API Reference
Check prior authorization requirements
Evaluate if Medicare procedures require prior authorization based on procedure codes and state/jurisdiction. Returns matched policies, coverage disposition, and documentation requirements.
Authorization
bearerAuth AuthorizationBearer <token>
API key in format: vrt_live_xxxxx or vrt_test_xxxxx
In: header
Header Parameters
X-Idempotency-Key?string
Unique key for idempotent requests (recommended for safe retries)
Request Body
application/json
procedure_codes*array<string>
CPT/HCPCS codes to check
Items
1 <= items <= 10state?string
Two-letter state code for MAC jurisdiction lookup
Length
2 <= length <= 2criteria_page?integer
Page number for criteria pagination
Default
1Range
1 <= valuecriteria_per_page?integer
Items per page for criteria
Default
25Range
1 <= value <= 100Response Body
application/json
application/json
application/json
application/json
curl -X POST "https://verity.backworkai.com/api/v1/prior-auth/check" \ -H "Content-Type: application/json" \ -d '{ "procedure_codes": [ "string" ] }'{
"success": true,
"data": {
"pa_required": true,
"confidence": "high",
"reason": "string",
"matched_policies": [
{
"policy_id": "string",
"title": "string",
"policy_type": "string",
"jurisdiction": "string",
"codes": [
{
"code": "string",
"code_system": "string",
"disposition": "string",
"condition_reference": "string"
}
]
}
],
"documentation_checklist": [
"string"
],
"criteria_details": {
"indications": [
{
"text": "string",
"tags": [
"string"
],
"policy_id": "string"
}
],
"limitations": [
{
"text": "string",
"tags": [
"string"
],
"policy_id": "string"
}
],
"pagination": {
"page": 0,
"per_page": 0,
"indications": {
"total": 0,
"total_pages": 0,
"has_next": true,
"has_previous": true
},
"limitations": {
"total": 0,
"total_pages": 0,
"has_next": true,
"has_previous": true
},
"documentation": {
"total": 0,
"total_pages": 0,
"has_next": true,
"has_previous": true
}
}
},
"mac": {
"name": "string",
"jurisdiction": "string",
"states": [
"string"
]
}
},
"meta": {
"request_id": "string",
"timestamp": "2019-08-24T14:15:22Z",
"idempotency_key": "string",
"cached": true
}
}{
"success": false,
"error": {
"code": "VALIDATION_ERROR",
"message": "Request validation failed",
"details": {
"q": [
"Search query is required"
]
},
"docUrl": "https://docs.verity.io/errors#validation-error"
},
"meta": {
"request_id": "req_abc123",
"timestamp": "2024-01-15T10:30:00Z"
}
}{
"success": false,
"error": {
"code": "AUTH_KEY_NOT_FOUND",
"message": "API key not found",
"hint": "Check that your API key is correct",
"docUrl": "https://docs.verity.io/errors#auth-key-not-found"
},
"meta": {
"request_id": "req_abc123",
"timestamp": "2024-01-15T10:30:00Z"
}
}{
"success": false,
"error": {
"code": "RATE_LIMIT_EXCEEDED",
"message": "Rate limit exceeded",
"hint": "Upgrade to pay-as-you-go for higher limits",
"docUrl": "https://docs.verity.io/errors#rate-limit-exceeded"
},
"meta": {
"request_id": "req_abc123",
"timestamp": "2024-01-15T10:30:00Z"
}
}