The Prior Authorization API from Truepill — 2 operation(s) for prior authorization.
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openapi: 3.2.0
info:
title: Truepill API documentation Prior Authorization API
version: 0.0.1
description: DOCS
servers:
- url: https://rxapi.fuzehealth.com/
- url: http://rxapi.fuzehealth.com/
security:
- apiKey: []
tags:
- name: Prior Authorization
paths:
/v1/prior_authorization:
post:
summary: Create a Prior Authorization request
operationId: postV1Prior_authorization
description: 'A prior authorization can be created by making a Prior Authorization Request.
Truepill will provide a receipt confirmation of the request, and multiple subsequent webhook events throughout the lifecycle of your PA.'
tags:
- Prior Authorization
responses:
'202':
description: Accepted
content:
application/json:
schema:
$ref: '#/components/schemas/Model169'
'400':
description: Bad Request
content:
application/json:
schema:
$ref: '#/components/schemas/Model170'
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/Prior%20Authorization%20Request%20Fields'
/api/v1/prior_authorization:
post:
summary: Create a Prior Authorization request
operationId: postApiV1Prior_authorization
description: 'A prior authorization can be created by making a Prior Authorization Request.
Truepill will provide a receipt confirmation of the request, and multiple subsequent webhook events throughout the lifecycle of your PA.'
tags:
- Prior Authorization
responses:
'202':
description: Accepted
content:
application/json:
schema:
$ref: '#/components/schemas/Model169'
'400':
description: Bad Request
content:
application/json:
schema:
$ref: '#/components/schemas/Model170'
requestBody:
content:
application/json:
schema:
$ref: '#/components/schemas/Prior%20Authorization%20Request%20Fields'
components:
schemas:
Model170:
type: object
properties:
statusCode:
type: number
example: 400
error:
type: string
example: Bad Request
message:
type: string
example: Invalid request payload JSON format
Model169:
type: object
properties:
request_id:
type: string
example: e8ab3dc37eb5be523508cbb5d707adf0
timestamp:
type: integer
example: 1631571795
status:
type: string
example: success
details:
$ref: '#/components/schemas/Model168'
Model168:
type: object
properties:
message:
type: string
example: Your prior authorization request has been processed successfully.
patient_token:
type: string
description: Associated patient's record token
example: 4526d90a
insurance_token:
type: string
description: Associated patient's insurance record token
example: 19sienglo92831n5
prescription_token:
type: string
description: Token to reference the prescription
example: z3q2jr
metadata:
type: string
description: Customer-side identifier to reference the PA request in customer system
example: cfe146
prescriber_phone:
type: string
description: Phone number associated with the prescribe
example: 1-800-123-4567
prescriber_fax:
type: string
description: Fax number associated with the prescriber
example: 1-800-123-4567
required:
- patient_token
- insurance_token
- prescription_token
securitySchemes:
apiKey:
type: apiKey
name: Authorization
in: header
x-alt-definitions:
selected_allergies:
type: array
items:
type: string
allergies:
type: object
properties:
selected_allergies:
$ref: '#/x-alt-definitions/selected_allergies'
presented_allergies:
$ref: '#/x-alt-definitions/selected_allergies'
free_form_allergy_information:
type: string
required:
- selected_allergies
- presented_allergies
- free_form_allergy_information
Model1:
type: object
properties:
name:
type: string
strength:
type: number
dosage:
type: string
frequency:
type: string
required:
- name
medications:
type: array
items:
$ref: '#/x-alt-definitions/Model1'
Model2:
type: object
properties:
type:
type: string
year:
type: number
reason:
type: string
required:
- type
- year
- reason
events:
type: array
items:
$ref: '#/x-alt-definitions/Model2'
patient_consent:
type: object
properties:
consent_statement:
type: string
consent_method:
type: string
consent_date:
type: string
consent_type:
type: string
patient_name:
type: string
consent_provided_by:
type: string
item:
type: string
Model3:
type: object
properties:
insurance_token:
type: string
description: Insurance token
example: adcbc795028c009d
minLength: 1
prior_authorization_number:
type: string
example: ABC123
pattern: ^[0-9a-zA-Z]{1,35}$
other_coverage_code:
type: string
example: '8'
pattern: ^[0-8]{1}$
submission_clarification_code:
type: string
example: '3'
pattern: ^(?:[1-9]\d?|0)$
required:
- insurance_token
claim_overrides:
type: array
items:
$ref: '#/x-alt-definitions/Model3'
pricing:
type: object
properties:
ingredient_cost_submitted:
type: number
x-constraint:
greater: 0
precision: 2
Model4:
type: object
properties:
prescription_token:
type: string
description: Prescription token
example: 4526d90a
minLength: 1
quantity:
type: number
example: 8.7
days_supply:
type: number
example: 30
patient_consent:
$ref: '#/x-alt-definitions/patient_consent'
claim_overrides:
$ref: '#/x-alt-definitions/claim_overrides'
ndc:
type: string
description: National drug code
example: '71858002504'
pattern: ^[0-9]{10,11}$
daw:
type: string
example: '2'
enum:
- '0'
- '2'
copay_limit:
type: number
minimum: 0
x-constraint:
precision: 2
pricing:
$ref: '#/x-alt-definitions/pricing'
required:
- prescription_token
- daw
insurance_token:
type: array
example:
- skhsyq83rkd3uht9
- ubqfc1a0a17hjb1c
- oi4aafwcsv5zzvvj
minItems: 1
items:
type: string
copay_payment:
type: object
properties:
cardholder_name:
type: string
description: Cardholder name
example: John Doe
payment_type:
type: string
last_four_digits:
type: string
example: '4132'
transaction_amount:
type: number
card_type:
type: string
transaction_date:
type: string
transaction_id:
type: string
required:
- payment_type
Medication:
type: object
description: Medication description
example:
- prescription_token: z3q2jr
- prescription_token: 3cs873
properties:
medication_name:
type: string
description: Medication name
example: Ritalin
maxLength: 255
quantity_dispensed:
type: number
description: Dispensed medication quantity
example: 60
days_supply:
type: number
description: Days supply
example: 30
is_refill:
type: boolean
description: Is prescription a refill or new fill
example: true
medication_sig:
type: string
description: Recommendations for medicines
example: Apply daily.
prescribing_doctor:
type: string
description: Prescribing doctor
example: Dr. Storm
prescription_token:
type: string
description: Prescription token
example: 4526d90a
minLength: 1
rx_link:
type: string
minLength: 1
quantity:
type: number
description: Quantity sent
example: 30
x-constraint:
greater: 0
copay_payment:
$ref: '#/x-alt-definitions/copay_payment'
ndc:
type: string
description: National drug code
example: '12345678901'
pattern: ^[0-9]{11}$
daw:
type: string
example: '2'
enum:
- '0'
- '2'
patient_consent:
$ref: '#/x-alt-definitions/patient_consent'
required:
- daw
MedicationArray:
type: array
x-constraint: {}
items:
$ref: '#/x-alt-definitions/Medication'
auto_refill:
type: object
properties:
date_provided:
type: string
format: date
description: Date of consent
example: '2022-05-12'
consent_statement:
type: string
description: Statement confirming consent
example: I consent
required:
- date_provided
- consent_statement
Model5:
type: object
properties:
consent_statement:
type: string
consent_method:
type: string
consent_date:
type: string
consent_type:
type: string
patient_name:
type: string
consent_provided_by:
type: string
item:
type: string
auto_refill:
$ref: '#/x-alt-definitions/auto_refill'
Model6:
type: object
description: Medication description
example:
- prescription_token: z3q2jr
- prescription_token: 3cs873
properties:
medication_name:
type: string
description: Medication name
example: Ritalin
maxLength: 255
quantity_dispensed:
type: number
description: Dispensed medication quantity
example: 60
days_supply:
type: number
description: Days supply
example: 30
is_refill:
type: boolean
description: Is prescription a refill or new fill
example: true
medication_sig:
type: string
description: Recommendations for medicines
example: Apply daily.
prescribing_doctor:
type: string
description: Prescribing doctor
example: Dr. Storm
prescription_token:
type: string
description: Prescription token
example: 4526d90a
minLength: 1
rx_link:
type: string
minLength: 1
quantity:
type: number
description: Quantity sent
example: 30
x-constraint:
greater: 0
copay_payment:
$ref: '#/x-alt-definitions/copay_payment'
ndc:
type: string
description: National drug code
example: '12345678901'
pattern: ^[0-9]{11}$
daw:
type: string
example: '2'
enum:
- '0'
- '2'
patient_consent:
$ref: '#/x-alt-definitions/Model5'
required:
- daw
Model7:
type: array
x-constraint: {}
items:
$ref: '#/x-alt-definitions/Model6'
Shipping Address:
type: object
properties:
name:
type: string
minLength: 1
company:
type: string
minLength: 0
street1:
type: string
description: Primary street of the address
minLength: 1
street2:
type: string
description: Secondary street
minLength: 0
city:
type: string
description: City
minLength: 1
state:
type: string
description: State
minLength: 1
zip:
type: string
minLength: 0
pattern: ^\d{5}(-\d{4})?$
country:
type: string
description: Country
default: US
minLength: 1
phone:
type: string
minLength: 0
email:
type: string
minLength: 1
fax:
type: string
minLength: 0
required:
- name
- street1
- city
- state
- zip
- country
- email
shipping_address:
type: object
properties:
phone:
type: string
minLength: 0
required:
- phone
external_location:
type: object
properties:
id:
type: string
description: 'Stringified UUIDv4.
See [RFC 4112](https://tools.ietf.org/html/rfc4122)'
minLength: 0
pattern: ^[0-9A-Fa-f]{8}-[0-9A-Fa-f]{4}-4[0-9A-Fa-f]{3}-[89ABab][0-9A-Fa-f]{3}-[0-9A-Fa-f]{12}$
pharmacy:
type: string
description: References GET /v1/external_location_pharmacies
minLength: 0
npi:
type: string
description: NPI - likely type 2
minLength: 0
maxLength: 10
pattern: ^[0-9]{10}$
address_to_street1:
type: string
minLength: 0
address_to_street2:
type: string
minLength: 0
address_to_city:
type: string
minLength: 0
address_to_state:
type: string
minLength: 0
pattern: ^[A-Z]{2}$
address_to_zip:
type: string
minLength: 0
pattern: ^\d{5}(-?\d{4})?$
address_to_country:
type: string
minLength: 0
pattern: ^[A-Z]{2}$
address_to_phone:
type: string
minLength: 0
pattern: ^(\+)?[1-9]\d{1,14}$
address_to_fax:
type: string
description: The fax number of the address
minLength: 0
maxLength: 255
pattern: ^[1-9]\d{1,14}$
required:
- id
- pharmacy
- npi
- address_to_street1
- address_to_city
- address_to_state
- address_to_zip
- address_to_country
Model8:
type: object
properties:
ncpdpid:
type: string
description: NCPDP ID - National Council for Prescription Drug Programs
minLength: 0
distance_from_origin:
type: number
description: Approximate distance rounded to nearest 0.01 mile
required:
- ncpdpid