Forta Health

Forta Health Policies API

The policies API from Forta Health — 3 operation(s) for policies.

GitHub OpenAPI

Documentation

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Authentication
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Specifications

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

Other Resources

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ErrorCatalog
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Conventions
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DataModel
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OpenAPI Specification

forta-health-policies-api-openapi.yml Raw ↑ 
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
    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
    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
    PayorResponsibilityEnum:
      type: string
      enum:
      - PRIMARY
      - SECONDARY
      - TERTIARY
      title: PayorResponsibilityEnum
    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
    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
    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
    HTTPValidationError:
      properties:
        detail:
          items:
            $ref: '#/components/schemas/ValidationError'
          type: array
          title: Detail
      type: object
      title: HTTPValidationError
    ServiceCodeTypeEnum:
      type: string
      enum:
      - CPT
      - HCPCS
      title: ServiceCodeTypeEnum
    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
    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
    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
    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.
    RelationshipToPolicyHolderEnum:
      type: string
      enum:
      - SELF
      - SPOUSE
      - CHILD
      - OTHER
      title: RelationshipToPolicyHolderEnum
    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
    OperatorEnum:
      type: string
      enum:
      - AND
      - OR
      title: OperatorEnum
    ServiceCodeEnum:
      type: string
      enum:
      - '97151'
      - '97152'
      - '97153'
      - '97155'
      - '97156'
      - '97157'
      - '99366'
      title: ServiceCodeEnum
    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
    Sex:
      type: string
      enum:
      - female
      - male
      - other
      - unknown
      title: Sex
    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
    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
  securitySchemes:
    HTTPBearer:
      type: http
      scheme: bearer