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GenHealth integration

Check Prior Auth Required

Perform Check Prior Auth Required through GenHealth.

View as Markdown
genhealth_check_prior_auth_required
write

Inputs

  • cpt_code
    expressionrequired
    Cpt Code

    Required literal value or workflow expression.

  • payer_name
    expression
    Payer Name

    Optional literal value or workflow expression.

  • payer_class
    expressionrequired
    Payer Class

    Required literal value or workflow expression.

Outputs

  • successSuccess
  • determinationDetermination
  • requires_prior_authRequires Prior Auth
  • reasonReason
  • payer_namePayer Name
  • publisher_displayPublisher Display
  • plan_namePlan Name
  • plan_typePlan Type
  • source_urlSource Url
  • effective_dateEffective Date
  • errorError

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.

Input schema
{
  "type": "object",
  "required": [
    "cpt_code",
    "payer_class"
  ],
  "properties": {
    "cpt_code": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "payer_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "payer_class": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    }
  },
  "additionalProperties": false
}
Output schema
{
  "type": "object",
  "properties": {
    "error": {},
    "reason": {},
    "success": {},
    "plan_name": {},
    "plan_type": {},
    "payer_name": {},
    "source_url": {},
    "determination": {},
    "effective_date": {},
    "publisher_display": {},
    "requires_prior_auth": {}
  },
  "additionalProperties": true
}
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