BeneficiaryAuthorizationDetailResource
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]
claims object[]
payment object
diagnoses object[]
Coding system used for the diagnosis (for example, ICD-10, CIE-10).
Diagnosis code within the coding system.
Diagnosis type as a free-form string.
Diagnosis type. One of CHIEF_COMPLAINT, DIFFERENTIAL_DIAGNOSIS, MEDICAL_DIAGNOSIS.
Role of the diagnosis in the encounter.
CHIEF_COMPLAINT: the primary reason the beneficiary sought care.DIFFERENTIAL_DIAGNOSIS: an alternative diagnosis being considered.MEDICAL_DIAGNOSIS: the confirmed medical diagnosis.
Possible values: [CHIEF_COMPLAINT, DIFFERENTIAL_DIAGNOSIS, MEDICAL_DIAGNOSIS]
products object[]
OSIGU product identifier.
Update action to apply to this line. Values include ADD, REMOVE, UPDATE.
Slug of the provider that will dispense this product.
Provider-side SKU or code for this product.
Number of units the sponsor has authorized.
Line status after the update (for example, APPROVED, REJECTED).
Free-text explanation of the current status.