Skip to main content

​
Authentication

All requests require an API key passed via the x-api-key header, along with a tenant_id query parameter.
​
x-api-key
string
required
Your tenant API key.

​
Query Parameters

​
tenant_id
integer
required
Your tenant ID.
​
visit_number
string
required
The visit number to check authorization requirements for.

​
Response

​
visit_number
string
The visit number that was queried.
​
status
string
Call status. One of completed, in_progress, or failed.
​
patient_name
string
Patient name on the claim.
​
payer_name
string
Name of the insurance payer.
​
procedure_code
string
CPT/HCPCS procedure code being checked.
​
procedure_description
string
Human-readable description of the procedure.
​
auth_required
boolean
Whether prior authorization is required for this procedure.
​
auth_submission_method
string
How to submit the authorization request (e.g. portal, phone, fax).
​
auth_turnaround_days
integer
Expected turnaround time for authorization decision in business days.
​
required_documentation
string[]
List of documents required for the authorization request.
​
notes
string
Additional notes or instructions from the payer representative.
curl -X GET "https://api.refactorbilling.com/verify-auth-requirements?tenant_id=1&visit_number=V12345" \
  -H "x-api-key: your-api-key"

{
  "visit_number": "V12345",
  "status": "completed",
  "patient_name": "John Doe",
  "payer_name": "UnitedHealthcare",
  "procedure_code": "27447",
  "procedure_description": "Total knee replacement",
  "auth_required": true,
  "auth_submission_method": "portal",
  "auth_turnaround_days": 5,
  "required_documentation": [
    "Operative report",
    "Clinical notes demonstrating conservative treatment failure",
    "Imaging results (X-ray or MRI)"
  ],
  "notes": "Authorization valid for 60 days from approval date. Must be submitted at least 10 business days before scheduled procedure."
}