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The Prior Auth API gives you one durable resource for prior authorization: the authorization itself. You create a draft authorization with coverage context and a coded service. The API resolves the matching payer questionnaire, and the same authorization carries the entire lifecycle from data collection through submission, payer outcome, and every artifact and event along the way.

Why we built this

Most prior auth integrations treat the payer questionnaire as a static form. Your system renders it, collects answers, and sends the packet. If the answers are complete, it looks ready. But payer forms aren’t static. They branch. A “No” on question 3 disables questions 4 through 7 and activates an entirely different set of follow-ups. A change to the provider’s specialty makes a field required that wasn’t before. A answer to a parent question invalidates three downstream answers that were already filled in. When your system doesn’t understand these rules, submissions look complete but aren’t. A single incorrectly filled field — an answer left over from the wrong branch, a clinical criterion that was required but never asked — is enough for a payer to deny the request. One bad field, and the patient waits longer for care. This API doesn’t let that happen. It understands the form:
  • When an upstream answer changes, stale downstream answers are automatically cleared.
  • Answers to questions that aren’t currently active are rejected.
  • Submission is blocked until every required field, contextual dependency, and grouped validation rule is satisfied.
  • At every step, the API tells you exactly what’s still needed to reach a clean submission.

Integration flow

1

Create the authorization

Send payer coverage context, a coded service, diagnoses, and your case metadata. The API creates a draft authorization and returns the resolved FHIR R4 Questionnaire immediately.
2

Complete the case data

Patch questionnaire answers on the authorization and attach any supporting files you want included in the submission packet.
3

Generate a preview

Call the preview endpoint to render the current filled form and draft packet. Use submittable, validationIssues, contextRequirements, and activeRequirementGroups to decide whether the case is ready.
4

Submit and monitor

Submit once. After that, track workflow state, blocking actions, artifacts, and events until the payer responds.

Core resources

ResourcePurpose
AuthorizationDurable work item for data collection, preview, submission, and lifecycle tracking.
FileUploadable file resource used for supporting documents and sandbox payer documents.
ActionBlocking work that must be resolved before the authorization can continue.
ArtifactGenerated or payer-provided document correlated to an authorization.
EventImmutable audit record for lifecycle changes.

State model

Each authorization exposes two independent state fields:
FieldValuesMeaning
workflowStateneeds_input, ready_to_submit, submitting, pending_payer, action_required, completed, cancelledOperational state of the case.
decisionStateunknown, pending, approved, deniedCurrent payer decision, if any.
See Authorization lifecycle for the transition rules.

Payer catalog

Use the catalog endpoint to determine what the API currently supports: Use the returned payerId in authorization creation. If the coverage and service combination is not available, authorization creation returns unsupported_case.

Environments and authentication

EnvironmentBase URLWhat to use
Sandboxhttps://api.sandbox.trycollate.aiSandbox credential for integration testing, including /v1/sandbox/*
Productionhttps://api.trycollate.aiProduction credential for live traffic
Sandbox and production credentials are issued separately. They can belong to the same WorkOS organization, but they are not interchangeable.

Next steps

Quickstart

Create, preview, submit, and test a full authorization flow with curl.

Authorization lifecycle

Review workflow states, actions, submission semantics, and idempotency.

Sandbox testing

Use the sandbox endpoint to inject payer approvals, denials, and requests for information.

API reference

Review authentication, files, errors, pagination, and endpoint conventions.