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AuthorizationFormResource

A beneficiary-search or reimbursement form configured for a sponsor.

form_slugstring

Machine-readable identifier of the form.

reimbursementboolean

True when the form is used for reimbursement flows.

authorization_coveragestring

Insurance coverage type this form applies to.

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]

sponsor_slugstring

Slug of the sponsor the form belongs to.

fallback_namestring

Human-readable name shown when the form has no translation for the client's locale.

fields object[]

Ordered list of fields the provider must fill.

  • Array [
    • idinteger<int64>

    Field identifier. Long integer.

    slugstring

    Field slug. Machine-readable identifier used in form submissions.

    typestring

    Field data type. Controls the widget rendered by the client.

    Widget type used to render the form field.

    • TEXT, TEXTAREA, EMAIL, PHONE: text inputs.
    • INTEGER, DECIMAL, PERCENTAGE, CURRENCY: numeric inputs. 'decimal_precision' applies to DECIMAL and CURRENCY.
    • DATE: date picker.
    • BOOLEAN: checkbox.
    • SELECT, DROPDOWN, SPONSOR_PROVIDERS_DROPDOWN, SPECIALTY_SELECTOR: selection widgets. 'options' describes the choices.
    • FILE_UPLOAD: file upload. 'mime_types' and 'file_limit' apply.
    • BENEFICIARY, BENEFICIARY_CARD, DOCTOR_CARD: pre-formatted read-only cards.
    • DIAGNOSES, CHIEF_COMPLAINT_DIAGNOSES, DIFFERENTIAL_DIAGNOSES, DIAGNOSES_PRODUCT, MEDICAL_PROCEDURE_PRODUCT, PRE_INVOICE_ITEMS: composite widgets specific to clinical workflows.
    • SEARCH_BENEFICIARY_WITH_EXTERNAL_BENEFITS: beneficiary search integrated with external benefits systems.
    • SECTION_TITLE, TEXT_LIST, DASHED_DIVIDER: layout-only elements without user input.

    Possible values: [CURRENCY, TEXT, FILE_UPLOAD, BOOLEAN, SELECT, DATE, DECIMAL, INTEGER, PERCENTAGE, DROPDOWN, BENEFICIARY, DIAGNOSES, MEDICAL_PROCEDURE_PRODUCT, EMAIL, PHONE, TEXTAREA, SPONSOR_PROVIDERS_DROPDOWN, DIFFERENTIAL_DIAGNOSES, CHIEF_COMPLAINT_DIAGNOSES, SEARCH_BENEFICIARY_WITH_EXTERNAL_BENEFITS, BENEFICIARY_CARD, DOCTOR_CARD, SECTION_TITLE, TEXT_LIST, DASHED_DIVIDER, SPECIALTY_SELECTOR, DIAGNOSES_PRODUCT, PRE_INVOICE_ITEMS]

    labelstring

    Human-readable label to display next to the field.

    show_orderinteger<int32>

    Rendering order within the form.

    requiredboolean

    True when the field must be filled to submit the form.

    descriptionstring

    Long-form description shown as help text.

    group_namestring

    Name of the group this field belongs to, for grouped form layouts.

    mime_typesstring

    Comma-separated list of accepted MIME types. Only meaningful when 'type' is FILE_UPLOAD.

    file_limitinteger<int32>

    Maximum number of files allowed. Only meaningful when 'type' is FILE_UPLOAD.

    prefixstring

    Text or symbol shown before the input (for example, a currency symbol).

    suffixstring

    Text or symbol shown after the input (for example, a unit).

    placeholderstring

    Placeholder text shown when the field is empty.

    decimal_precisioninteger<int32>

    Number of decimal places allowed. Only meaningful when 'type' is DECIMAL or CURRENCY.

    group_orderinteger<int32>

    Rendering order of the group this field belongs to.

    css_classstring

    Primary CSS class hint for rendering.

    additional_css_classstring

    Additional CSS class hint for rendering.

    minnumber

    Minimum allowed value. Only meaningful for numeric field types.

    maxnumber

    Maximum allowed value. Only meaningful for numeric field types.

    default_valuestring

    Default value pre-filled when the form is rendered.

    help_textstring

    Short help text shown next to the input.

    group_fieldstring

    Slug of the parent group field, for nested layouts.

    options object[]

    Selectable options. Only meaningful when 'type' is SELECT or DROPDOWN.

  • Array [
    • keystring

    Machine-readable value submitted when this option is selected.

    labelstring

    Human-readable label displayed to the user.

  • ]
    • props object

    Free-form additional properties consumed by custom widgets.

    property name*object
  • ]