API Change (21.7): Updated Ask at Order Entry Questions in Authorization and Insurance Referrals Section on Orders

Summary: With the release of the new feature athenaNet Standardizes Prior Authorization and Insurance Fields for Some Order Types, practices can now enter prior authorization (PA) and insurance information for the following order types in a new Authorization and Insurance Referrals section:  

  • Surgery  
  • Procedure  
  • Consult  
  • Imaging  

This new section replaces the “ask at order entry” (AOE) questions that you previously used to record prior authorizations. 

Products: athenaClinicals, athenaCollector 

Available: 21.7 GA

Highlights: 

  • This has a breaking change
  • New fields in the Authorization and Insurance Referrals section replace outdated AOEs on orders 
  • You must update Encounter Group and Auth Ops Group APIs with the new AOE questions 
     

Overview

Updated Order questions

New order questions added:

  • Place of Service (SURGERY and PROCEDURE orders only) 
  • Procedure Code 
  • Authorization Status 
  • Authorization # 
  • Effective Start Date 
  • Effective End Date 
  • Visits Approved (CONSULT orders only) 
  • Authorization Notes 
  • Date of Service 

Old order questions removed:

  • Anticipated Date 
  • Appointment Date 
  • auth 
  • Authorization Notes 
  • Authorization # 
  • CPT 
  • Date 
  • Date Needed 
  • Date of Appointment 
  • Date of Procedure 
  • Date of Surgery 
  • Date of Treatment 
  • End Date 
  • Expected service date 
  • Initial Consult Date 
  • Number of Visits 
  • Patient Admission 
  • Pre Authorization 
  • Precertification Required? 
  • Preference for Date of Surgery 
  • Prior Authorization # 
  • Prior Authorization? 
  • Procedure Code 
  • Procedure Date 
  • Referral Number 
  • Requested appointment date 
  • Requested Date 
  • Schedule Date 
  • Start Date 
  • Stop Date 
  • Surgery Date 
  • Surgery Date/Time 
  • Total # of Visits 
  • Visits Approved 

 

API Endpoint Updates

API Name: Encounter Group 

Endpoint: GET /chart/encounter/{encounterid}/orders/{orderid}  

What is being changed: For all practices, date and authorization data will be captured in the new order questions and the old order questions will be removed from the orders. When you call the API, you will receive only the new order questions, and they may have different names than the old order questions. You are receiving all the questions and answers on the order. For instance, previously the procedure code question may have been called “CPT” and now it will be called “Procedure code”. 

Is this a breaking change: Yes

What will current users of the endpoint need to update in their code: If your code specifically references one of the old order questions, you should update your code to use one of the new questions instead. If you do not rely on any specific order questions, or do not use order question data at all, no change is required. You will continue to receive all the fields on the order when you call the API.  

What will happen if the changes are not made: If your code specifically references one of the old order questions and you do not update it, this data will no longer be pulled into your application as you intended.

 

API Name: Encounter Group 

Endpoint: POST /chart/encounter/{encounterid}/orders/referral 

What is being changed: If the procedure code or start date are provided, these will no longer be added to the order.  

Is this a breaking change: No

What will current users of the endpoint need to update in their code: n/a

What will happen if the changes are not made: n/a

 

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