Prior Authorizations

Trigger a prior-authorization test status

Sets a deterministic outcome on a request created with test_mode=true and enqueues the same signed webhook used by live status changes. Ordinary requests cannot use this endpoint. A terminal test outcome cannot be changed; create a separate test request for each terminal scenario. See test statuses and webhook examples.

post/api/prior-authorizations/v1/{id}/test-status

Request

  • Base URL: https://api.taigabilling.com
  • URL: https://api.taigabilling.com/api/prior-authorizations/v1/{id}/test-status
  • Auth: HTTP bearer

Path parameters

idstring required

Request body

status'NEEDS_INFORMATION' | 'PARTIALLY_APPROVED' | 'DENIED' required

The deterministic test outcome to emit.

Response

Test status triggered

billing_provider_npistring required
clinical_notesstring nullable
coverage_idstring required

Existing patient coverage. Taiga resolves payer, plan, member, and routing details from this coverage.

diagnosis_codesstring[] required
external_idstring required

Partner-generated idempotency key. Replays with an identical body return the existing request; a different body returns 409.

patient_idstring required
payer_specific_fieldsobject

Escape hatch for payer questions discovered during requirements review. Use stable snake_case keys supplied by Taiga.

place_of_service_codestring required

Two-digit CMS place-of-service code for the requested care.

rendering_provider_npistring required

Rendering therapist NPI. This NPI must be in the partner organization's scope.

request_type'INITIAL' | 'REAUTHORIZATION' | 'MODIFICATION' | 'RETROSPECTIVE' required

REAUTHORIZATION also requires previous_authorization. INITIAL is used for a new patient, condition, or payer-defined new episode.

requesting_provider_npistring nullable
service_facility_idstring required
service_type'PHYSICAL_THERAPY' | 'OCCUPATIONAL_THERAPY' | 'SPEECH_THERAPY' | 'OTHER' required
test_modeboolean required
urgency'ROUTINE' | 'URGENT' required

URGENT requires urgency_reason and should only be used when the payer's expedited-review standard is met.

urgency_reasonstring nullable
approved_unit_typestring nullable
approved_unitsinteger nullable
created_atstring date-time required
determined_atstring date-time nullable
effective_datestring date nullable
expiration_datestring date nullable
idstring required
last_status_atstring date-time required
payer_idstring required
payer_namestring required
plan_namestring nullable
plan_typestring nullable
portal_reference_numberstring nullable
prior_authorization_numberstring nullable
requirements_checked_atstring date-time nullable
status'RECEIVED' | 'NEEDS_INFORMATION' | 'READY_FOR_REVIEW' | 'AUTHORIZATION_NOT_REQUIRED' | 'SUBMITTED' | 'PENDING_PAYER' | 'APPROVED' | 'PARTIALLY_APPROVED' | 'DENIED' | 'CANCELLED' required
status_messagestring nullable
submission_channel'PORTAL' | 'PHONE' | 'FAX' | 'API' | 'OTHER' nullable
submission_destinationstring nullable
submitted_atstring date-time nullable
updated_atstring date-time required

Changes

No recorded changes to this operation across all 1 revision of this API.