# Authentication
Source: https://docs.casehealth.ai/api-reference/authentication



# 🔐 Authentication

Case Health AI (CHAI) uses **API keys** to authenticate requests. Once you have signed a BAA and agreement too partner with us, we will provide you with a workspace. Inside the workspace you will find your keys inside your Developer Settings > API Keys.

We do not support public signups or self-service API key generation.

To access the API:

* Book a demo with our sales engineering team
* We'll provision your organization-specific credentials

👉 [Book a demo](https://calendly.com/fadi-casehealth)

After your demo, we’ll provide:

* Your **API key**
* A **sandbox base URL**
* Access to optional plugins like Compendiums and CMS policies

***

## 🧾 How to Authenticate

All requests must include your API key in the `X-API-KEY` header. All requests must be made in HTTPS. Using your X-API-KEY we will find your workspace and authenticate your request.

### 🔑 Header format

```http  theme={null}
X-API-KEY: YOUR_API_KEY
```


# Create Prior Auth
Source: https://docs.casehealth.ai/api-reference/endpoint/create

POST /prior_auths
Creates a new prior authorization. The status and intake_status fields can have the following values: Processing, Succeeded, Cancelled, Failed



# Run Determination
Source: https://docs.casehealth.ai/api-reference/endpoint/prior_auths/determination

POST /prior_auths/{prior_auth_id}/determination
Submits a determination for a specific prior authorization. This will run a policy check, generate a summary, and submit supporting information.



# Get Prior Auth
Source: https://docs.casehealth.ai/api-reference/endpoint/prior_auths/get

GET https://app.casehealth.com/api/v1/prior_auths/{prior_auth_id}
Returns a specific prior authorization by ID

## Path Parameters

<ParamField path="prior_auth_id" type="string" required>
  Unique identifier of the prior authorization (UUID format)
</ParamField>

## Response

<ResponseField name="id" type="string">
  Unique identifier for the prior authorization
</ResponseField>

<ResponseField name="status" type="string">
  Current status of the prior authorization. Possible values: `Processing`, `Succeeded`, `Cancelled`, `Failed`
</ResponseField>

<ResponseField name="intake_status" type="string">
  Current intake status of the prior authorization. Possible values: `Processing`, `Succeeded`, `Cancelled`, `Failed`
</ResponseField>

<ResponseField name="document_url" type="string">
  URL to the associated document
</ResponseField>

<ResponseField name="created_at" type="string">
  Timestamp when the prior authorization was created
</ResponseField>

<ResponseField name="updated_at" type="string">
  Timestamp when the prior authorization was last updated
</ResponseField>

<RequestExample>
  ```bash cURL theme={null}
  curl --location --request GET 'https://app.casehealth.com/api/v1/prior_auths/550e8400-e29b-41d4-a716-446655440000' \
  --header 'X-API-Key: YOUR_API_KEY'
  ```
</RequestExample>

<ResponseExample>
  ```json Response theme={null}
  {
    "id": "550e8400-e29b-41d4-a716-446655440000",
    "status": "pending",
    "intake_status": "Succeeded",
    "document_url": "https://chai-test-storage.nyc3.cdn.digitaloceanspaces.com/Jackie%20McDonald.pdf",
    "created_at": "2025-08-21T16:41:29.4822",
    "updated_at": "2025-08-21T16:42:56.1892"
  }
  ```
</ResponseExample>


# Get Intake Data
Source: https://docs.casehealth.ai/api-reference/endpoint/prior_auths/intake

GET https://app.casehealth.com/api/v1/prior_auths/{prior_auth_id}/intake
Returns FHIR intake data for a specific prior authorization including patient, practitioners, diagnoses, and medication requests

## Path Parameters

<ParamField path="prior_auth_id" type="string" required>
  Unique identifier of the prior authorization (UUID format)
</ParamField>

## Response

<ResponseField name="fhir" type="object">
  FHIR bundle containing all intake data

  <Expandable title="fhir object">
    <ResponseField name="patient" type="object">
      FHIR Patient resource containing patient demographics and information
    </ResponseField>

    <ResponseField name="practitioners" type="array">
      Array of FHIR Practitioner resources containing healthcare provider information
    </ResponseField>

    <ResponseField name="diagnoses" type="array">
      Array of FHIR Condition resources containing diagnosis information
    </ResponseField>

    <ResponseField name="medication_requests" type="array">
      Array of FHIR MedicationRequest resources containing prescribed medication information
    </ResponseField>
  </Expandable>
</ResponseField>

<RequestExample>
  ```bash cURL theme={null}
  curl --location --request GET 'https://app.casehealth.com/api/v1/prior_auths/550e8400-e29b-41d4-a716-446655440000/intake' \
  --header 'X-API-Key: YOUR_API_KEY'
  ```
</RequestExample>

<ResponseExample>
  ```json Response theme={null}
  {
      "fhir": {
          "patient": {
              "resourceType": "Patient",
              "id": "ZzG8MUQbkFhCZLZ3XmfA7UyL",
              "active": true,
              "name": [
                  {
                      "use": "official",
                      "given": [
                          "Jackie"
                      ],
                      "family": "McDonald"
                  }
              ],
              "gender": "f",
              "birthDate": "2012-10-24"
          },
          "practitioners": [
              {
                  "resourceType": "Practitioner",
                  "id": "SAT34oczEqXVqwpswyL6iSQe",
                  "active": true,
                  "identifier": [
                      {
                          "use": "official",
                          "type": {
                              "coding": [
                                  {
                                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                      "code": "NPI",
                                      "display": "National Provider Identifier"
                                  }
                              ]
                          },
                          "system": "http://hl7.org/fhir/sid/us-npi",
                          "value": "1548517105"
                      }
                  ],
                  "name": [
                      {
                          "use": "official",
                          "given": [
                              "STACY",
                              ""
                          ],
                          "family": "CHANCE",
                          "prefix": [
                              "DR."
                          ]
                      }
                  ],
                  "telecom": [
                      {
                          "system": "phone",
                          "value": "(541) 746 6816",
                          "use": "work"
                      }
                  ],
                  "address": [
                      {
                          "use": "work",
                          "type": "physical",
                          "country": ""
                      }
                  ],
                  "qualification": [
                      {
                          "code": {
                              "text": "PEDIATRICS"
                          }
                      }
                  ]
              }
          ],
          "diagnoses": [
              {
                  "resourceType": "Condition",
                  "id": "fBvqxiqYiaDPpeU6Np8kuvAn",
                  "clinicalStatus": {
                      "coding": [
                          {
                              "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                              "code": "active",
                              "display": "Active"
                          }
                      ]
                  },
                  "verificationStatus": {
                      "coding": [
                          {
                              "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
                              "code": "confirmed",
                              "display": "Confirmed"
                          }
                      ]
                  },
                  "code": {
                      "coding": [
                          {
                              "system": "http://hl7.org/fhir/sid/icd-10-cm",
                              "code": "F90.2",
                              "display": "Attention-deficit hyperactivity disorder, combined type"
                          }
                      ],
                      "text": "Attention-deficit hyperactivity disorder, combined type"
                  },
                  "note": [
                      {
                          "text": "ADHD"
                      }
                  ],
                  "extension": [
                      {
                          "url": "http://example.org/fhir/StructureDefinition/ai-summary",
                          "valueString": "The primary diagnosis for the medication request is ADHD, with the ICD-10 code F90.2, indicating Attention-deficit hyperactivity disorder, combined type. There are no secondary diagnoses listed."
                      }
                  ],
                  "meta": {
                      "tag": [
                          {
                              "system": "http://example.org/fhir/CodeSystem/metadata",
                              "code": "description",
                              "display": ""
                          },
                          {
                              "system": "http://example.org/fhir/CodeSystem/metadata",
                              "code": "diagnosis_name",
                              "display": "ADHD"
                          },
                          {
                              "system": "http://example.org/fhir/CodeSystem/metadata",
                              "code": "diagnosis_codes",
                              "display": "[\"F90.2\"]"
                          }
                      ]
                  }
              }
          ],
          "medication_requests": [
              {
                  "resourceType": "MedicationRequest",
                  "id": "TkWtTQ579msjFzzAgtBEW66W",
                  "status": "active",
                  "intent": "order",
                  "medicationCodeableConcept": {
                      "display": "ADZENYS XR OPT",
                      "coding": [
                          {
                              "system": "http://hl7.org/fhir/sid/ndc",
                              "code": "70165-005",
                              "display": "ADZENYS XR OPT"
                          }
                      ]
                  },
                  "dosageInstruction": [
                      {
                          "text": "Take 1 tab Po Daily",
                          "route": {
                              "text": "Po"
                          },
                          "doseAndRate": [
                              {
                                  "doseQuantity": {
                                      "value": "6.3 mg",
                                      "unit": "dose"
                                  }
                              }
                          ]
                      }
                  ],
                  "reasonCode": [
                      {
                          "text": "ADHD"
                      }
                  ],
                  "extension": [
                      {
                          "url": "http://example.org/fhir/StructureDefinition/total-units-requested",
                          "valueDecimal": 30
                      },
                      {
                          "url": "http://example.org/fhir/StructureDefinition/ai-summary",
                          "valueString": "The medication requested is ADZENYS XR OPT with a strength of 6.3 mg. The patient is instructed to take 1 tablet orally daily, with a total quantity of 30 tablets per month. The medication is self-administered. The diagnosis for use is ADHD, with an ICD-10 code of F90.2. The request is for a new medication, not a continuation of therapy. The patient has a history of failure with the medication Strattera, but no contraindications or intolerances were noted. The patient is not currently hospitalized, pregnant, or recently discharged. The urgency level is not specified."
                      }
                  ]
              }
          ]
      }
  }
  ```
</ResponseExample>


# Run policy check
Source: https://docs.casehealth.ai/api-reference/endpoint/prior_auths/policy_check

POST /prior_auths/{prior_auth_id}/policy_check
Triggers a policy check for a specific prior authorization



# Add Supporting Information
Source: https://docs.casehealth.ai/api-reference/endpoint/prior_auths/supporting_information

POST /prior_auths/{prior_auth_id}/supporting_information
Submits supporting information for a specific prior authorization including claim history and test claims



# Introduction
Source: https://docs.casehealth.ai/api-reference/introduction



# 👋 Welcome to Case Health AI

Case Health AI (CHAI) is an API-first platform designed to power modern prior authorization workflows with intelligent automation.

We partner with health plans and utilization management (UM) platforms to streamline the clinical decision-making process using modular AI agents that can handle intake, eligibility checks, policy validation, and real-time decisioning.

***

## 🌐 Base URL

All API requests are made to the following base URL:

```bash  theme={null}
https://app.casehealth.ai/api/v1
```

***

## 🛠 Need Help?

For engineering support or technical questions:\
📧 **[mas@casehealth.ai](mailto:mas@casehealth.ai)**

To schedule a live demo and receive your API key:\
📅 [Book with our team →](https://calendly.com/mas-casehealth)

***

## 🔒 Security & Compliance

CHAI is built for enterprise-grade security and full compliance with healthcare regulations.

We support:

* HIPAA-compliant infrastructure
* Encrypted data at rest and in transit
* Role-based access controls (RBAC)
* Full audit logs for every decision
* Isolated environments and per-org API keys

We are actively pursuing **SOC 2 Type II** and **HITRUST** certification.

***

If you're ready to start, check out the [Authentication](/authentication) page to get your API key and begin integrating.


# Introduction
Source: https://docs.casehealth.ai/index

Welcome to the Case Health AI (CHAI) API documentation

# 👋 Welcome to the CHAI API

**Case Health AI (CHAI)** is a modern API platform built to automate prior authorization workflows using modular AI agents. We integrate directly into your utilization management (UM) systems to streamline intake, eligibility validation, policy enforcement, and AI-powered decisions.

For policy checks, you'll need to submit your PDF policies from your workspace portal by going to Plan from the side navigation. We use NDC and CPT codes to determine which policy to use.

***

## ⚡ Quick Start

<CardGroup cols={2}>
  <Card title="Schedule a demo" icon="paper-plane" href="https://calendly.com/mas-casehealth">
    Schedule a demo to learn how to submit a FHIR-based prior authorization to kick off the AI workflow.
  </Card>

  <Card title="Get an API Key" icon="key" href="/api-reference/authentication">
    Book a short onboarding session to receive your secure API key and environment access.
  </Card>
</CardGroup>

***

## 🔌 Add AI Decision Support

CHAI offers modular AI agents and plugin options:

<CardGroup cols={2}>
  <Card title="Submit your first Prior Auth" icon="file-pdf" href="/api-reference/endpoint/prior_auths/get">
    Submit your first Prior Auth to kick off the AI workflow.
  </Card>

  <Card title="View intake results" icon="address-card" href="/api-reference/endpoint/prior_auths/intake">
    View intake results to see the patient, practitioners, diagnoses, and medication requests.
  </Card>

  <Card title="View policy check results" icon="book-medical" href="/api-reference/endpoint/prior_auths/policy_check">
    View policy check results to see the policy check results.
  </Card>

  <Card title="Run a determination" icon="sitemap" href="/api-reference/endpoint/prior_auths/determination">
    Run a determination to see the final decision if the prior auth should be approved, denied, or Request For Info.
  </Card>
</CardGroup>

***

Need help integrating? [Book a session with our engineers](https://calendly.com/mas-casehealth) or reach out at **[mas@casehealth.ai](mailto:mas@casehealth.ai)**.