Authorization (Orchestration) Request Body
ISA*00* *00* *ZZ*943207296 *ZZ*INQDEMO *230810*1021*^*00501*916040697*0*P*:~GS*HI*943207296*INQDEMO*20230810*102137*3294199*X*005010X215~ST*278*0001*005010X215~BHT*0007*28*1402448037*20230810*102137~HL*1**20*1~NM1*PR*2*INQDEMO*****PI*INQDEMO~HL*2*1*21*1~NM1*1P*2*Demo Hospital*****XX*1234567890~REF*EI*123456789~N4*Nashville*TN*12345~PER*IC**TE*1112223333*FX*2223334444~HL*3*2*22*1~NM1*IL*1*DOE*JOE****MI*TST1~REF*6P*00000000~DMG*D8*19010101~HL*4*3*EV*1~UM*HS*I*1*11:B~DTP*AAH*D8*20230802~HI*ABK:C34.32~NM1*SJ*2*Demo Hospital*****XX*1234567890~NM1*DN*2*Demo Hospital*****XX*1234567890~REF*ZH*123456789~HL*5*4*SS*0~DTP*472*D8*20160615~SV1*HC:70488~SE*24*0001~GE*1*3294199~IEA*1*916040697~
curl --request POST \
--url https://sandbox-apigw.optum.com/rcm/prior-authorization/v1/authorization \
--header 'accept: application/json' \
--header 'authorization: Bearer eyJraWQiOiIxIiwidHlwIjoiSldUIiwiYWxnIjoiUlMyNTYifQ.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.RvKAOR3HbsY5EFj61EiW0UPFRssoGUAMMxYNcl5n2kIWu9udsBTFEqX2bsmUtftUjOegt9fpx00X2Vi7yC37e4N-WnLMGi4ctFoIKY8hgIm-BUUmroo1EKIs6MGZHzYtjBklyGVOsKsDvMNOE4BVaUsREnASd5GtPDOtST-I2CvAaKFGRCBkrykNaNgUjxqdbLtWtfccSnQ52JCPvo37YYh9r_4bpTeE-bgvpuDxLidj-cx0z-EOdGobkt5oVcku8hh5xQin7dEmq_Rks6Bah3iS0WHbOmtL7e2bgr_s-Nq8_RBUOehOVACsOV4BjAm7_VvYAcSG685XIO8oFIpibQ' \
--header 'content-type: application/json' \
--header 'x-optum-tenant-id: 9fb77454-8c58-4345-aa50-43f133e06d20' \
--data '
{
"requester": {
"requesterIdentification": {
"employerIdentificationNumber": "123456789"
},
"requesterType": "1P",
"organizationName": "Regional Medical Center",
"lastName": "Regional Medical Center",
"city": "Orangeburg",
"state": "SC",
"postalCode": "12345",
"npi": "1234567890",
"contactTelephone": "803-395-2200"
},
"subscriber": {
"lastName": "TEST",
"firstName": "BRITTANY",
"memberId": "ZCS12345678",
"dateOfBirth": "19701231"
},
"patientEventDetail": {
"patientEventProviderName": [
{
"entityIdentifierCode": "SJ",
"lastName": "TEST",
"firstName": "STEVEN",
"identificationCodeQualifier": "XX",
"identifier": "1234567890"
}
],
"requestCategoryCode": "HS",
"certificationTypeCode": "I",
"serviceTypeCode": "1",
"facilityTypeCode": "11",
"facilityCodeQualifier": "B",
"eventDateBegin": "20231017",
"eventDateEnd": "20231017"
},
"senderId": "201985AAS",
"submitterTransactionIdentifier": "1234567890",
"payerId": "BCBSSC",
"payerName": "South Carolina Blue Cross Blue",
"umClearingHouseId": "INQDEMO",
"rhPayerId": "UHCDEMODV1",
"planId": "41"
}
'
Updated 4 days ago