Check Patient Authorization

Endpoint Overview

This API endpoint checks patient authorization through the Nphies module using patient information, claim details, diagnoses, services, and encounter information.

Endpoint Details

• Method: POST
• URL: /api/v1/nphies/authorization
• Summary: Check patient authorization
• Authentication: Bearer Token required
• Content-Type: application/json

Parameters

• Path Parameters: None
• Query Parameters: None

Request Body

A JSON request body is required.

{
  "patientInfo": {
    "id": "string",
    "identifier_type": "PRC",
    "name": "string",
    "phone": "string",
    "gender": "string",
    "date_of_birth": "string",
    "insurance_name": "string",
    "insurance_id": "string",
    "marital_status": "M",
    "coverage_class": "string",
    "patient_occupation": "string"
  },
  "customer": "demo",
  "claimType": "institutional",
  "claimSubType": "ip",
  "diagnosis": [
    {
      "diagnosisCode": "string",
      "diagnosisName": "string",
      "diagnosisType": "string",
      "institutionalInputs": {
        "diastolic": 0,
        "estimatedLengthOfStay": 0,
        "height": 0,
        "icuHours": 0,
        "onAdmission": "string",
        "oxygenSaturation": 0,
        "pulse": 0,
        "respiratoryRate": 0,
        "systolic": 0,
        "temperature": 0,
        "weight": 0
      },
      "practitioner": {
        "name": "string",
        "licenseNumber": "string",
        "practiceCode": "string"
      },
      "services": [
        {
          "serviceCode": "string",
          "serviceDate": "string",
          "priceList": 0,
          "addTax": true,
          "discount": 0,
          "maternity": true,
          "bodyRegion": "string",
          "qty": 0,
          "labTest": {
            "lonicCode": "string",
            "unit": "string",
            "value": 0
          }
        }
      ],
      "snomedCode": "string",
      "snomedText": "string"
    }
  ],
  "encounterDetails": {
    "admitSource": "string",
    "class": "string",
    "endDate": "string",
    "service": "string",
    "startDate": "string",
    "status": "string"
  },
  "priority": "normal",
  "referral": true,
  "visionPrescription": [
    {
      "axis": 0,
      "cylinder": 0,
      "eye": "left",
      "lensType": "lens",
      "sphere": 0
    }
  ]
}

Field Descriptions

Main Fields

• patientInfo (object): Patient identification and insurance information.
• customer (string): Customer identifier.
• claimType (string): Claim type. The example uses institutional.
• claimSubType (string): Claim subtype. The example uses ip.
• diagnosis (array): Diagnoses and their associated clinical information and services.
• encounterDetails (object): Encounter information.
• priority (string): Request priority. The example uses normal.
• referral (boolean): Referral flag.
• visionPrescription (array): Vision prescription entries.

Patient Information (patientInfo)

• id (string): Patient identifier.
• identifier_type (string): Patient identifier type. The example uses PRC.
• name (string): Patient name.
• phone (string): Patient phone number.
• gender (string): Patient gender.
• date_of_birth (string): Patient date of birth.
• insurance_name (string): Insurance name.
• insurance_id (string): Insurance identifier.
• marital_status (string): Patient marital status code.
• coverage_class (string): Insurance coverage class.
• patient_occupation (string): Patient occupation.

Diagnosis (diagnosis[])

• diagnosisCode (string): Diagnosis code.
• diagnosisName (string): Diagnosis name.
• diagnosisType (string): Diagnosis type.
• institutionalInputs (object): Clinical measurements and institutional information.
• practitioner (object): Practitioner information.
• services (array): Services associated with the diagnosis.
• snomedCode (string): SNOMED code.
• snomedText (string): SNOMED description.

Institutional Inputs (diagnosis[].institutionalInputs)

• diastolic (number): Diastolic blood pressure.
• estimatedLengthOfStay (number): Estimated length of stay.
• height (number): Patient height.
• icuHours (number): ICU hours.
• onAdmission (string): On-admission value.
• oxygenSaturation (number): Oxygen saturation.
• pulse (number): Pulse rate.
• respiratoryRate (number): Respiratory rate.
• systolic (number): Systolic blood pressure.
• temperature (number): Patient temperature.
• weight (number): Patient weight.

Practitioner (diagnosis[].practitioner)

• name (string): Practitioner name.
• licenseNumber (string): Practitioner license number.
• practiceCode (string): Practice code.

Services (diagnosis[].services[])

• serviceCode (string): Service code.
• serviceDate (string): Service date.
• priceList (number): Service price list value.
• addTax (boolean): Tax flag.
• discount (number): Discount value.
• maternity (boolean): Maternity flag.
• bodyRegion (string): Body region.
• qty (number): Service quantity.
• labTest (object): Laboratory test information.

Laboratory Test (diagnosis[].services[].labTest)

• lonicCode (string): Laboratory test code, using the field name supplied by the API.
• unit (string): Result unit.
• value (number): Test result value.

Encounter Details (encounterDetails)

• admitSource (string): Admission source.
• class (string): Encounter class.
• endDate (string): Encounter end date.
• service (string): Encounter service.
• startDate (string): Encounter start date.
• status (string): Encounter status.

Vision Prescription (visionPrescription[])

• axis (number): Prescription axis.
• cylinder (number): Cylinder value.
• eye (string): Eye. The example uses left.
• lensType (string): Lens type. The example uses lens.
• sphere (number): Sphere value.

note

The example shows the request structure. Individual field requirements, supported codes, date formats, measurement units, monetary units, and conditional requirements are not specified in the available API reference. Example values do not represent the complete set of allowed values.

Response

• 201 Created
• 400 Bad Request: Bad request.
• 401 Unauthorized: Unauthorized.

Response Body

The available API reference does not specify success or error response bodies.

Example

Request

curl

curl -X POST \
  "https://$ACCOUNT_NAME.juleb.com/api/v1/nphies/authorization" \
  -H "Content-Type: application/json" \
  -H "Authorization: Bearer $API_KEY" \
  --data @authorization.json

Save the request body above as authorization.json and replace the example values before sending the request.

NodeJS

const axios = require('axios');
const body = require('./authorization.json');

const accountName = process.env.ACCOUNT_NAME;
const apiKey = process.env.API_KEY;

axios.post(
  `https://${accountName}.juleb.com/api/v1/nphies/authorization`,
  body,
  {
    headers: {
      'Content-Type': 'application/json',
      'Authorization': `Bearer ${apiKey}`
    }
  }
)
.then(response => {
  console.log(response.data);
})
.catch(error => {
  console.error('Error:', error.response?.data || error.message);
});

Save the request body above as authorization.json and replace the example values before running the example.