UnitedHealthcare · Schema
UnitedHealthcare Prior Auth Check Request
Request to check prior authorization requirements for a procedure
Health InsuranceHealthcareFHIRClaimsEligibility
Properties
| Name | Type | Description |
|---|---|---|
| memberId | string | Member ID |
| npi | string | Provider NPI |
| serviceCode | string | CPT/HCPCS service code |
| serviceType | string | Service type description |
| dateOfService | string | Planned date of service |
| diagnosisCodes | array | ICD-10 codes |
| placeOfService | string | Place of service code |
JSON Schema
{
"$schema": "https://json-schema.org/draft/2020-12/schema",
"$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-prior-auth-check-request-schema.json",
"title": "UnitedHealthcare Prior Auth Check Request",
"description": "Request to check prior authorization requirements for a procedure",
"type": "object",
"required": [
"memberId",
"npi",
"serviceCode"
],
"properties": {
"memberId": {
"type": "string",
"description": "Member ID"
},
"npi": {
"type": "string",
"description": "Provider NPI"
},
"serviceCode": {
"type": "string",
"description": "CPT/HCPCS service code"
},
"serviceType": {
"type": "string",
"description": "Service type description"
},
"dateOfService": {
"type": "string",
"format": "date",
"description": "Planned date of service"
},
"diagnosisCodes": {
"type": "array",
"items": {
"type": "string"
},
"description": "ICD-10 codes"
},
"placeOfService": {
"type": "string",
"description": "Place of service code"
}
}
}
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