Predetermination
A hospital planning a treatment can learn the benefit a payer would approve for it before the patient is admitted, and plan the admission and the patient's share of the cost around the answer.
Calls
| Call | Method and path | What it does |
|---|---|---|
| Predetermination request | POST /v1/predetermination/submit | Provider asks the payer what it would approve for a proposed treatment before committing to a pre-authorisation. |
| Predetermination callback | POST /v1/predetermination/on_submit | Payer returns its estimate for a predetermination request to the provider: a ClaimResponse with use predetermination and the benefit it would approve. |
Callbacks you host
The exchange posts these to the endpoint_url you registered. Answer each with HTTP 202 first.
| Path | Hosted by |
|---|---|
/v1/predetermination/submit | The payer |
/v1/predetermination/on_submit | The provider |
Base URLs
| Environment | Base URL |
|---|---|
| Sandbox, NHCX exchange. | https://apisbx.abdm.gov.in/hcx |
| Production. | https://apisprod.nha.gov.in/hcx |
Guides that use these calls
The whole specification, with a request you can send from the page, is the Predetermination API reference.