PAS $submit-attachment FHIR API Specification
$submit-attachment Overview
InterSystems PAS (Prior Authorization Support) FHIR APIs are designed in compliance with the CMS-0057-F regulationsOpens in a new tab.
Refer to the Getting Started section for information on connectivity, authentication and how to get help. To use the FHIR APIs, you will need to know the base URL of the FHIR server you will be connecting to. You can also retrieve the PAS capability statement for the service.
As part of the PAS APIs, a provider can use the $submit-attachment APIOpens in a new tab to submit an attachment related to a claim or a prior authorization request. Attachment content may be provided as a Base64-encoded representation of the attachment or as a URL that gives the location where the attachment may be fetched from.
Solicited attachments are submitted by you as the provider to support a claim or prior authorization in response to a payer's request for additional documentation. The payer assigns a tracking control number (the TrackingId) and includes it in the request they send to you.
Unsolicited attachments are sent by you without a request from the payer. You assign a tracking control number to the claim or prior authorization transaction and use the same number for its attachments. This allows them to be associated with the transaction whether they are submitted before, with, or after it.
Workflow
A typical prior authorization workflow involving the $submit-attachment operation might be:
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The provider collects necessary patient information, treatment details, and supporting documentation
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The provider's system prepares and sends a request to the payer's PAS API endpoint using the $submit operation
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The payer's system receives and reviews the request and decides that more information is required
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The payer's system generates a response requesting attachments
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The provider uses the $submit-attachment API to send the requested information to the payer
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The payer associates the submitted attachments with the prior authorization transaction
Endpoint: $submit-attachment
URL
The URL for this API is:
<BaseURL>/csp/healthshare/<namespace-identifier>/pas-v<IG version>/$submit-attachment
where <BaseURL> and <namespace-identifier> have been provided to you by the payer organization you are connecting with, and <IG version> is the version number of the PAS Implementation Guide you are working with. In the current version of this API, the supported versions are 2.0.1 and 2.1.0.
Optional Capabilities
None.
Endpoint Prerequisites
None.
Required Header Settings
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Content-Type: application/fhir+json
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Accept: application/fhir+json
Request Methods
Invokes the $submit-attachment operation with a Submit Attachment Parameters resource.
Query Parameters
None.
Request Body
The CDex Implementation Guide describes the Submit Attachment operationOpens in a new tab and requirements of the associated Submit Attachment Parameters resourceOpens in a new tab.
Success Response
The request succeeded.
Error Responses
Error due to a bad request. The response body contains a FHIR OperationOutcome resource with further details.
Possible causes of a bad request include:
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Missing or invalid parameters in the request body
The user does not have the necessary authorization for the operation.
Possible causes include:
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Missing or invalid JWT
Possible causes include:
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Token does not include required OAuth scopes.
Possible causes include:
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Failed authorization.
Possible causes include:
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Accept header does not include application/fhir+json.
Possible causes include:
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Content-Type header is not application/fhir+json.
A generic error message, returned when no more specific message is suitable.