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This document covers athenahealth_check_active_referral_authorization, the AthenaHealth referral authorization status tool exposed through the Agents Platform.

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Authentication

Uses the existing AthenaHealth connector credentials.

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athenahealth_check_active_referral_authorization

Checks referral authorizations for a patient and returns whether an active authorization appears to match the billed insurance name.

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Inputs

Required:
  • patient_id: AthenaHealth patient ID.
Optional:
  • department_id: the encounter’s department ID (from the encounter summary/details). Forwarded to AthenaHealth as departmentid when provided.
  • billed_insurance_name: Insurance name from encounter/patient summary. When present, matching is restricted to authorizations that appear related to that payer.

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Output

Common failure reasons:
  • athenahealth_not_connected
  • AthenaHealth API error fetching referral authorizations

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Human-readable text

The tool emits markdown for the feed: a ## Referral Authorization table (patient, practice, billed insurance, active-match) and an ## Authorizations table (status, auth #, details) when present. The raw authorizations payload stays in structuredContent.

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Agent Instruction Guidance

Use this in the realtime coding workflow after summary checks pass. Feed has_active_pa into CPT-generation prompts for Spravato/PA-sensitive decisions.