Process HST Prior Authorization Patient

Inputs

• patient_item

  expressionrequired
  Patient Item

  Required literal value or workflow expression.

Outputs

• successSuccess
• errorError
• failure_categoryFailure Category
• statusStatus
• reason_codesReason Codes
• candidateCandidate
• review_note_writtenReview Note Written
• completion_tag_repairedCompletion Tag Repaired
• authorization_confirmedAuthorization Confirmed
• patient_idPatient Id
• carelon_order_idCarelon Order Id
• outcomeOutcome
• operator_actionOperator Action
• dry_runDry Run
• is_authorizedIs Authorized
• retryableRetryable
• manual_reviewManual Review
• observed_health_planObserved Health Plan
• submission_statusSubmission Status
• valid_fromValid From
• valid_throughValid Through
• authorized_note_writtenAuthorized Note Written
• unanswered_question_idUnanswered Question Id
• unanswered_question_textUnanswered Question Text
• unanswered_question_kindUnanswered Question Kind
• unanswered_question_optionsUnanswered Question Options
• unanswered_question_exclusive_optionsUnanswered Question Exclusive Options
• answered_question_countAnswered Question Count
• configured_answer_countConfigured Answer Count
• supplied_answer_countSupplied Answer Count
• derived_answer_countDerived Answer Count
• lowest_derived_confidenceLowest Derived Confidence
• clinical_outcomesClinical Outcomes
• provider_substitutionProvider Substitution
• substituted_ordering_npiSubstituted Ordering Npi
• substituted_ordering_taxonomy_codeSubstituted Ordering Taxonomy Code
• substituted_ordering_taxonomy_descriptionSubstituted Ordering Taxonomy Description
• routeRoute
• portal_messagePortal Message
• provider_resolution_reasonProvider Resolution Reason
• is_bcbsIs Bcbs

Output schema completeness: best_effort_declared

Safety

External effect

write

Confirmation recommended

No

Retry safe

No

Dry run supported

No

Schemas

These schemas are first-pass authoring guidance. Runtime validation remains authoritative.

{
  "type": "object",
  "required": [
    "patient_item"
  ],
  "properties": {
    "patient_item": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    }
  },
  "additionalProperties": false
}

{
  "type": "object",
  "properties": {
    "error": {},
    "route": {},
    "status": {},
    "dry_run": {},
    "is_bcbs": {},
    "outcome": {},
    "success": {},
    "candidate": {},
    "retryable": {},
    "patient_id": {},
    "valid_from": {},
    "reason_codes": {},
    "is_authorized": {},
    "manual_review": {},
    "valid_through": {},
    "portal_message": {},
    "operator_action": {},
    "carelon_order_id": {},
    "failure_category": {},
    "clinical_outcomes": {},
    "submission_status": {},
    "review_note_written": {},
    "derived_answer_count": {},
    "observed_health_plan": {},
    "provider_substitution": {},
    "supplied_answer_count": {},
    "unanswered_question_id": {},
    "answered_question_count": {},
    "authorization_confirmed": {},
    "authorized_note_written": {},
    "completion_tag_repaired": {},
    "configured_answer_count": {},
    "substituted_ordering_npi": {},
    "unanswered_question_kind": {},
    "unanswered_question_text": {},
    "lowest_derived_confidence": {},
    "provider_resolution_reason": {},
    "unanswered_question_options": {},
    "substituted_ordering_taxonomy_code": {},
    "unanswered_question_exclusive_options": {},
    "substituted_ordering_taxonomy_description": {}
  },
  "additionalProperties": true
}