SearchProviders

• MISSING_REQUIRED_FIELD
  • Missing mandatory field: XXXX
• INVALID_SEARCH
  • At least one provider detail must be provided
• BACKEND_VALIDATION_FAILED
  • Invalid or missing fields: XXXX
  • PCP not available for this member
  • Requested tin is not matching with Primary care provider tin
  • No provider found for the given search criteria
  • This Service does not support the selected member plan or platform
  • Member lookup failed. Verify input
  • No Member Policy found for the member
  • The member’s plan does not have an active policy
  • This service is not supported for NICE-migrated members
  • This service does not support delegated members.
  • Primary care provider is not found for the member
  • Primary care provider Tin is empty or not applicable
  • Derived Line of Business is blank

SubmitReferral

• MISSING_REQUIRED_FIELD
  • Missing mandatory field: XXXX
• INVALID_SEARCH
  • Invalid value for XXXX
• BACKEND_VALIDATION_FAILED
  • Invalid or missing fields: XXXX
  • No Member Policy found for the member
  • The member's plan does not have an active policy
  • This member's plan does not require referrals
  • This service is not supported for NICE-migrated members
  • This service does not support delegated members
  • Primary care provider Tin is empty or not applicable
  • Requesting Provider tin is not matching with Pcp tin
  • No Provider found for the requesting provider combination
  • No Unique Provider found for the requesting provider combination
  • Valid address not found for the requesting provider
  • Valid contract not found for the requesting provider
  • No matching policies with plan benefits.
  • Multiple matching policies found.
  • No provider found for the servicing provider combination
  • No Unique Provider found for the serving provider combination
  • No exact match found for the diagnosis code: XXXX
  • Invalid diagnosis code provided: XXXX
  • This Service does not support the selected member plan or platform
  • Derived Line of Business is blank

SearchReferrals

• MISSING_REQUIRED_FIELD
  • Missing mandatory field: XXXX
• BACKEND_VALIDATION_FAILED
  • Invalid or missing fields: XXXXX
  • This Service does not support the selected member plan or platform
  • Member lookup failed. Verify input.

PriorAuth Search

• MISSING_REQUIRED_FIELD
  • Missing mandatory header field: XXXX
  • Missing mandatory field: XXXX
• BACKEND_VALIDATION_FAILED
  • Provider not found for the requested corporateTin
  • Provider not found for the requested provider.firstName/provider.lastOrOrgName
  • No records found
  • Member not found
  • Service setting is invalid. Please update your request with one of the following - Inpatient, Outpatient Facility, Outpatient, or All and resubmit your request
  • Status is invalid. Please update your request with one of the following - Cancelled, Open, Closed or All and resubmit your request
  • corporateTin/provider.firstName/provider.lastOrOrgName is invalid, please provide a valid input
  • The case search results in excessive number of cases returned. Please refine the search criteria or date range
  • No Case Detail record found
• CASE_SUMMARY_NOT_FOUND
  • Provider and Member SRN not found
• INFORMATION
  • Multiple SRNs found for the requested details. For case details, include a SRN number on the request

Bad Request

Unauthorized

Internal server error