNotSubmittedOutcome' title: Outcome description: Details of the outcome of the prior authorization request. discriminator: propertyName: result mapping: Approved: $ref: '#/components/schemas/PriorAuthSubmissionApprovalOutcome' Denied: $ref: '#/components/schemas/PriorAuthSubmissionDenialOutcome' Other: $ref: '#/components/schemas/PriorAuthSubmissionOtherOutcome' Pending: $ref: '#/components/schemas/PriorAuthSubmissionPendingOutcome' Not Submitted: $ref: '#/components/schemas/PriorAuthSubmissionNotSubmittedOutcome' type: object required: - id - url - status - diagnoses - patient - insurance - provider - outcome title: GetPriorAuthResponseData ValidationError: properties: loc: items: anyOf: - type: string - type: integer type: array title: Location msg: type: string title: Message type: type: string title: Error Type type: object required: - loc - msg - type title: ValidationError PriorAuthRequestStatus: type: string enum: - failed - not_submitted - processing - awaiting_review - awaiting_outcome - validating_outcome - completed - cancelled - awaiting_provider_response title: PriorAuthRequestStatus description: The status of a prior authorization request. Diagnosis: properties: code: type: string title: Code description: ICD-10 code for the diagnosis. i.e. 'E66.9' type: object required: - code title: Diagnosis description: Represents a medical diagnosis with a code and description. ResponseEvidenceItem: properties: asset: allOf: - $ref: '#/components/schemas/AssetResponse' title: Asset description: File asset containing the evidence. content: type: object title: Content description: >- Detailed content of the evidence, which varies based on the type of evidence. date_created: type: string format: date-time title: Date Created description: >- The date and time (if available) when the evidence was created. This is important for ensuring we have an accurate timeline of the patient's history. document_date: type: string format: date title: Document Date description: >- The clinical/source document date to display to reviewers, when known. This excludes ingestion/upload/export timestamps. title: type: string title: Title description: >- Title of the evidence. This will be shown to users in the platform UI so it's recommended to give it a name that would be meaningful to them, such as 'Intake Form' type: object required: - date_created - title title: ResponseEvidenceItem description: >- Represents an item of evidence, which can include an associated digital asset. Patient: properties: address: allOf: - $ref: '#/components/schemas/Address' title: Address description: The patient's postal address date_of_birth: type: string format: date title: Date Of Birth description: The patient's date of birth email: type: string format: email title: Email description: The patient's email address first_name: type: string minLength: 1 title: First Name description: The patient's first name last_name: type: string minLength: 1 title: Last Name description: The patient's last name gender: allOf: - $ref: '#/components/schemas/Gender' description: The patient's gender internal_id: type: string minLength: 1 title: Internal Id description: >- Your internal ID for this patient. This is used for linking all of the requests for a given patient. mrn: type: string title: Mrn description: Medical record number phone: type: string title: Phone description: The patient's phone number type: object required: - address - date_of_birth - first_name - last_name - gender - internal_id title: Patient description: Represents patient information. InsuranceDocumentInfo: properties: scanned_content: allOf: - $ref: '#/components/schemas/ScannedContent' title: Scanned Content description: >- An object containing details that were extracted from the insurance card images provided in the creation request. discrete_content: allOf: - $ref: '#/components/schemas/PartialInsuranceInfo' title: Discrete Content description: >- An object containing manually-provided insurance details from the creation request. url: type: string title: Url description: >- If applicable, the Base64 encoded insurance card image you send in the request is stored on our servers. A signed URL to the image is returned here. This URL has a short expiry time, so you should download the image immediately after receiving it if you want to view the asset. type: object required: - scanned_content - discrete_content title: InsuranceDocumentInfo Prescription: properties: days_supply: type: integer title: Days Supply description: The number of days the prescription will be expected to last. quantity: type: integer title: Quantity description: The quantity of the medication. directions: type: string minLength: 1 title: Directions description: Instructions on how the medication should be taken. drug_name: type: string minLength: 1 title: Drug Name description: The name of the medication. strength: type: string minLength: 1 title: Strength description: The strength of the medication. dose_form: allOf: - $ref: '#/components/schemas/DoseForm' description: The form of the medication. route_of_administration: allOf: - $ref: '#/components/schemas/RouteOfAdministration' description: The route of administration for the medication. extra: type: object title: Extra description: >- An optional dictionary containing additional information related to the drug or future prescription. expected_length_of_therapy: type: string title: Expected Length Of Therapy description: >- The expected length of therapy for the prescribed drug. Defaults to 'Until No Longer Needed' if not provided. examples: - Until No Longer Needed - 12 months - 6 weeks prescription_date: type: string format: date-time title: Prescription Date description: The date the prescription was issued type: object required: - days_supply - quantity - directions - drug_name - strength - dose_form - route_of_administration - prescription_date title: Prescription description: |- Represents a prescription issued by a healthcare provider. Prefer CodedPrescription when NDCs are available. Provider: properties: address: allOf: - $ref: '#/components/schemas/OptionalAddress' title: Address description: The provider's postal address. fax: type: string title: Fax description: The provider's fax number. first_name: type: string minLength: 1 title: First Name description: The provider's first name. internal_id: type: string title: Internal Id description: >- Your internal ID for this provider. This is used for linking all of the requests for a given provider. last_name: type: string minLength: 1 title: Last Name description: The provider's last name. npi: type: string minLength: 1 title: Npi description: The provider's NPI. phone: type: string title: Phone description: The provider's phone number. type: object required: - address - first_name - last_name - npi title: Provider description: Represents a healthcare provider. Pharmacy: properties: name: type: string minLength: 1 title: Name description: The name of the pharmacy. address: $ref: '#/components/schemas/Address' type: object required: - name title: Pharmacy description: |- Represents a pharmacy. Attributes: name (str): The name of the pharmacy. address (Address): The pharmacy's postal address. Questionnaire: properties: questions: items: $ref: '#/components/schemas/Question' type: array title: Questions description: A list of questions included in the questionnaire. date_created: type: string format: date-time title: Date Created description: >- The date and time when the questionnaire was answered. This is important for ensuring we have an accurate timeline of the patient's history. type: object required: - questions - date_created title: Questionnaire VisitNote: properties: title: type: string minLength: 1 title: Title description: >- The title of the visit note. This is optional and can be used to give the note a meaningful name, such as 'Initial Consultation'. content: type: string minLength: 1 title: Content description: The content of the visit note. date_created: type: string format: date-time title: Date Created description: >- The date and time (if available) when the visit note was created. This is important for ensuring we have an accurate timeline of the patient's history. type: object required: - content - date_created title: VisitNote description: Represents a note made during a patient visit. PriorAuthRequestNDPSubmission: properties: prescription_message_id: type: string minLength: 1 title: Prescription Message Id description: The Surescripts message ID for the prescription transfer. ignore_eligibility_check_error: type: boolean title: Ignore Eligibility Check Error description: >- If set to True, error responses from the eligibility check will not terminate the PA request. submit_pa_with_eligibility_check_government_plan: type: boolean title: Submit Pa With Eligibility Check Government Plan description: >- If set to True, the PA request will be submitted even if the eligibility check reveals the patient has only government insurance plan(s). default: false preferred_pharmacy_ncpdp_id: type: string pattern: ^\d{7}$ title: Preferred Pharmacy Ncpdp Id description: >- The NCPDP ID of the preferred pharmacy where the prescription will be transferred after the PA request has been approved. preferred_pharmacy_details: type: string title: Preferred Pharmacy Details description: >- Free-text pharmacy preference information (e.g. 'CVS Pharmacy, 123 Main St, Portland OR 97201'). At least one of preferred_pharmacy_ncpdp_id or preferred_pharmacy_details must be provided. type: object required: - prescription_message_id - ignore_eligibility_check_error title: PriorAuthRequestNDPSubmission description: >- Configuration for processing the prescription associated with this PA request. This field should only be provided when a prescription has been sent to Develop Health's non-dispensing pharmacy. PriorAuthRequestResubmissionInfo: properties: previous_prior_auth_request_id: type: string title: Previous Prior Auth Request Id description: Identifier of the previous prior authorization request. note: type: string title: Note description: >- Reason for resubmission or additional instructions for this attempt. Required unless `appeal_details` is provided. quantity_limit_exception_reason: type: string title: Quantity Limit Exception Reason description: >- Explanation for requesting an exception to the plan's quantity limit. Required when resubmitting due to a quantity limit denial. type: object title: PriorAuthRequestResubmissionInfo description: Information provided when resubmitting a prior authorization request. PriorAuthActivityLogSentFax: properties: id: type: string title: Id created_at: type: string format: date-time title: Created At type: type: string enum: - sent_fax title: Type default: sent_fax details: $ref: '#/components/schemas/PriorAuthActivityLogFaxDetails' type: object required: - id - created_at - details title: PriorAuthActivityLogSentFax PriorAuthActivityLogReceivedFax: properties: id: type: string title: Id created_at: type: string format: date-time title: Created At type: type: string enum: - received_fax title: Type default: received_fax details: $ref: '#/components/schemas/PriorAuthActivityLogFaxDetails' type: object required: - id - created_at - details title: PriorAuthActivityLogReceivedFax PriorAuthActivityLogFollowUpCall: properties: id: type: string title: Id created_at: type: string format: date-time title: Created At type: type: string enum: - follow_up_call title: Type default: follow_up_call details: $ref: '#/components/schemas/PriorAuthActivityLogFollowUpCallDetails' type: object required: - id - created_at - details title: PriorAuthActivityLogFollowUpCall User: properties: first_name: type: string title: First Name description: The first name of the user. last_name: type: string title: Last Name description: The last name of the user. email: type: string title: Email description: The email of the user. type: object required: - email title: User EligibilityCheckResponseSuccessItem: properties: status: type: string enum: - success title: Status default: success health_plan_name: type: string title: Health Plan Name description: Health plan name nullable: true plan_type: allOf: - $ref: '#/components/schemas/EligibilityCheckPlanType' description: Type of the health plan if determined. rx_bin: type: string pattern: ^\d{6}$ title: Rx Bin description: Rx BIN nullable: true rx_pcn: type: string title: Rx Pcn description: Rx PCN nullable: true rx_grp: type: string title: Rx Grp description: Rx GRP nullable: true effective_start_date: type: string format: date title: Effective Start Date description: Effective start date of coverage effective_end_date: type: string format: date title: Effective End Date description: Effective end date of coverage type: object required: - effective_start_date title: EligibilityCheckResponseSuccessItem EligibilityCheckResponseErrorItem: properties: status: type: string enum: - error title: Status default: error error_code: allOf: - $ref: '#/components/schemas/EligibilityCheckErrorCode' description: >- The error code indicating the specific error encountered. Possible values are: - **provider_not_on_file**: The payer has no record of the provider ID supplied. Provider is not registered with the payer, provider must call payer directly to register their NPI. - **patient_birth_date_does_not_match_database**: The DOB supplied doesn’t match the payer’s record for the member ID. - **invalid_missing_subscriber_insured_id**: Member ID is empty, wrong length, or fails checksum/cross-file lookup. Or does not meet the payer requirements for subscriber ID. This error is rarely encountered. - **subscriber_insured_not_found**: Member could not be located with the ID / name / DOB combination submitted. This error is the most common by far. - **duplicate_subscriber_insured_id_number**: The ID supplied matches more than one person in the payer’s system; inquiry is ambiguous. This error is very rarely encountered, usually only around New Year. error_message: type: string maxLength: 256 title: Error Message description: >- Human-readable description of the error. This always corresponds to the error code. action_code: allOf: - $ref: '#/components/schemas/EligibilityCheckActionCode' description: >- The action suggested by the payer in response to the error. Possible values are: - **please_correct_and_resubmit**: The transaction failed basic edits (e.g., missing or invalid data). Fix the errors and resubmit. This indicates the data submitted is incorrect. - **resubmission_not_allowed**: The payer will not accept this inquiry again in its current form; requires taking action outside of PMS / contacting the payer directly. For example, (49) PCP assignment requires updating, (76) duplicate patient records must be merged. type: object required: - error_code - error_message - action_code title: EligibilityCheckResponseErrorItem RealTimeBenefitsCheckResponse: properties: patient_cost: type: string title: Patient Cost description: Patient cost for the requested prescription prior_auth_required: type: boolean title: Prior Auth Required description: >- Whether a prior authorization is required for the requested prescription alternatives: items: $ref: '#/components/schemas/RealTimeBenefitsCheckAlternative' type: array title: Alternatives description: List of alternative drugs type: object required: - patient_cost title: RealTimeBenefitsCheckResponse PrescriptionTransfer: properties: status: allOf: - $ref: '#/components/schemas/PrescriptionTransferStatus' description: Status of the pharmacy transfer confirmed: type: boolean title: Confirmed description: True if completed and confirmation succeeded default: false error_code: allOf: - $ref: '#/components/schemas/PrescriptionTransferErrorCode' description: >- Error code if transfer failed. Note: this list of codes may grow over time, so your implementation should handle unrecognized values (probably in the same way as 'other'). - **pharmacy_does_not_exist**: The specified pharmacy does not exist in our records. - **pharmacy_permanently_closed**: The pharmacy has been permanently closed and cannot accept any transfers. - **pharmacy_unable_to_accept_transfer**: The pharmacy is unable to accept the prescription transfer. - **pharmacy_unable_to_fill_prescription**: The pharmacy cannot fill the prescription due to restrictions or lack of stock. - **prescription_transfer_not_received**: The pharmacy did not receive the prescription transfer, possibly after several attempts. - **transfer_timed_out**: The prescription transfer timed out before it could be completed. - **other**: An unexpected error occurred during the prescription transfer process. transfer_attempts: items: $ref: '#/components/schemas/PrescriptionTransferAttempt' type: array title: Transfer Attempts description: List of transfer attempts confirmation_attempts: items: $ref: '#/components/schemas/PrescriptionTransferConfirmationAttempt' type: array title: Confirmation Attempts description: List of confirmation attempts type: object required: - status title: PrescriptionTransfer description: Information about prescription transfer status and attempts PriorAuthMockResultApproved: properties: result: type: string enum: - Approved const: Approved title: Result description: The Prior Authorization has been approved. default: Approved detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeApprovalDetail' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **prior_auth_not_required**: A prior authorization is not required. - **approval**: The prior authorization request has been approved. - **existing_approval**: An active prior authorization approval already exists for the patient. prescription_transfer_error_code: allOf: - $ref: '#/components/schemas/PrescriptionTransferErrorCode' description: >- This field is only used if the ndp_submission.preferred_pharmacy_ncpdp_id was provided in the request. If provided, a prescription transfer error will be mocked. Otherwise / by default, a successful transfer will be mocked. type: object title: PriorAuthMockResultApproved description: Represents a mock result for a prior authorization request. PriorAuthMockResultDenied: properties: result: type: string enum: - Denied const: Denied title: Result description: The Prior Authorization has been denied. default: Denied detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeDenialDetail' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **formulary_alternative_preferred**: The formulary alternative is preferred. - **medical_necessity_criteria_not_met**: The medical necessity criteria are not met. - **plan_exclusion**: The drug is excluded by the plan. - **step_therapy_criteria_not_met**: The step therapy criteria are not met. - **existing_denial**: An existing denial is on file for this medication and patient. Please follow the appeals process if you wish to adjust this outcome - **coverage_limits_exceeded**: The coverage limits have been exceeded for this patient's plan. - **prior_weight_loss_program_required**: The patient has not completed the required weight loss program prior to therapy. - **unknown**: The prior authorization request has been denied. client_code: type: string title: Client Code description: >- A client-specific outcome code for the denial. This will be returned in the outcome response. type: object title: PriorAuthMockResultDenied description: Represents a mock result for a prior authorization request. PriorAuthMockResultOther: properties: result: type: string enum: - Other const: Other title: Result description: >- The Prior Authorization has completed without an approval/denial determination. default: Other detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeOtherDetailPublic' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **coverage_inactive**: The patient's coverage has expired. - **coverage_not_yet_started**: The patient's coverage has not yet started. - **no_pharmacy_benefits**: The patient's insurance does not include pharmacy benefits. - **payer_unable_to_locate_member**: The payer could not locate the member in their system. - **npi_taxonomy_ineligible**: The payer rejected the request because the prescriber's NPI taxonomy, provider type, specialty, or credentials are not eligible to submit this prior authorization. - **payer_reported_invalid_patient_info**: The payer located the patient in their system but some submitted patient information does not match. - **duplicate_request**: The request is a duplicate. Please cancel the existing request and resubmit if needed. - **prior_auth_not_required**: A prior authorization is not required for this medication. - **patient_consent_required**: The payer requires verbal consent from the patient before discussing or processing the prior authorization. - **more_information_required**: Insufficient information provided to complete the prior authorization. - **other**: A problem not listed here was encountered. Check the `outcome.detail` field for more information. trigger_message: type: boolean title: Trigger Message description: >- If True, a message will be added to the prior authorization after creation. This simulates a follow-up message and will trigger the prior authorization message webhook. default: false type: object title: PriorAuthMockResultOther description: Represents a mock result for a prior authorization request. PriorAuthMockResultNotSubmitted: properties: result: type: string enum: - Not Submitted const: Not Submitted title: Result description: >- The prior authorization request will not be submitted. For example, when the eligibility check is enabled and the check returns as error. default: Not Submitted detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeNotSubmittedDetail' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **eligibility_check_error**: Indicates eligibility check encountered an error. Error details will be surfaced in the `eligibility_check_response` field. This status will not happen if `ndp_submission.ignore_eligibility_check_error` was set to True for the PA request. - **eligibility_check_government_plan**: Indicates that the eligibility check revealed the patient has only government insurance plan(s). The `eligibility_check_response` field will contain the successful eligibility check response. This status will not happen if `ndp_submission.submit_pa_with_eligibility_check_government_plan` was set to True for the PA request. - **prescription_message_not_found**: Indicates the provided prescription message ID does not correspond to a prescription. This can happen if the eScript received to the NDP could not be converted into a valid prescription. - **more_information_required**: Indicates that additional information is required before this request can be submitted. The request was not submitted and should be resubmitted with the additional details. - **formulary_alternative_required**: Indicates that the patient needs to try a formulary alternative before the PA can be approved. The request was not submitted and should instead be submitted for the formulary alternative outlined in the outcome message. - **benefit_verification_no_medication_coverage**: Indicates that a triggered benefit verification determined the prescribed medication is not covered by the patient's plan. - **benefit_verification_only_alternative_medication_covered**: Indicates that a triggered benefit verification determined the prescribed medication is not covered, but an alternative medication specified in the request is covered. - **benefit_verification_pa_not_required**: Indicates that a triggered benefit verification determined the prescribed medication is covered and does not require prior authorization. - **pbm_excluded**: Indicates that the eligibility check revealed only an excluded PBM payer and the PA was not submitted. The `eligibility_check_response` field will contain the successful eligibility check response. - **payer_not_supported**: Indicates that the eligibility check revealed the patient's health plan is not supported. Currently, Kaiser health plans are not supported. The `eligibility_check_response` field will contain the successful eligibility check response. type: object title: PriorAuthMockResultNotSubmitted description: >- Represents a mock result where the prior authorization was NOT submitted because the eligibility check either encountered an error or revealed the patient has a government plan. CopayOption: properties: amount_cents: type: integer title: Amount Cents description: The amount of the copay in cents. supply_duration_days: type: integer title: Supply Duration Days description: The duration of the supply in days. Use null if unknown. type: object title: CopayOption DenialReasonAnalysis: properties: categories: items: type: string type: array title: Categories description: Categories describing the denial reason explanation: type: string title: Explanation description: Explanation of the denial next_steps_code: allOf: - $ref: '#/components/schemas/DenialReasonNextStepsCode' description: >- A machine-readable code for the recommended next step. Possible values are: - **resubmit_current**: Resubmit the current prior authorization request as-is. - **resubmit_additional_information**: Resubmit the prior authorization request with additional information. - **appeal**: Appeal the denial. - **consider_alternative_therapy**: Consider an alternative therapy, such as a formulary alternative or step therapy. - **other**: Take another action not represented by the other codes. next_steps: type: string title: Next Steps description: Human-readable description of the recommended next steps next_steps_explanation: type: string title: Next Steps Explanation description: Human-readable explanation of why the next steps are recommended type: object required: - categories - explanation - next_steps_code - next_steps - next_steps_explanation title: DenialReasonAnalysis description: Summary of why a prior authorization was denied. PlatformMessageThread: properties: is_resolved: type: boolean title: Is Resolved description: >- Whether this message thread is currently resolved. A thread may be unresolved/reopened if further discussion is needed. messages: items: $ref: '#/components/schemas/PlatformMessage' type: array title: Messages description: Messages in this thread. type: object required: - is_resolved - messages title: PlatformMessageThread description: A thread of messages related to this prior authorization. PriorAuthSubmissionApprovalOutcome: properties: detail: type: string maxLength: 2048 title: Detail description: >- A human-readable note providing additional information about the outcome. This will usually be an automated message corresponding to `detail_code`. In some cases it will contain more specific details about the outcome. For example, "Patient must enroll in the Omada Health Program." result: type: string enum: - Approved const: Approved title: Result description: The Prior Authorization has been approved. default: Approved detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeApprovalDetail' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **prior_auth_not_required**: A prior authorization is not required. - **approval**: The prior authorization request has been approved. - **existing_approval**: An active prior authorization approval already exists for the patient. authorization_start_date: type: string format: date title: Authorization Start Date description: >- The date when the authorization became effective. This will typically only be populated for approved outcomes. authorization_expiration: type: string format: date title: Authorization Expiration description: >- The date when the authorization expires. This information is not always available, but it will be included where possible. type: object title: PriorAuthSubmissionApprovalOutcome PriorAuthSubmissionDenialOutcome: properties: detail: type: string maxLength: 2048 title: Detail description: >- A human-readable note providing additional information about the outcome. This will usually be an automated message corresponding to `detail_code`. In some cases it will contain more specific details about the outcome. For example, "Patient must enroll in the Omada Health Program." result: type: string enum: - Denied const: Denied title: Result description: The Prior Authorization has been denied. default: Denied detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeDenialDetail' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **formulary_alternative_preferred**: The formulary alternative is preferred. - **medical_necessity_criteria_not_met**: The medical necessity criteria are not met. - **plan_exclusion**: The drug is excluded by the plan. - **step_therapy_criteria_not_met**: The step therapy criteria are not met. - **existing_denial**: An existing denial is on file for this medication and patient. Please follow the appeals process if you wish to adjust this outcome - **coverage_limits_exceeded**: The coverage limits have been exceeded for this patient's plan. - **prior_weight_loss_program_required**: The patient has not completed the required weight loss program prior to therapy. - **unknown**: The prior authorization request has been denied. client_code: type: string title: Client Code description: >- A client-specific outcome code for the prior authorization request. This field is only populated for clients with custom client codes configured. To configure your outcome codes, please contact support. type: object title: PriorAuthSubmissionDenialOutcome PriorAuthSubmissionOtherOutcome: properties: detail: type: string maxLength: 2048 title: Detail description: >- A human-readable note providing additional information about the outcome. This will usually be an automated message corresponding to `detail_code`. In some cases it will contain more specific details about the outcome. For example, "Patient must enroll in the Omada Health Program." result: type: string enum: - Other const: Other title: Result description: >- The Prior Authorization has completed without an approval/denial determination. default: Other detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeOtherDetailPublic' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **coverage_inactive**: The patient's coverage has expired. - **coverage_not_yet_started**: The patient's coverage has not yet started. - **no_pharmacy_benefits**: The patient's insurance does not include pharmacy benefits. - **payer_unable_to_locate_member**: The payer could not locate the member in their system. - **npi_taxonomy_ineligible**: The payer rejected the request because the prescriber's NPI taxonomy, provider type, specialty, or credentials are not eligible to submit this prior authorization. - **payer_reported_invalid_patient_info**: The payer located the patient in their system but some submitted patient information does not match. - **duplicate_request**: The request is a duplicate. Please cancel the existing request and resubmit if needed. - **prior_auth_not_required**: A prior authorization is not required for this medication. - **patient_consent_required**: The payer requires verbal consent from the patient before discussing or processing the prior authorization. - **more_information_required**: Insufficient information provided to complete the prior authorization. - **other**: A problem not listed here was encountered. Check the `outcome.detail` field for more information. type: object title: PriorAuthSubmissionOtherOutcome PriorAuthSubmissionPendingOutcome: properties: detail: type: 'null' title: Detail result: type: string enum: - Pending const: Pending title: Result description: >- The Prior Authorization has been submitted but does not yet have a determination. default: Pending detail_code: type: 'null' title: Detail Code type: object required: - detail - detail_code title: PriorAuthSubmissionPendingOutcome PriorAuthSubmissionNotSubmittedOutcome: properties: detail: type: string maxLength: 2048 title: Detail description: >- A human-readable note providing additional information about the outcome. This will usually be an automated message corresponding to `detail_code`. In some cases it will contain more specific details about the outcome. For example, "Patient must enroll in the Omada Health Program." result: type: string enum: - Not Submitted const: Not Submitted title: Result description: >- The prior authorization request will not be submitted. For example, when the eligibility check is enabled and the check returns as error. default: Not Submitted detail_code: allOf: - $ref: '#/components/schemas/PriorAuthOutcomeNotSubmittedDetail' description: >- A code indicating the reason for the prior auth outcome. The possible values are: - **eligibility_check_error**: Indicates eligibility check encountered an error. Error details will be surfaced in the `eligibility_check_response` field. This status will not happen if `ndp_submission.ignore_eligibility_check_error` was set to True for the PA request. - **eligibility_check_government_plan**: Indicates that the eligibility check revealed the patient has only government insurance plan(s). The `eligibility_check_response` field will contain the successful eligibility check response. This status will not happen if `ndp_submission.submit_pa_with_eligibility_check_government_plan` was set to True for the PA request. - **prescription_message_not_found**: Indicates the provided prescription message ID does not correspond to a prescription. This can happen if the eScript received to the NDP could not be converted into a valid prescription. - **more_information_required**: Indicates that additional information is required before this request can be submitted. The request was not submitted and should be resubmitted with the additional details. - **formulary_alternative_required**: Indicates that the patient needs to try a formulary alternative before the PA can be approved. The request was not submitted and should instead be submitted for the formulary alternative outlined in the outcome message. - **benefit_verification_no_medication_coverage**: Indicates that a triggered benefit verification determined the prescribed medication is not covered by the patient's plan. - **benefit_verification_only_alternative_medication_covered**: Indicates that a triggered benefit verification determined the prescribed medication is not covered, but an alternative medication specified in the request is covered. - **benefit_verification_pa_not_required**: Indicates that a triggered benefit verification determined the prescribed medication is covered and does not require prior authorization. - **pbm_excluded**: Indicates that the eligibility check revealed only an excluded PBM payer and the PA was not submitted. The `eligibility_check_response` field will contain the successful eligibility check response. - **payer_not_supported**: Indicates that the eligibility check revealed the patient's health plan is not supported. Currently, Kaiser health plans are not supported. The `eligibility_check_response` field will contain the successful eligibility check response. type: object title: PriorAuthSubmissionNotSubmittedOutcome AssetResponse: properties: url: type: string minLength: 1 title: Url description: The URL where the asset can be accessed. file_type: allOf: - $ref: '#/components/schemas/DocType' description: MIME type of the file. e.g. `application/pdf` type: object required: - url - file_type title: AssetResponse Address: properties: street: type: string minLength: 1 title: Street description: Street address of residence. street_line_2: type: string title: Street Line 2 description: Additional street address information. city: type: string minLength: 1 title: City description: City of residence. state_province: type: string minLength: 1 title: State Province description: State or province of residence. zip_postal_code: type: string minLength: 1 title: Zip Postal Code description: ZIP or postal code part of the address. country: type: string title: Country description: Country of residence. default: USA type: object required: - street - city - state_province - zip_postal_code title: Address description: Represents a postal address. Gender: type: string enum: - male - female - other - not_specified title: Gender description: An enumeration. ScannedContent: properties: client_name: type: string title: Client Name description: The client/employer name. group_number: type: string title: Group Number description: The group number on the card. member_name: type: string title: Member Name description: The member name on the card. member_number: type: string title: Member Number description: The member number on the card. payer_name: type: string title: Payer Name description: >- The payer name on the card. This field is not normalized, so the same plan may have different names depending on the way it appears on the card. i.e. 'United Healthcare', 'United', 'United Health' could all appear plan_name: type: string title: Plan Name description: >- The plan name on the card. This field is not normalized, so the same plan may have different names depending on the way it appears on the card rx_bin: type: string title: Rx Bin description: The Rx BIN number on the card. rx_group: type: string title: Rx Group description: The Rx group number on the card. rx_pcn: type: string title: Rx Pcn description: The Rx PCN number on the card. error: type: string title: Error description: >- Error message if we were unable to extract information from the card. type: object title: ScannedContent PartialInsuranceInfo: properties: client_name: type: string title: Client Name description: The client/employer name. group_number: type: string title: Group Number description: The group number on the card. member_name: type: string title: Member Name description: The member name on the card. member_number: type: string title: Member Number description: The member number on the card. payer_name: type: string title: Payer Name description: >- The payer name on the card. This field is not normalized, so the same plan may have different names depending on the way it appears on the card. i.e. 'United Healthcare', 'United', 'United Health' could all appear plan_name: type: string title: Plan Name description: >- The plan name on the card. This field is not normalized, so the same plan may have different names depending on the way it appears on the card rx_bin: type: string title: Rx Bin description: The Rx BIN number on the card. rx_group: type: string title: Rx Group description: The Rx group number on the card. rx_pcn: type: string title: Rx Pcn description: The Rx PCN number on the card. type: object title: PartialInsuranceInfo DoseForm: type: string enum: - aerosol - bar - bead - breadstick - bulk - capsule - catheter - cement - cigarette - cloth - concentrate - cone - cream - crystal - culture - dentifrice - deposit - device - diaphragm - disc - douche - dressing - drops - elixir - emulsion - enema - extract - film - food - foam - gel - generator - globule - graft - gum - implant - infusion - inhalant - inhalation - inhaler - injectable - injection - insert - irrigant - irrigation - jelly - kit - lens - liner - liniment - lipstick - liquid - lollipop - lotion - lozenge - miscellaneous - mouthwash - mucilage - oil - ointment - packing - paste - pastille - patch - pellet - pill - plaster - poultice - powder - resin - ring - rinse - rod - salve - shampoo - soap - sol - solution - sponge - spray - stick - strip - suppository - suspension - suture - swab - syrup - tablet - tampon - tape - tea - test - tincture - troche - vaginal_suppository - vaginal_tablet - wafer - wash - wax title: DoseForm description: An enumeration. RouteOfAdministration: type: string enum: - auricular (otic) - otic - buccal - conjunctival - cutaneous - dental - electro-osmosis - endocervical - endosinusial - endotracheal - enteral - epidural - extra-amniotic - extracorporeal - hemodialysis - infiltration - interstitial - intra-abdominal - intra-amniotic - intra-arterial - intra-articular - intrabiliary - intrabronchial - intrabursal - intracameral - intracanalicular - intracardiac - intracartilaginous - intracaudal - intracavernous - intracavitary - intracerebral - intracisternal - intracorneal - intracoronal, dental - intracoronary - intracorporus cavernosum - intracranial - intradermal - intradiscal - intraductal - intraduodenal - intradural - intraepicardial - intraepidermal - intraesophageal - intragastric - intragingival - intrahepatic - intraileal - intralesional - intralingual - intraluminal - intralymphatic - intramammary - intramedullary - intrameningeal - intramuscular - intranodal - intraocular - intraomentum - intraovarian - intrapericardial - intraperitoneal - intrapleural - intraprostatic - intrapulmonary - intraruminal - intrasinal - intraspinal - intrasynovial - intratendinous - intratesticular - intrathecal - intrathoracic - intratubular - intratumor - intratympanic - intrauterine - intravascular - intravenous - intraventricular - intravesical - intravitreal - iontophoresis - irrigation - laryngeal - nasal - nasogastric - not applicable - occlusive dressing technique - ophthalmic - oral - oropharyngeal - parenteral - percutaneous - periarticular - peridural - perineural - periodontal - rectal - respiratory (inhalation) - inhalation - retrobulbar - soft tissue - subarachnoid - subconjunctival - subcutaneous - subgingival - sublingual - submucosal - subretinal - suprachoroidal - topical - transdermal - transendocardial - transmucosal - transplacental - transtracheal - transtympanic - ureteral - urethral - vaginal title: RouteOfAdministration description: >- See: https://www.fda.gov/industry/structured-product-labeling-resources/route-administration OptionalAddress: properties: street: type: string title: Street description: Street address of residence. street_line_2: type: string title: Street Line 2 description: Additional street address information. city: type: string title: City description: City of residence. state_province: type: string title: State Province description: State or province of residence. zip_postal_code: type: string title: Zip Postal Code description: ZIP or postal code part of the address. country: type: string title: Country description: Country of residence. type: object title: OptionalAddress description: >- Represents a postal address with optional fields. Used for cases where address information may not be complete at creation time. Question: properties: answer: type: string minLength: 1 title: Answer description: The answer to the question. choices: items: type: string type: array title: Choices description: >- Optional list of choices for the question. If provided, the answer must be one of the choices. It's important to include this list of choices for any multiple choice question. This allows our AI to know what a user has effectively said 'no' to by picking another option. I.e. for a question 'Do you have any of the following conditions: Diabetes, Heart Disease, Cancer, None of the above' if the user answers 'None of the above' we can infer that they don't have any of those conditions. Without the choices list we would have no way of knowing that. question: type: string minLength: 1 title: Question description: The question to be answered. type: object required: - answer - question title: Question description: Represents a single question, as part of a questionnaire. PriorAuthActivityLogFaxDetails: properties: url: type: string title: Url description: >- A signed URL to download the fax file. Note that this URL has a short lifespan and should be used immediately to download the file. type: object required: - url title: PriorAuthActivityLogFaxDetails PriorAuthActivityLogFollowUpCallDetails: properties: notes: type: string title: Notes description: Notes from the follow-up call. recording_url: type: string title: Recording Url description: URL to download the call recording. transcript: type: string title: Transcript description: Transcript of the follow-up call if available. type: object title: PriorAuthActivityLogFollowUpCallDetails EligibilityCheckPlanType: type: string enum: - medicare - medicare_advantage - medicaid - tricare title: EligibilityCheckPlanType description: An enumeration. EligibilityCheckErrorCode: type: string enum: - provider_not_on_file - patient_birth_date_does_not_match_database - invalid_missing_subscriber_insured_id - subscriber_insured_not_found - duplicate_subscriber_insured_id_number title: EligibilityCheckErrorCode description: Error code indicating the specific error encountered EligibilityCheckActionCode: type: string enum: - please_correct_and_resubmit - resubmission_not_allowed title: EligibilityCheckActionCode description: >- Action code indicating the action suggested by the payer in the error case RealTimeBenefitsCheckAlternative: properties: product_id: type: string title: Product Id description: The product ID (NDC or RxNorm) of the alternative drug description: type: string title: Description description: Drug name and strength of the alternative drug patient_cost: type: string title: Patient Cost description: Patient cost for the alternative drug prior_auth_required: type: boolean title: Prior Auth Required description: Whether prior authorization is required for the alternative drug type: object required: - product_id - description - patient_cost title: RealTimeBenefitsCheckAlternative PrescriptionTransferStatus: type: string enum: - in_progress - cancelled - awaiting_provider_response - completed - error title: PrescriptionTransferStatus description: An enumeration. PrescriptionTransferErrorCode: type: string enum: - pharmacy_does_not_exist - pharmacy_permanently_closed - pharmacy_unable_to_accept_transfer - pharmacy_unable_to_fill_prescription - prescription_transfer_not_received - transfer_timed_out - other title: PrescriptionTransferErrorCode description: An enumeration. PrescriptionTransferAttempt: properties: timestamp: type: string format: date-time title: Timestamp description: Timestamp of transfer attempt pharmacy_ncpdp_id: type: string title: Pharmacy Ncpdp Id description: NCPDP ID for the pharmacy receiving the transfer type: object required: - timestamp title: PrescriptionTransferAttempt PrescriptionTransferConfirmationAttempt: properties: timestamp: type: string format: date-time title: Timestamp description: Timestamp of confirmation attempt outcome: allOf: - $ref: >- #/components/schemas/PrescriptionTransferConfirmationAttemptOutcome description: Outcome of the transfer confirmation attempt type: object required: - timestamp - outcome title: PrescriptionTransferConfirmationAttempt PriorAuthOutcomeApprovalDetail: type: string enum: - prior_auth_not_required - approval - existing_approval title: PriorAuthOutcomeApprovalDetail description: An enumeration. PriorAuthOutcomeDenialDetail: type: string enum: - formulary_alternative_preferred - medical_necessity_criteria_not_met - plan_exclusion - step_therapy_criteria_not_met - existing_denial - coverage_limits_exceeded - prior_weight_loss_program_required - unknown title: PriorAuthOutcomeDenialDetail description: An enumeration. PriorAuthOutcomeOtherDetailPublic: type: string enum: - coverage_inactive - coverage_not_yet_started - no_pharmacy_benefits - payer_unable_to_locate_member - npi_taxonomy_ineligible - payer_reported_invalid_patient_info - duplicate_request - prior_auth_not_required - patient_consent_required - more_information_required - other title: PriorAuthOutcomeOtherDetailPublic description: >- Public version of PriorAuthOutcomeOtherDetail. This is used in the API response. PriorAuthOutcomeNotSubmittedDetail: type: string enum: - eligibility_check_error - eligibility_check_government_plan - prescription_message_not_found - more_information_required - formulary_alternative_required - benefit_verification_no_medication_coverage - benefit_verification_only_alternative_medication_covered - benefit_verification_pa_not_required - pbm_excluded - payer_not_supported title: PriorAuthOutcomeNotSubmittedDetail description: An enumeration. DenialReasonNextStepsCode: type: string enum: - resubmit_current - resubmit_additional_information - appeal - consider_alternative_therapy - other title: DenialReasonNextStepsCode description: Machine-readable action recommended after a prior authorization denial. PlatformMessage: properties: id: type: string title: Id description: The ID of this message. timestamp: type: string format: date-time title: Timestamp description: Timestamp of when the message was sent content: type: string title: Content description: Message content sent_by_name: type: string title: Sent By Name description: Display name of the sender of this message. direction: type: string enum: - sent - received title: Direction description: Direction of the message relative to you. is_resolution: type: boolean title: Is Resolution description: Whether this message resolves the thread. attachments: items: $ref: '#/components/schemas/PlatformMessageAttachment' type: array title: Attachments description: Files attached to this message. type: object required: - id - timestamp - content - sent_by_name - direction - is_resolution title: PlatformMessage description: A message within a message thread. DocType: type: string enum: - application/pdf - application/msword - text/plain - application/vnd.ms-excel title: DocType description: An enumeration. PrescriptionTransferConfirmationAttemptOutcome: type: string enum: - success - failed title: PrescriptionTransferConfirmationAttemptOutcome description: An enumeration. PlatformMessageAttachment: properties: id: type: string title: Id description: The ID of this attachment. file_name: type: string title: File Name description: Original filename. url: type: string title: Url description: Download URL for the attachment. type: object required: - id - file_name - url title: PlatformMessageAttachment securitySchemes: FronteggJWTAuthentication: type: http scheme: bearer bearerFormat: JWT description: >- Bearer authentication header of the form `Bearer `, where `` is your auth token. ````