Forta Health

Forta Health Payor API

The payor API from Forta Health — 6 operation(s) for payor.

GitHub OpenAPI

Operations 9

GET /api/v1/payors/ Get Payors #
POST /api/v1/payors/ Create Payor #
GET /api/v1/payors/{payor_id} Get Payor #
PUT /api/v1/payors/{payor_id} Update Payor #
POST /api/v1/payors/{payor_id}/contracts/ Create Payor Contract #
PATCH /api/v1/payors/{payor_id}/contracts/{contract_id} Update Payor Contract #
DELETE /api/v1/payors/{payor_id}/contracts/{contract_id} Delete Payor Contract #
POST /api/v1/payors/{payor_id}/service_code_descriptions/ Create Service Code Description #
PATCH /api/v1/payors/{payor_id}/service_code_descriptions/{service_code_description_id}/ Update Service Code Description #

Documentation

📖
Authentication
https://raw.githubusercontent.com/api-evangelist/forta-health/refs/heads/main/authentication/forta-health-authentication.yml

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/forta-health/refs/heads/main/openapi/forta-health-payor-api-openapi.yml

Other Resources

🔗
ErrorCatalog
https://raw.githubusercontent.com/api-evangelist/forta-health/refs/heads/main/errors/forta-health-problem-types.yml
🔗
Conventions
https://raw.githubusercontent.com/api-evangelist/forta-health/refs/heads/main/conventions/forta-health-conventions.yml
🔗
DataModel
https://raw.githubusercontent.com/api-evangelist/forta-health/refs/heads/main/data-model/forta-health-data-model.yml

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OpenAPI Specification

forta-health-payor-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Forta Health Payor API
  version: 0.1.0
  description: 'Operations tagged payor across 2 of this provider''s published API definitions: forta-health-payor-api-openapi.yml, forta-health-platform-openapi.yml. Each path carries the servers of the definition it was published in.'
servers:
- url: https://api.prod.fortahealth.com/api/v1/
  description: Base URL declared by the provider in apis.yml (roadmap#122).
tags:
- name: payor
paths:
  /api/v1/payors/:
    get:
      tags:
      - payor
      summary: Get Payors
      operationId: get_payors_api_v1_payors__get
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                items:
                  $ref: '#/components/schemas/PayorListResponse'
                type: array
                title: Response Get Payors Api V1 Payors  Get
      security:
      - HTTPBearer: []
    post:
      tags:
      - payor
      summary: Create Payor
      operationId: create_payor_api_v1_payors__post
      requestBody:
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/PayorCreate'
        required: true
      responses:
        '201':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorDetailedResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
      security:
      - HTTPBearer: []
    servers:
    - url: https://api.prod.fortahealth.com/api/v1/
      description: Base URL declared by the provider in apis.yml (roadmap#122).
  /api/v1/payors/{payor_id}:
    get:
      tags:
      - payor
      summary: Get Payor
      operationId: get_payor_api_v1_payors__payor_id__get
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorDetailedResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    put:
      tags:
      - payor
      summary: Update Payor
      operationId: update_payor_api_v1_payors__payor_id__put
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/PayorPatch'
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorDetailedResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    servers:
    - url: https://api.prod.fortahealth.com/api/v1/
      description: Base URL declared by the provider in apis.yml (roadmap#122).
  /api/v1/payors/{payor_id}/contracts/:
    post:
      tags:
      - payor
      summary: Create Payor Contract
      operationId: create_payor_contract_api_v1_payors__payor_id__contracts__post
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/PayorContractCreate'
      responses:
        '201':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorContractResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    servers:
    - url: https://api.prod.fortahealth.com/api/v1/
      description: Base URL declared by the provider in apis.yml (roadmap#122).
  /api/v1/payors/{payor_id}/contracts/{contract_id}:
    patch:
      tags:
      - payor
      summary: Update Payor Contract
      operationId: update_payor_contract_api_v1_payors__payor_id__contracts__contract_id__patch
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      - name: contract_id
        in: path
        required: true
        schema:
          type: integer
          title: Contract Id
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/PayorContractPatch'
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorContractResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    delete:
      tags:
      - payor
      summary: Delete Payor Contract
      operationId: delete_payor_contract_api_v1_payors__payor_id__contracts__contract_id__delete
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      - name: contract_id
        in: path
        required: true
        schema:
          type: integer
          title: Contract Id
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema: {}
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    servers:
    - url: https://api.prod.fortahealth.com/api/v1/
      description: Base URL declared by the provider in apis.yml (roadmap#122).
  /api/v1/payors/{payor_id}/service_code_descriptions/:
    post:
      tags:
      - payor
      summary: Create Service Code Description
      operationId: create_service_code_description_api_v1_payors__payor_id__service_code_descriptions__post
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/PayorServiceCodeDescriptionCreate'
      responses:
        '201':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorServiceCodeDescriptionResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    servers:
    - url: https://api.prod.fortahealth.com/api/v1/
      description: Base URL declared by the provider in apis.yml (roadmap#122).
  /api/v1/payors/{payor_id}/service_code_descriptions/{service_code_description_id}/:
    patch:
      tags:
      - payor
      summary: Update Service Code Description
      operationId: update_service_code_description_api_v1_payors__payor_id__service_code_descriptions__service_code_description_id___patch
      security:
      - HTTPBearer: []
      parameters:
      - name: payor_id
        in: path
        required: true
        schema:
          type: integer
          title: Payor Id
      - name: service_code_description_id
        in: path
        required: true
        schema:
          type: integer
          title: Service Code Description Id
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/PayorServiceCodeDescriptionPatch'
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayorServiceCodeDescriptionResponse'
        '422':
          description: Validation Error
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
    servers:
    - url: https://api.prod.fortahealth.com/api/v1/
      description: Base URL declared by the provider in apis.yml (roadmap#122).
components:
  schemas:
    PayorServiceCodeDescriptionPatch:
      properties:
        description:
          type: string
          minLength: 2
          title: Description
      type: object
      required:
      - description
      title: PayorServiceCodeDescriptionPatch
    ClientSupervisionRequirements-Input:
      properties:
        is_required:
          type: boolean
          title: Is Required
        criteria:
          anyOf:
          - $ref: '#/components/schemas/ClientSupervisionCriteria'
          - type: 'null'
      type: object
      required:
      - is_required
      title: ClientSupervisionRequirements
    PayorListResponse:
      properties:
        id:
          type: integer
          title: Id
        label:
          type: string
          title: Label
        state:
          type: string
          title: State
        clearinghouse_payor_id:
          anyOf:
          - type: string
          - type: 'null'
          title: Clearinghouse Payor Id
        type:
          anyOf:
          - $ref: '#/components/schemas/PayorTypeEnum'
          - type: 'null'
        modifier:
          anyOf:
          - type: string
          - type: 'null'
          title: Modifier
        preferred_service_code_type:
          anyOf:
          - $ref: '#/components/schemas/ServiceCodeTypeEnum'
          - type: 'null'
        evv_enabled:
          type: boolean
          title: Evv Enabled
          default: false
        taxonomy_code:
          anyOf:
          - type: string
          - type: 'null'
          title: Taxonomy Code
      type: object
      required:
      - id
      - label
      - state
      title: PayorListResponse
    HTTPValidationError:
      properties:
        detail:
          items:
            $ref: '#/components/schemas/ValidationError'
          type: array
          title: Detail
      type: object
      title: HTTPValidationError
    PayorDetailedResponse:
      properties:
        label:
          type: string
          title: Label
        state:
          type: string
          title: State
        clearinghouse_payor_id:
          anyOf:
          - type: string
          - type: 'null'
          title: Clearinghouse Payor Id
        type:
          anyOf:
          - $ref: '#/components/schemas/PayorTypeEnum'
          - type: 'null'
        modifier:
          anyOf:
          - type: string
            maxLength: 2
            minLength: 2
          - type: 'null'
          title: Modifier
        preferred_service_code_type:
          anyOf:
          - $ref: '#/components/schemas/ServiceCodeTypeEnum'
          - type: 'null'
        is_using_taxonomy_code:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Using Taxonomy Code
        sector:
          anyOf:
          - $ref: '#/components/schemas/PayorSectorEnum'
          - type: 'null'
        internal_classification:
          anyOf:
          - type: string
          - type: 'null'
          title: Internal Classification
        forta_website_payor_name:
          anyOf:
          - type: string
          - type: 'null'
          title: Forta Website Payor Name
        changehealthcare_eligibility_payor_id:
          anyOf:
          - type: string
          - type: 'null'
          title: Changehealthcare Eligibility Payor Id
        max_client_age:
          anyOf:
          - type: integer
          - type: 'null'
          title: Max Client Age
        is_pbt_allowed:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Pbt Allowed
        is_telehealth_allowed:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Telehealth Allowed
        evv_enabled:
          type: boolean
          title: Evv Enabled
          default: false
        bt_type:
          anyOf:
          - $ref: '#/components/schemas/BTTypeEnum'
          - type: 'null'
        client_supervision_requirements:
          anyOf:
          - $ref: '#/components/schemas/ClientSupervisionRequirements-Output'
          - type: 'null'
        id:
          type: integer
          title: Id
        taxonomy_code:
          anyOf:
          - type: string
          - type: 'null'
          title: Taxonomy Code
        contracts:
          items:
            $ref: '#/components/schemas/PayorContractResponse'
          type: array
          title: Contracts
        service_code_descriptions:
          items:
            anyOf:
            - $ref: '#/components/schemas/PayorServiceCodeDescriptionResponse'
            - $ref: '#/components/schemas/PayorServiceCodeDefaultDescriptionResponse'
          type: array
          title: Service Code Descriptions
      type: object
      required:
      - label
      - state
      - id
      - contracts
      - service_code_descriptions
      title: PayorDetailedResponse
    ClientSupervisionCriteria:
      properties:
        minimum_percentage:
          anyOf:
          - type: number
          - type: 'null'
          title: Minimum Percentage
        minimum_hours:
          anyOf:
          - type: integer
          - type: 'null'
          title: Minimum Hours
        operator:
          anyOf:
          - $ref: '#/components/schemas/OperatorEnum'
          - type: 'null'
          default: OR
      type: object
      title: ClientSupervisionCriteria
    PayorCreate:
      properties:
        label:
          type: string
          title: Label
        state:
          type: string
          title: State
        clearinghouse_payor_id:
          type: string
          title: Clearinghouse Payor Id
        type:
          $ref: '#/components/schemas/PayorTypeEnum'
        modifier:
          anyOf:
          - type: string
            maxLength: 2
            minLength: 2
          - type: 'null'
          title: Modifier
        preferred_service_code_type:
          $ref: '#/components/schemas/ServiceCodeTypeEnum'
        is_using_taxonomy_code:
          type: boolean
          title: Is Using Taxonomy Code
        sector:
          $ref: '#/components/schemas/PayorSectorEnum'
        internal_classification:
          anyOf:
          - type: string
            maxLength: 50
            minLength: 1
          - type: 'null'
          title: Internal Classification
        forta_website_payor_name:
          anyOf:
          - type: string
            maxLength: 50
            minLength: 1
          - type: 'null'
          title: Forta Website Payor Name
        changehealthcare_eligibility_payor_id:
          anyOf:
          - type: string
            maxLength: 50
            minLength: 1
          - type: 'null'
          title: Changehealthcare Eligibility Payor Id
        max_client_age:
          anyOf:
          - type: integer
          - type: 'null'
          title: Max Client Age
        is_pbt_allowed:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Pbt Allowed
        is_telehealth_allowed:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Telehealth Allowed
        evv_enabled:
          type: boolean
          title: Evv Enabled
          default: false
        bt_type:
          anyOf:
          - $ref: '#/components/schemas/BTTypeEnum'
          - type: 'null'
        client_supervision_requirements:
          $ref: '#/components/schemas/ClientSupervisionRequirements-Input'
      type: object
      required:
      - label
      - state
      - clearinghouse_payor_id
      - type
      - preferred_service_code_type
      - is_using_taxonomy_code
      - sector
      - client_supervision_requirements
      title: PayorCreate
    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
    PayorContractCreate:
      properties:
        date_start:
          type: string
          format: date
          title: Date Start
        date_end:
          anyOf:
          - type: string
            format: date
          - type: 'null'
          title: Date End
        rate_per_unit:
          type: number
          title: Rate Per Unit
        service_code_id:
          type: integer
          title: Service Code Id
      type: object
      required:
      - date_start
      - rate_per_unit
      - service_code_id
      title: PayorContractCreate
    PayorContractResponse:
      properties:
        date_start:
          type: string
          format: date
          title: Date Start
        date_end:
          anyOf:
          - type: string
            format: date
          - type: 'null'
          title: Date End
        rate_per_unit:
          type: number
          title: Rate Per Unit
        service_code_id:
          type: integer
          title: Service Code Id
        id:
          type: integer
          title: Id
      type: object
      required:
      - date_start
      - rate_per_unit
      - service_code_id
      - id
      title: PayorContractResponse
    ServiceCodeTypeEnum:
      type: string
      enum:
      - CPT
      - HCPCS
      title: ServiceCodeTypeEnum
    PayorServiceCodeDescriptionResponse:
      properties:
        description:
          type: string
          minLength: 2
          title: Description
        service_code_id:
          type: integer
          title: Service Code Id
        id:
          type: integer
          title: Id
        payor_id:
          type: integer
          title: Payor Id
        service_code:
          anyOf:
          - $ref: '#/components/schemas/ServiceCodeEnum'
          - type: string
          title: Service Code
      type: object
      required:
      - description
      - service_code_id
      - id
      - payor_id
      - service_code
      title: PayorServiceCodeDescriptionResponse
    PayorTypeEnum:
      type: string
      enum:
      - Medicare Part A
      - Medicare Part B
      - Medicaid
      - Tricare
      - ChampVa
      - Group Health Plan
      - FECA Blk Lung
      - Other
      title: PayorTypeEnum
      description: Enum for payor types.
    OperatorEnum:
      type: string
      enum:
      - AND
      - OR
      title: OperatorEnum
    ServiceCodeEnum:
      type: string
      enum:
      - '97151'
      - '97152'
      - '97153'
      - '97155'
      - '97156'
      - '97157'
      - '99366'
      title: ServiceCodeEnum
    PayorServiceCodeDefaultDescriptionResponse:
      properties:
        description:
          type: string
          minLength: 2
          title: Description
        service_code_id:
          anyOf:
          - type: integer
          - type: 'null'
          title: Service Code Id
        id:
          anyOf:
          - type: integer
          - type: 'null'
          title: Id
        payor_id:
          type: integer
          title: Payor Id
        service_code:
          anyOf:
          - $ref: '#/components/schemas/ServiceCodeEnum'
          - type: string
          title: Service Code
      type: object
      required:
      - description
      - payor_id
      - service_code
      title: PayorServiceCodeDefaultDescriptionResponse
    PayorPatch:
      properties:
        label:
          type: string
          title: Label
        state:
          type: string
          title: State
        clearinghouse_payor_id:
          type: string
          title: Clearinghouse Payor Id
        type:
          $ref: '#/components/schemas/PayorTypeEnum'
        modifier:
          anyOf:
          - type: string
            maxLength: 2
            minLength: 2
          - type: 'null'
          title: Modifier
        preferred_service_code_type:
          $ref: '#/components/schemas/ServiceCodeTypeEnum'
        is_using_taxonomy_code:
          type: boolean
          title: Is Using Taxonomy Code
        sector:
          $ref: '#/components/schemas/PayorSectorEnum'
        internal_classification:
          anyOf:
          - type: string
            maxLength: 50
            minLength: 1
          - type: 'null'
          title: Internal Classification
        forta_website_payor_name:
          anyOf:
          - type: string
            maxLength: 50
            minLength: 1
          - type: 'null'
          title: Forta Website Payor Name
        changehealthcare_eligibility_payor_id:
          anyOf:
          - type: string
            maxLength: 50
            minLength: 1
          - type: 'null'
          title: Changehealthcare Eligibility Payor Id
        max_client_age:
          anyOf:
          - type: integer
          - type: 'null'
          title: Max Client Age
        is_pbt_allowed:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Pbt Allowed
        is_telehealth_allowed:
          anyOf:
          - type: boolean
          - type: 'null'
          title: Is Telehealth Allowed
        evv_enabled:
          type: boolean
          title: Evv Enabled
          default: false
        bt_type:
          anyOf:
          - $ref: '#/components/schemas/BTTypeEnum'
          - type: 'null'
        client_supervision_requirements:
          $ref: '#/components/schemas/ClientSupervisionRequirements-Input'
      type: object
      required:
      - label
      - state
      - clearinghouse_payor_id
      - type
      - preferred_service_code_type
      - is_using_taxonomy_code
      - sector
      - client_supervision_requirements
      title: PayorPatch
    PayorServiceCodeDescriptionCreate:
      properties:
        description:
          type: string
          minLength: 2
          title: Description
        service_code_id:
          type: integer
          title: Service Code Id
      type: object
      required:
      - description
      - service_code_id
      title: PayorServiceCodeDescriptionCreate
    PayorContractPatch:
      properties:
        date_start:
          type: string
          format: date
          title: Date Start
        date_end:
          anyOf:
          - type: string
            format: date
          - type: 'null'
          title: Date End
        rate_per_unit:
          type: number
          title: Rate Per Unit
      type: object
      required:
      - date_start
      - rate_per_unit
      title: PayorContractPatch
    PayorSectorEnum:
      type: string
      enum:
      - Commercial
      - Medicaid
      - MCO
      - Government Plan
      title: PayorSectorEnum
      description: Enum for payor sectors.
    ClientSupervisionRequirements-Output:
      properties:
        is_required:
          type: boolean
          title: Is Required
        criteria:
          anyOf:
          - $ref: '#/components/schemas/ClientSupervisionCriteria'
          - type: 'null'
      type: object
      required:
      - is_required
      title: ClientSupervisionRequirements
    BTTypeEnum:
      type: string
      enum:
      - BT
      - RBT
      - RLT
      - CBT
      title: BTTypeEnum
  securitySchemes:
    HTTPBearer:
      type: http
      scheme: bearer
x-refined-from:
- forta-health-payor-api-openapi.yml
- forta-health-platform-openapi.yml