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AuthorizationResource

Authorization retrieved from OSIGU, including its products, sponsor, payment type, and current status.

idinteger<int64>

Authorization identifier. Long integer assigned by OSIGU.

beneficiary_idinteger<int64>

Beneficiary identifier. Long integer.

codestring

OSIGU authorization code. Human-readable identifier the beneficiary uses at the point of service.

sponsor_slugstring

Slug of the sponsor that issued the authorization.

sponsor_authorization_codestring

Authorization code assigned by the sponsor, when applicable.

doctor_medical_license_numberstring

Prescribing doctor's medical license number.

doctor_country_codestring

ISO 3166-1 alpha-2 code of the country that issued the doctor's license.

doctor_specialty_namestring

Prescribing doctor's medical specialty.

doctor_namestring

Prescribing doctor's full name.

manual_review_requiredboolean

True when the authorization requires manual review by the sponsor before it can be redeemed.

manually_approvedboolean

True when a sponsor operator has manually approved the authorization.

coverage_typestring

Insurance coverage type of the authorization.

Insurance coverage type.

  • OUTPATIENT_CARE: ambulatory medical care.
  • PRESCRIPTION_DRUGS: pharmacy drug coverage.
  • DIAGNOSTIC_TESTS: imaging and diagnostic studies.
  • EDUCATION, SPORTS, WELLNESS: non-medical benefits.
  • CREDIT_CARD_BALANCE, PERMANENT_DISABILITY, UNEMPLOYMENT, FUNERAL_ASSISTANCE, PPI, TEMPORARY_DISABILITY: non-medical insurance benefits handled through OSIGU.
  • MEDICAL_PROCEDURES: stand-alone medical procedures.
  • SECOND_ASSESSMENT: second-opinion consultations.
  • CANCER_DIAGNOSIS, DAILY_HOSPITALIZATION_INCOME, ACCIDENT_MEDICAL_REIMBURSEMENT, DIABETES_ACCIDENTAL_DEATH, DIABETES, CELL_PROTECTION, CASH_ROBBERY: specialized coverage lines.
  • HOSPITAL_CARE, HOSPITALIZATION: inpatient care coverage.

Possible values: [OUTPATIENT_CARE, PRESCRIPTION_DRUGS, DIAGNOSTIC_TESTS, EDUCATION, SPORTS, WELLNESS, CREDIT_CARD_BALANCE, PERMANENT_DISABILITY, UNEMPLOYMENT, FUNERAL_ASSISTANCE, PPI, TEMPORARY_DISABILITY, MEDICAL_PROCEDURES, SECOND_ASSESSMENT, CANCER_DIAGNOSIS, DAILY_HOSPITALIZATION_INCOME, ACCIDENT_MEDICAL_REIMBURSEMENT, DIABETES_ACCIDENTAL_DEATH, DIABETES, CELL_PROTECTION, CASH_ROBBERY, HOSPITAL_CARE, HOSPITALIZATION]

product_typestring

Product type of the authorization. One of DRUG, LABORATORY, DIAGNOSTIC_TEST, MEDICAL_PROCEDURE.

Kind of product covered by an authorization line.

  • DRUG: pharmacy medication.
  • LABORATORY: laboratory test.
  • DIAGNOSTIC_TEST: imaging or other diagnostic study.
  • MEDICAL_PROCEDURE: in-clinic medical procedure.

Possible values: [DRUG, LABORATORY, DIAGNOSTIC_TEST, MEDICAL_PROCEDURE]

statusstring

Current lifecycle status of the authorization.

Overall lifecycle status of an authorization.

  • PENDING_REVIEW: awaiting sponsor manual review before it can be approved.
  • CREATED: created in OSIGU but not yet processed.
  • READY: approved and ready to be redeemed by the beneficiary.
  • PARTIALLY_CLAIMED: partially redeemed; remaining quantities are still available.
  • CLAIMED: fully redeemed.
  • VOIDED: cancelled; cannot be redeemed.
  • PAID: settlement to the provider has been confirmed by the sponsor.
  • ERROR: processing failed. Response contains a diagnostic reason.
  • REQUEST_IN_PROGRESS: still being processed by the authorization engine.
  • QUALIFICATION: undergoing sponsor coverage qualification.
  • INCOMPLETE: waiting for the provider to attach required documents or data.
  • REJECTED: rejected by the sponsor.
  • APPROVED: approved by the sponsor.
  • CANCELLED: cancelled by the sponsor.
  • USER_ERROR: request payload was invalid.
  • CANCELLED_BY_PATIENT: cancelled at the beneficiary's request.
  • PENDING_MEDICAL_REPORT: waiting for a medical report from the provider.
  • COMPLETED: workflow completed.
  • NOT_ATTENDED: the beneficiary did not attend the scheduled service.
  • SENT_TO_SPONSOR: dispatched to the sponsor for downstream processing.
  • PAYMENT_CONFIRMED: sponsor has confirmed payment to the provider.

Possible values: [PENDING_REVIEW, CREATED, READY, PARTIALLY_CLAIMED, CLAIMED, VOIDED, PAID, ERROR, REQUEST_IN_PROGRESS, QUALIFICATION, INCOMPLETE, REJECTED, APPROVED, CANCELLED, USER_ERROR, CANCELLED_BY_PATIENT, PENDING_MEDICAL_REPORT, COMPLETED, NOT_ATTENDED, SENT_TO_SPONSOR, PAYMENT_CONFIRMED]

file_pathstring

Storage path to the generated authorization document.

satisfies_documents_policyboolean

True when all documents required by the sponsor are attached.

activation_atstring<date-time>

Timestamp from which the authorization can be redeemed. ISO 8601.

expiration_atstring<date-time>

Timestamp after which the authorization can no longer be redeemed. ISO 8601.

created_atstring<date-time>

Timestamp when the authorization was created. ISO 8601.

updated_atstring<date-time>

Timestamp of the most recent update. ISO 8601.

products object[]

Products included in the authorization.

  • Array [
  • idinteger<int64>

    Authorization product-line identifier.

    product_idinteger<int64>

    OSIGU catalog product identifier.

    product_namestring

    Product name.

    product_type_slugstring

    Slug of the product type.

    treatment_duration_daysinteger<int32>

    Prescribed treatment duration in days.

    quantityinteger<int32>

    Quantity requested by the doctor.

    authorized_quantityinteger<int32>

    Quantity the sponsor authorized to be dispensed.

    claimed_quantityinteger<int32>

    Quantity that has already been claimed against this line.

    recurrent_treatmentboolean

    True when the product is part of a recurring treatment plan.

    recurrenceinteger<int32>

    Current recurrence number, when 'recurrent_treatment' is true.

    total_of_recurrencesinteger<int32>

    Total number of recurrences authorized for the treatment plan.

    statusstring

    Current status of this product line (for example, APPROVED, REJECTED, PENDING_REVIEW).

    reasonstring

    Free-text explanation of the current status.

    provider_products object[]

    Provider-side SKUs mapped to this authorized product line.

  • Array [
  • provider_slugstring

    Provider slug.

    provider_product_codestring

    Provider-side product code.

  • ]
  • ]
  • non_associated_products object[]

    Products submitted with the request but not associated with any authorized line.

  • Array [
  • provider_slugstring

    Provider that offered the product.

    provider_product_codestring

    Provider-side product code.

    product_namestring

    Human-readable product name.

    treatment_duration_daysinteger<int32>

    Prescribed treatment duration in days.

    quantityinteger<int32>

    Quantity submitted.

  • ]