MyndAuth API

Myndauth, Myndshft’s real-time prior authorization and value-based contracting engine, provides recommendations to clinicians, payer U/M teams, and has the ability to fully automate approval for Prior Authorization requests. Myndauth leverages Natural Language Processing (NLP) and Machine Learning (ML) to digitize a Payer’s clinical guidelines into a sophisticated rules engine.

This API specification highlights the process to authenticate, send USCDI FHIR V4 based JSON bundle for a PA decision request, and to consume a JSON response back from the MyndAuth engine. MyndAuth enables two key work streams:

1. Determinations - This API is to facilitate Clinical teams and Providers to send a Prior Auth request to the Myndauth engine to assess the likely outcome for a PA request and any missing information the bundle has that need to be provided before an adjudication can be rendered.
2. Authorization- This API is to facilitate Clinical teams and Providers to send a Prior Auth request to the Payer to obtain a determination from the Payers. This endpoint facilitates both manual and automated response from the Payers.

While the data requirements for both Determinations and Authorization work streams are the same, the endpoint to trigger either of these APIs are different, and the anticipated response from these APIs are different.

The key words “MUST”, “MUST NOT”, “REQUIRED”, “SHALL”, “SHALL NOT”, “SHOULD”, “SHOULD NOT”, “RECOMMENDED”, “MAY”, and “OPTIONAL” in this document are to be interpreted as described in RFC 2119.