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Create a Pre-authorization request

POST 
/v1/pa-requests

Create a Pre-authorization request

Request​

Body

required

Pre-authorization Information

    hmo_code string

    Required only for Provider / EMR integrations

    The human friendly unique code of the Insurer who should receive this PA request.

    See insurer list endpoint for available Insurers

    hmo_id number

    The ID of the Insurer who should receive this pa request. Used when hmo_code is not supplied

    provider_code string

    Required for Insurer / HMO integrations only. This is the unique code/ID with which you(The Insurer) identify the provider within your database. NB: This code must be attached to the provider on your curacel account.

    enrollee objectrequired

    Specifies the Enrollee / Patient for whom this pa request is created

    insurance_no string

    The insurance number of the enrollee as supplied by the HMO. This would be validated against existing insurance numbers.

    first_name string

    The name to be saved for floating enrollee.

    last_name string

    The name to be saved for floating enrollee.

    sex string

    Possible values: [M, F]

    The sex/gender to be saved for floating enrollee.

    is_floating boolean

    Default value: false

    Floating enrollees are those whose insurance numbers are not yet registered with Curacel. Pass this as true when this is the case and the insurance number will no longer be validated (Avoid using this as much as possible)

    create_if_not_found boolean

    Default value: false

    Insurer / HMO integrations only.

    Automatically creates a new record for the enrollee if the insurance number doesn't match an existing record.

    first_name, last_name and sex should be supplied if this is true as they would be used to create the record.

    diagnoses objectrequired

    The collection of diagnoses that should be attached to this PA request.

    icd_codes string[]

    (Recommended)If ICD10 codes are available, an array of the icd10 codes which represent the diagnoses concerned. E.g [‘b54’, ‘k27’]

    names string[]

    Where ICD codes are not available, the names / descriptions of the diagnoses can be used as an alternative to identify them.

    items object[]required

    Collection of all the line items that make up the pa request.

  • Array [
    • description string

    Description of the service rendered to the enrollee.

    unit_price_billed double

    Unit price of the item

    qty integer

    Qty of the item. Would be automatically multiplied with unit price to derive sub_total for the item

    tariff_code string

    If the tariff code as agreed between the hospital and HMO is available, this can be supplied to aid precise validation of the tariff.

    tariff_id integer

    If the unique ID of the tariff on Curacel for the service is available, supply it to aid validation

    is_approved boolean

    Default value: false

    Insurer / HMO integrations only. Only HMOs can approve or reject a Pa request on creation

    reject_reason string

    Insurer / HMO integrations only. Only HMOs can reject a Pa request on creation and supply reason for rejection

  • ]
    • ref string

    Required for insurer / HMO integrations

    Unique identifier for the pa request as is on the source system. E.g it’s ID

Responses​

Success

Schema
    message string

    The success message

    data object

    Created pre-authorization information

    id integer

    The ID of the created pre-authorization request.

    ref string

    Unique identifier for the pre-authorization request as is on the source system. E.g it’s ID

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