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POST
/
prior_auths
/
{prior_auth_id}
/
determination
cURL
curl --request POST \
  --url https://app.casehealth.ai/api/v1/prior_auths/{prior_auth_id}/determination \
  --header 'X-API-Key: <api-key>'
{
  "determination": {
    "status": "approved",
    "reasoning": [
      {
        "step": 1,
        "description": "Patient meets age and diagnosis criteria for ADHD treatment",
        "source": "policy_document/section_3.2"
      },
      {
        "step": 2,
        "description": "No concurrent contraindicated medications identified in claim history",
        "source": "claim_history"
      },
      {
        "step": 3,
        "description": "Step therapy requirement completed - patient tried immediate-release stimulants",
        "source": "prior_auth_history"
      }
    ],
    "recommendation": "Approve PA for Adzenys XR 30-day supply",
    "references": [
      "policy_document/ADZENYS_XR.pdf",
      "claim_history",
      "prior_auth_history"
    ],
    "generated_at": "2025-08-22T17:45:00Z"
  }
}

Authorizations

​
X-API-Key
string
header
required

Path Parameters

​
prior_auth_id
string<uuid>
required

Unique identifier of the prior authorization

Response

Determination generated successfully

​
determination
object
Example:
{
  "status": "approved",
  "reasoning": [
    {
      "step": 1,
      "description": "Patient meets age and diagnosis criteria for ADHD treatment",
      "source": "policy_document/section_3.2"
    },
    {
      "step": 2,
      "description": "No concurrent contraindicated medications identified in claim history",
      "source": "claim_history"
    },
    {
      "step": 3,
      "description": "Step therapy requirement completed - patient tried immediate-release stimulants",
      "source": "prior_auth_history"
    }
  ],
  "recommendation": "Approve PA for Adzenys XR 30-day supply",
  "references": [
    "policy_document/ADZENYS_XR.pdf",
    "claim_history",
    "prior_auth_history"
  ],
  "generated_at": "2025-08-22T17:45:00Z"
}
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