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Documentation Index

Fetch the complete documentation index at: https://docs.medera.info/llms.txt

Use this file to discover all available pages before exploring further.

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1. Evaluate criteria

curl -X POST https://api.medera.ai/api/prior-auth/evaluate \
  -H "Authorization: Bearer $TOKEN" \
  -d '{
    "patient_data": { "diagnosis_codes": ["F32.1"], "phq9_score": 14 },
    "procedure_codes": ["90834"],
    "payer_id": "AETNA"
  }'
Response: recommendation (AUTO_APPROVE / LIKELY_APPROVE / NEEDS_REVIEW / LIKELY_DENY).

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2. Create the PA request

curl -X POST https://api.medera.ai/api/prior-auth/requests \
  -H "Authorization: Bearer $TOKEN" \
  -d '{
    "patient_id": "pat_abc",
    "diagnosis_codes": ["F32.1"],
    "procedure_codes": ["90834"],
    "clinical_justification": "...",
    "payer_id": "AETNA"
  }'
Initial state: PA_INITIATED.

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3. Generate documents

curl -X POST https://api.medera.ai/api/prior-auth/documents/generate \
  -H "Authorization: Bearer $TOKEN" \
  -d '{
    "request_id": "pa_abc",
    "document_types": ["MEDICAL_NECESSITY", "CLINICAL_SUMMARY"]
  }'

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4. Submit

curl -X POST https://api.medera.ai/api/prior-auth/requests/{id}/submit \
  -H "Authorization: Bearer $TOKEN"
Channel priority: EPA_API → CLEARINGHOUSE → PORTAL → FAX → MANUAL.

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5. Track and appeal

curl https://api.medera.ai/api/prior-auth/requests/{id} \
  -H "Authorization: Bearer $TOKEN"

# If denied:
curl -X POST https://api.medera.ai/api/prior-auth/requests/{id}/appeal \
  -H "Authorization: Bearer $TOKEN"