UnitedHealthcare · JSON Structure

Provider Prior Auth Check Response Structure

Prior authorization requirement and status response

Type: object Properties: 0
Health InsuranceHealthcareFHIRClaimsEligibility

UnitedHealthcare Prior Auth Check Response is a JSON Structure definition published by UnitedHealthcare. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Meta-schema: https://json-structure.org/meta/core/v0/#

JSON Structure

Raw ↑
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-structure/provider-prior-auth-check-response-structure.json",
  "name": "UnitedHealthcare Prior Auth Check Response",
  "type": "object",
  "description": "Prior authorization requirement and status response",
  "fields": [
    {
      "name": "authorizationRequired",
      "type": "boolean",
      "description": "Whether prior auth is required"
    },
    {
      "name": "authorizationStatus",
      "type": "string",
      "description": "Authorization status",
      "enum": [
        "NOT_REQUIRED",
        "REQUIRED",
        "APPROVED",
        "PENDING",
        "DENIED"
      ]
    },
    {
      "name": "authorizationNumber",
      "type": "string",
      "description": "Authorization number"
    },
    {
      "name": "validFromDate",
      "type": "date",
      "description": "Auth valid from"
    },
    {
      "name": "validToDate",
      "type": "date",
      "description": "Auth valid to"
    },
    {
      "name": "approvedUnits",
      "type": "integer",
      "description": "Approved units/visits"
    },
    {
      "name": "referralRequired",
      "type": "boolean",
      "description": "Referral required"
    }
  ]
}