Medication Prior Auth Webhook

When using the ePA solution in Akute, an organization can set up webhooks in Akute to be sent when there is an update to a prior auth (PA) request.

Webhooks can be set up in the Settings->Developer section in Akute.

The PA webhook contains many fields detailing information about the PA meta data (e.g. case id), PA history, and PA status. Below is documentation explaining the data structure and the meaning of the fields.

case_id   : Integer (PA case ID),
prescription_id   : Integer (Unique prescription ID),
case_alias   : String (Alternate name for prior auth case),
note   : String (Notes from payer),
offline   : Boolean (true    if PA request is offline request; otherwise false   ),
initialized_date   : Date String UTC (Date PA request was initialized),
next_response_deadline   : Date String UTC (Latest date next response is expected),
status   : String (Current status of PA. See status    enum below),
status_code   : Integer (Coded status field to allow better programmatic deciphering),
status_date   : Date String UTC (Date status was last updated),
expected_response_date   : Date String UTC (Date current response is expected to be
updated),
attachment_required   : Boolean (true    if attachments are required; otherwise false   ),
next_question_id   : Integer (If multiple questions, displays next Question
ID),
expedited   : Boolean (true    if request is expedited; otherwise false   ),
final_status   : {
  prior_authorization_status   : String (Final status of PA. See status    enum below),
  prior_authorization_status_code   : Integer (Coded status field to allow better programmatic deciphering),
  closed_reason   : String (Reason PA is closed. See closed_reason    enum below),
  closed_reason_code   : Integer (Coded closed_reason    field to allow better programmatic deciphering),
  authorization_number   : String (PA Number),
  authorization_period_start   : Date String UTC (Start date of the authorization request),
  authorization_period_end   : Date String UTC (End date of the authorization request),
  pharmacy_type   : String (Pharmacy specialty type. See pharmacy_type    enum below),
  quantity   : String (Prescribed dispense quantity (can include decimal)),
  days_supply   : String (Unit days supply the medication is priced for),
  number_of_cycles   : String (Number of cycles PA is approved for),
  number_of_refills   : String (Number of refills PA is approved for),
  note   : String (Note from payer),
  can_appeal   : Boolean (If true, prescribers can submit an appeal request),
},
appeal_details   : 
  appeal_case_id   : String (PA case ID),
  notes_for_appeal   : String (Notes regarding appeal),
  appeal_reason   : String (Reason for prior authorization request appeal),
},
cancel_details   : 
  cancel_reason   : String (Reason ePA request was cancelled),
},
attachments   : [
  {
    created_timestamp   : Date String UTC (Date attachment was uploaded),
    file_path   : String (File path to attachment),
  }
]

status enum:

  0: "unknown",
  1: "requested",
  2: "not required",
  3: "closed",
  4: "deferred",
  5: "action required",
  6: "pending",
  7: "approved",
  8: "denied",
  9: "appeal requested",
  10: "cancel requested",
  11: "canceled",
  12: "cancel denied",
  13: "error",
  14: "deleted",
  15: "partially denied",
  16: "in process"

pharmacy_type enum:

  0: "Unknown",
  1: "Retail",
  2: "MailOrder",
  3: "SpecialtyPharmacy",
  4: "LongTermCarePharmacy",
  5: "Any",
  6: "TwentyFourHourPharmacy",
  7: "FaxPharmacy",
  8: "EPCS",
  9: "InHouseDispensing",
  10: "Compounding",
  11: "DME",
  12: "Kiosk",
  13: "SupportsDigitalSignature",
  14: "FaxPharmacyExternal"

closed_reason enum:

  0: "Unknown",
  1: "ElectronicPriorAuthNotSupported",
  2: "Other",
  3: "PriorAuthNotRequired",
  4: "CannotFindMatchingPatient",
  5: "PatientNotEligible",
  6: "PriorAuthDuplicateApproved",
  7: "PriorAuthDuplicateInProgress",
  8: "ClosedByPayer",
  9: "ClosedByProvider",
  10: "ClosedByMember",
  11: "AttachmentTypeNotSupported",
  12: "PrescriberNotAllowedToSubmitPAReqest",
  13: "ResponseInconsistentWithQuestion",
  14: "ReceiverNotPAProcessorForThisPatient",
  15: "ReceiverNotPAProcessorForPatientMedicationCombo",
  16: "DuplicateDenied",
  17: "ProviderRespondedAfterDeadlineToReply",
  18: "ProductNotCoveredByThisPlanPriorAuthorizationNotAvailable",
  19: "PrescriptionWithinPrescribingLimitsPriorAuthorizationNotRequiredForPatientMedication",
  20: "CoverageLimitsMayExistForQuantityAndOrDaysSupply",
  21: "CoverageLimitsHaveBeenExceededExceptionNotAvailable",
  22: "ActivePAOnFile",
  23: "SubmittedProductCodeIsNotValid"