Forta Health Policies API
The policies API from Forta Health — 3 operation(s) for policies.
Operations 5
Documentation
Authentication
https://artifacts.apis.io/forta-health/authentication/forta-health-authentication.yml
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OpenAPI Specification
openapi: 3.2.0
info:
title: Fast Policies API
version: 0.1.0
tags:
- name: Policies
paths:
/api/v1/policies/:
post:
tags:
- Policies
summary: Create Policy
operationId: create_policy_api_v1_policies__post
security:
- HTTPBearer: []
requestBody:
required: true
content:
application/json:
schema:
$ref: '#/components/schemas/PolicyCreate'
responses:
'201':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/PolicyResponse'
'422':
description: Validation Error
content:
application/json:
schema:
$ref: '#/components/schemas/HTTPValidationError'
get:
tags:
- Policies
summary: Get Policies
operationId: get_policies_api_v1_policies__get
security:
- HTTPBearer: []
parameters:
- name: client_id
in: query
required: false
schema:
anyOf:
- type: integer
- type: 'null'
title: Client Id
responses:
'200':
description: Successful Response
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/PolicyResponse'
title: Response Get Policies Api V1 Policies Get
'422':
description: Validation Error
content:
application/json:
schema:
$ref: '#/components/schemas/HTTPValidationError'
/api/v1/policies/{policy_id}/:
get:
tags:
- Policies
summary: Get Policy
operationId: get_policy_api_v1_policies__policy_id___get
security:
- HTTPBearer: []
parameters:
- name: policy_id
in: path
required: true
schema:
type: integer
title: Policy Id
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/PolicyResponse'
'422':
description: Validation Error
content:
application/json:
schema:
$ref: '#/components/schemas/HTTPValidationError'
patch:
tags:
- Policies
summary: Patch Policy
operationId: patch_policy_api_v1_policies__policy_id___patch
security:
- HTTPBearer: []
parameters:
- name: policy_id
in: path
required: true
schema:
type: integer
title: Policy Id
requestBody:
required: true
content:
application/json:
schema:
$ref: '#/components/schemas/PolicyPatch'
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/PolicyResponse'
'422':
description: Validation Error
content:
application/json:
schema:
$ref: '#/components/schemas/HTTPValidationError'
/api/v1/policies/{policy_id}/prior_authorization_details/{service_code_id}/:
get:
tags:
- Policies
summary: Get Prior Authorization Details
operationId: get_prior_authorization_details_api_v1_policies__policy_id__prior_authorization_details__service_code_id___get
security:
- HTTPBearer: []
parameters:
- name: policy_id
in: path
required: true
schema:
type: integer
title: Policy Id
- name: service_code_id
in: path
required: true
schema:
type: integer
title: Service Code Id
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/PolicyPriorAuthorizationDetails'
'422':
description: Validation Error
content:
application/json:
schema:
$ref: '#/components/schemas/HTTPValidationError'
components:
schemas:
PolicyPriorAuthorizationDetails:
properties:
prior_authorization_request_id:
anyOf:
- type: integer
- type: 'null'
title: Prior Authorization Request Id
client_id:
anyOf:
- type: integer
- type: 'null'
title: Client Id
policy_id:
anyOf:
- type: integer
- type: 'null'
title: Policy Id
prior_authorization_number_issued:
anyOf:
- type: string
- type: 'null'
title: Prior Authorization Number Issued
authorization_type:
anyOf:
- type: string
- type: 'null'
title: Authorization Type
date_of_service_start_approved:
anyOf:
- type: string
format: date
- type: 'null'
title: Date Of Service Start Approved
date_of_service_end_approved:
anyOf:
- type: string
format: date
- type: 'null'
title: Date Of Service End Approved
status:
anyOf:
- type: string
- type: 'null'
title: Status
submission_bay:
anyOf:
- type: string
- type: 'null'
title: Submission Bay
service_code_id:
anyOf:
- type: integer
- type: 'null'
title: Service Code Id
approved_units:
anyOf:
- type: integer
- type: 'null'
title: Approved Units
units_consumed:
anyOf:
- type: integer
- type: 'null'
title: Units Consumed
provider_modifier:
anyOf:
- type: string
- type: 'null'
title: Provider Modifier
service_modifier:
anyOf:
- type: string
- type: 'null'
title: Service Modifier
max_units_per_claim:
anyOf:
- type: integer
- type: 'null'
title: Max Units Per Claim
type: object
title: PolicyPriorAuthorizationDetails
PolicyResponse:
properties:
id:
type: integer
title: Id
client_id:
anyOf:
- type: integer
- type: 'null'
title: Client Id
payor_responsibility:
type: string
title: Payor Responsibility
relationship_to_policyholder:
anyOf:
- $ref: '#/components/schemas/RelationshipToPolicyHolderEnum'
- type: 'null'
group_number:
anyOf:
- type: string
- type: 'null'
title: Group Number
member_id:
anyOf:
- type: string
minLength: 1
- type: 'null'
title: Member Id
date_start:
anyOf:
- type: string
format: date
- type: 'null'
title: Date Start
policyholder:
anyOf:
- $ref: '#/components/schemas/PolicyHolder'
- type: 'null'
payor:
$ref: '#/components/schemas/PayorDetailedResponse'
billing_payor:
$ref: '#/components/schemas/PayorDetailedResponse'
date_end:
anyOf:
- type: string
format: date
- type: 'null'
title: Date End
is_PA1_required:
type: boolean
title: Is Pa1 Required
is_PA2_required:
type: boolean
title: Is Pa2 Required
is_monthly_plan:
anyOf:
- type: boolean
- type: 'null'
title: Is Monthly Plan
type: object
required:
- id
- payor_responsibility
- payor
- billing_payor
- is_PA1_required
- is_PA2_required
title: PolicyResponse
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
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
PayorResponsibilityEnum:
type: string
enum:
- PRIMARY
- SECONDARY
- TERTIARY
title: PayorResponsibilityEnum
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
PolicyHolder:
properties:
street_address_line_one:
type: string
title: Street Address Line One
street_address_line_two:
anyOf:
- type: string
- type: 'null'
title: Street Address Line Two
street_address_city:
type: string
minLength: 2
title: Street Address City
street_address_state:
type: string
maxLength: 2
title: Street Address State
street_address_zip:
type: string
minLength: 5
title: Street Address Zip
name:
type: string
title: Name
sex:
$ref: '#/components/schemas/Sex'
dob:
type: string
format: date
title: Dob
phone:
type: string
pattern: ^[1-9][0-9]{9}$
title: Phone
type: object
required:
- street_address_line_one
- street_address_city
- street_address_state
- street_address_zip
- name
- sex
- dob
- phone
title: PolicyHolder
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.
PolicyPatch:
properties:
date_start:
type: string
format: date
title: Date Start
date_end:
anyOf:
- type: string
format: date
- type: 'null'
title: Date End
policyholder:
$ref: '#/components/schemas/PolicyHolder'
relationship_to_policyholder:
$ref: '#/components/schemas/RelationshipToPolicyHolderEnum'
payor_responsibility:
$ref: '#/components/schemas/PayorResponsibilityEnum'
group_number:
anyOf:
- type: string
minLength: 2
- type: 'null'
title: Group Number
member_id:
type: string
minLength: 1
title: Member Id
billing_payor_id:
type: integer
title: Billing Payor Id
is_monthly_plan:
anyOf:
- type: boolean
- type: 'null'
title: Is Monthly Plan
is_PA1_required:
type: boolean
title: Is Pa1 Required
is_PA2_required:
type: boolean
title: Is Pa2 Required
type: object
required:
- date_start
- policyholder
- relationship_to_policyholder
- payor_responsibility
- member_id
- billing_payor_id
- is_PA1_required
- is_PA2_required
title: PolicyPatch
PolicyCreate:
properties:
date_start:
type: string
format: date
title: Date Start
date_end:
anyOf:
- type: string
format: date
- type: 'null'
title: Date End
policyholder:
$ref: '#/components/schemas/PolicyHolder'
relationship_to_policyholder:
$ref: '#/components/schemas/RelationshipToPolicyHolderEnum'
payor_responsibility:
$ref: '#/components/schemas/PayorResponsibilityEnum'
group_number:
anyOf:
- type: string
minLength: 2
- type: 'null'
title: Group Number
member_id:
type: string
minLength: 1
title: Member Id
billing_payor_id:
type: integer
title: Billing Payor Id
is_monthly_plan:
anyOf:
- type: boolean
- type: 'null'
title: Is Monthly Plan
is_PA1_required:
type: boolean
title: Is Pa1 Required
is_PA2_required:
type: boolean
title: Is Pa2 Required
client_id:
type: integer
title: Client Id
payor_id:
type: integer
title: Payor Id
create_eb_tracker_entry:
type: boolean
title: Create Eb Tracker Entry
default: true
type: object
required:
- date_start
- policyholder
- relationship_to_policyholder
- payor_responsibility
- member_id
- billing_payor_id
- is_PA1_required
- is_PA2_required
- client_id
- payor_id
title: PolicyCreate
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
Sex:
type: string
enum:
- female
- male
- other
- unknown
title: Sex
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
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
HTTPValidationError:
properties:
detail:
items:
$ref: '#/components/schemas/ValidationError'
type: array
title: Detail
type: object
title: HTTPValidationError
ServiceCodeEnum:
type: string
enum:
- '97151'
- '97152'
- '97153'
- '97155'
- '97156'
- '97157'
- '99366'
title: ServiceCodeEnum
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
RelationshipToPolicyHolderEnum:
type: string
enum:
- SELF
- SPOUSE
- CHILD
- OTHER
title: RelationshipToPolicyHolderEnum
OperatorEnum:
type: string
enum:
- AND
- OR
title: OperatorEnum
PayorSectorEnum:
type: string
enum:
- Commercial
- Medicaid
- MCO
- Government Plan
title: PayorSectorEnum
description: Enum for payor sectors.
BTTypeEnum:
type: string
enum:
- BT
- RBT
- RLT
- CBT
title: BTTypeEnum
securitySchemes:
HTTPBearer:
type: http
scheme: bearer
x-provenance:
method: harvested
publisher: Forta Health
source: https://api.prod.fortahealth.com/openapi.json
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)