Add Specialty Marketplace Override

post

https://clientuatgateway.rxsense.com/core/api/AuthorizedOverride/Create

Creates a Specialty Marketplace Authorization Override for a member. The override will only apply when: - The claim is submitted for the specified member. - The date of service falls within the override's effective date range. - The drug matches the authorization's product criteria. - The drug is in the Specialty Marketplace Configuration. - The claim was initially rejected with code "4W – Must Fill Through Specialty Pharmacy".

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Body Params

MemberIdentifier

integer

required

MemberCardIdentityId of the member for whom the Authorization is created.

ExternalAuthorizationNumber

int64

External authorization number. When provided, existing conflicting Overrides are deactivated and replaced.

GPI

string

Generic Product Identifier. Required if NDC is not provided.

NDC

string

National Drug Code. Required if GPI is not provided.

MscCode

string

Multi-Source Code(s): M, O, N, Y or any combination.

IsCompoundDrug

boolean

Indicates if the Authorization applies to a compound drug.

CompoundDrug

array of objects

List of compound drugs (minimum 2 required if IsCompoundDrug is true).

CompoundDrug

AdminOverrides

array of objects

required

List of Specialty Marketplace Override configurations.

AdminOverrides*

OverrideNotes

array of strings

Override notes explaining why the Override was created.

OverrideNotes

CallNotes

array of strings

Call notes documenting Customer Support calls.

CallNotes

Headers

X-Api-Key

string

required

Responses

400

Bad request.

200Override created successfully.