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OpenAPI Specification

openapi: 3.2.0
info:
  title: Develop Health Prior Authorization Eligibility Check API
  description: API services for managing prior authorization in the healthcare domain.
  version: 1.0.0
servers:
- url: https://api.develophealth.ai
security:
- BearerAuth: []
tags:
- name: Eligibility Check
paths:
  /eligibility-check:
    post:
      summary: Check patient eligibility for coverage
      operationId: checkEligibility
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/EligibilityRequest'
      responses:
        '200':
          description: Eligibility information
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/EligibilityResponse'
        '400':
          description: Invalid request data
        '401':
          $ref: '#/components/responses/UnauthorizedError'
      tags:
      - Eligibility Check
components:
  schemas:
    EligibilityRequest:
      type: object
      properties:
        patientId:
          type: string
          example: patient_123456
        insuranceDetails:
          type: object
          properties:
            policyNumber:
              type: string
            groupNumber:
              type: string
    EligibilityResponse:
      type: object
      properties:
        coverageStatus:
          type: string
          enum:
          - covered
          - not_covered
          - partial
        coverageDetails:
          type: object
          additionalProperties: true
  responses:
    UnauthorizedError:
      description: Access token is missing or invalid
  securitySchemes:
    BearerAuth:
      type: http
      scheme: bearer
      bearerFormat: JWT
x-provenance:
  method: harvested
  publisher: Develop Health
  source: https://docs.develophealth.ai/openapi.yaml
  note: split by refine-openapis from the provider's own published document, verified by fetch (openapi/_original/*.fetch.json);
    stamped by stamp-openapi-provenance.py (roadmap#793)