04 · Visit

Open a visit.

An encounter and its account, in one atomic write. consent_ref is required on every open, a purely clinical visit included. With service_lines the payer is asked for each; a refused line voids the whole open (422 VISIT_LINE_REFUSED), while an unreachable payer leaves the line pending. One open visit per patient. Send visit_number and invoice_number on every open: they are the provider's own numbers for the visit and its bill. For covers billed through Slade EDI both are required, or the line is refused, and invoice_number names that cover's first claim. For SHA, invoice_number is the number on the one comprehensive claim submitted for the visit at close, however many invoices the provider holds for it.

Keep from the response: visit_ref

Taught in: 04 · Visit

Add a service line.

Authorises a cover for a named intervention: the authorization unit, and the entry point for coordination of benefits. A line may name its own cover by sending selection_ref (and consent_ref) for it. Payer-first: pending, then authorized or refused. Outcomes: 200 authorized; 200 refused with the payer's verdict in refusal (the visit stays open); 200 consent_required with next_action step_up_consent when callback_url was sent and the cover needs a stronger factor than the visit's consent; 502 PAYER_UNREACHABLE, the line kept pending and the same request safe to retry. A visit opened clinical needs selection_ref here, or 409 SELECTION_UNUSABLE.

Keep from the response: service_line_ref

Taught in: 04 · Visit

Add a practitioner to the visit.

Given id, id_type and regulation_body, the identification is checked against the Health Worker Registry when one is wired; with no registry the check is skipped. A hospital doctor can be recorded by name instead, which skips the check.

Keep from the response: practitioner_ref

Taught in: 04 · Visit