> ## Documentation Index
> Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Prior authorization

> CRD-style PA check, documentation, and delegated vendors

Check whether a payer requires prior authorization **before** the service is ordered. This is the client PA API (`/v1/prior-auth`). Payer identity and filing rules live on [Payer network](/docs/network). Cited coverage policy text is [Payer policies](/docs/policies).

## Check a code

```bash theme={null}
curl "https://api-dev.rcintell.com/v1/prior-auth/check?payer_slug=uhc&code=27447&state=KS" \
  -H "X-API-Key: kp_test_..."
```

| Param              | Required | Notes                                                            |
| ------------------ | -------- | ---------------------------------------------------------------- |
| `payer_slug`       | yes      | Slug or alias (`uhc`, `aetna`, `bcbs_ma`)                        |
| `code`             | no       | CPT/HCPCS — enables code-specific and range match                |
| `service_category` | no       | e.g. `advanced_imaging`, `orthopedic_surgery`                    |
| `plan_type`        | no       | Plan filter when the payer has multiple books                    |
| `state`            | no       | Two-letter. Also inferred from `ccn`                             |
| `place_of_service` | no       | POS code                                                         |
| `visit_count`      | no       | Threshold-based payers                                           |
| `ccn`              | no       | Fills state/POS from the facility and applies facility overrides |

The response is a determination plus a rationale chain (code → range → category → payer default). Pass `ccn` when the facility is registered so overrides apply.

## Documentation and vendors

```bash theme={null}
curl "https://api-dev.rcintell.com/v1/prior-auth/documentation/uhc/27447" \
  -H "X-API-Key: kp_test_..."

curl "https://api-dev.rcintell.com/v1/prior-auth/requirements/uhc" \
  -H "X-API-Key: kp_test_..."

curl "https://api-dev.rcintell.com/v1/prior-auth/vendors" \
  -H "X-API-Key: kp_test_..."
```

Use documentation when you already know PA is required and need the packet. Use vendors when the payer delegates (e.g. radiology UM).

## MCP

| Tool                   | REST                                                                                                 |
| ---------------------- | ---------------------------------------------------------------------------------------------------- |
| `check_pa_required`    | `GET /v1/prior-auth/check` (pass `ccn`, `state`, `plan_type`, `place_of_service` when you have them) |
| `get_pa_documentation` | `GET /v1/prior-auth/documentation/{payer}/{code}`                                                    |
| `find_pa_vendor`       | `GET /v1/prior-auth/vendors`                                                                         |