UnitedHealthcare · Schema

UnitedHealthcare Prior Auth Check Response

Prior authorization requirement and status response

Health InsuranceHealthcareFHIRClaimsEligibility

Properties

Name Type Description
authorizationRequired boolean Whether prior auth is required
authorizationStatus string Authorization status
authorizationNumber string Authorization number
validFromDate string Auth valid from
validToDate string Auth valid to
approvedUnits integer Approved units/visits
referralRequired boolean Referral required
View JSON Schema on GitHub

JSON Schema

provider-prior-auth-check-response-schema.json Raw ↑
{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-prior-auth-check-response-schema.json",
  "title": "UnitedHealthcare Prior Auth Check Response",
  "description": "Prior authorization requirement and status response",
  "type": "object",
  "properties": {
    "authorizationRequired": {
      "type": "boolean",
      "description": "Whether prior auth is required"
    },
    "authorizationStatus": {
      "type": "string",
      "enum": [
        "NOT_REQUIRED",
        "REQUIRED",
        "APPROVED",
        "PENDING",
        "DENIED"
      ],
      "description": "Authorization status"
    },
    "authorizationNumber": {
      "type": "string",
      "description": "Authorization number"
    },
    "validFromDate": {
      "type": "string",
      "format": "date",
      "description": "Auth valid from"
    },
    "validToDate": {
      "type": "string",
      "format": "date",
      "description": "Auth valid to"
    },
    "approvedUnits": {
      "type": "integer",
      "description": "Approved units/visits"
    },
    "referralRequired": {
      "type": "boolean",
      "description": "Referral required"
    }
  }
}

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