Prior authorization API
API overview
Utah Medicaid's Prior Authorization API is an enterprise API that implements the HL7 FHIR standard, which allows providers to securely receive a list of covered items and services, request a prior authorization, and receive a response. Prior authorization decisions will be made within 72 hours for urgent requests and within 7 calendar days for standard requests. If a request is denied, we will tell you the exact reason why.
The Prior Authorization API follows the SMART Backend Services security model.
Capability statement
Getting started
In order to access the API, Providers will need to register by completing the form found on the Provider Registration page.
Authorize URL format:
https://sso.mylogin.utah.gov:443/am/oauth2/authorize?client_id={your_client_id}&redirect_uri={your_redirect_url}&response_type=codeGetting access token:
HTTP method: POST
URL: https://sso.mylogin.utah.gov:443/am/oauth2/access_token
HTTP headers:
| Header name | Value |
|---|---|
| content-type | application/json |
| accept | application/json |
| authorization | Basic base 64({client_id}:{client_secret}) |
HTTP body:
| Field name | Value |
|---|---|
| code | {oauth code} |
| grant_type | authorization_code |
| redirect_url | {your_redirect_uri} |
Explore API
Resources
| Resource | URL |
|---|---|
| Coverage |
https://fp.medicaid.utah.gov/ProviderClient/Coverage |
| Endpoint |
https://fp.medicaid.utah.gov/ProviderClient/Endpoint |
| ExplanationOfBenefit |
https://fp.medicaid.utah.gov/ProviderClient/ExplanationOfBenefit |
| HealthcareService |
https://fp.medicaid.utah.gov/ProviderClient/HealthcareService |
| InsurancePlan |
https://fp.medicaid.utah.gov/ProviderClient/InsurancePlan |
| Location |
https://fp.medicaid.utah.gov/ProviderClient/Location |
| Metadata |
https://fp.medicaid.utah.gov/ProviderClient/metadata |
| OperationDefinition |
https://fp.medicaid.utah.gov/ProviderClient/OperationDefinition |
| Organization |
https://fp.medicaid.utah.gov/ProviderClient/Organization |
| OrganizationAffiliation |
https://fp.medicaid.utah.gov/ProviderClient/OrganizationAffiliation |
| Patient |
https://fp.medicaid.utah.gov/ProviderClient/Patient |
| Practitioner |
https://fp.medicaid.utah.gov/ProviderClient/Practitioner |
| PractitionerRole |
https://fp.medicaid.utah.gov/ProviderClient/PractitionerRole |
| RelatedPerson |
https://fp.medicaid.utah.gov/ProviderClient/RelatedPerson |
| StructureDefinition |
https://fp.medicaid.utah.gov/ProviderClient/StructureDefinition |
Request header:
| Header name | Value |
|---|---|
| content-type | application/json |
| accept | application/json |
| authorization | Bearer {ACCESS_TOKEN} |