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

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$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"
    }
  }
}