Availity · Schema

ServiceReviewRequest

HealthcareClearinghouseHIPAAX12 EDIEligibilityClaimsPrior AuthorizationRevenue Cycle ManagementPayersPrice Transparency

Properties

Name	Type	Description
payerId	string
requestType	string
provider	object
subscriber	object
serviceInformation	object

View JSON Schema on GitHub

JSON Schema

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "#/components/schemas/ServiceReviewRequest",
  "title": "ServiceReviewRequest",
  "type": "object",
  "required": [
    "payerId",
    "provider",
    "subscriber",
    "requestType"
  ],
  "properties": {
    "payerId": {
      "type": "string",
      "example": "BCBS001"
    },
    "requestType": {
      "type": "string",
      "enum": [
        "INITIAL",
        "UPDATE",
        "CANCEL",
        "REFERRAL"
      ],
      "example": "INITIAL"
    },
    "provider": {
      "type": "object",
      "properties": {
        "npi": {
          "type": "string",
          "example": "1234567890"
        },
        "taxId": {
          "type": "string",
          "example": "123456789"
        }
      }
    },
    "subscriber": {
      "type": "object",
      "properties": {
        "memberId": {
          "type": "string",
          "example": "MEM123456"
        },
        "firstName": {
          "type": "string",
          "example": "Jane"
        },
        "lastName": {
          "type": "string",
          "example": "Smith"
        }
      }
    },
    "serviceInformation": {
      "type": "object",
      "properties": {
        "procedureCodes": {
          "type": "array",
          "items": {
            "type": "string"
          }
        },
        "diagnosisCodes": {
          "type": "array",
          "items": {
            "type": "string"
          }
        },
        "serviceFromDate": {
          "type": "string",
          "format": "date"
        },
        "serviceToDate": {
          "type": "string",
          "format": "date"
        }
      }
    }
  }
}

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