Authorization Pend Event Integration Point

Authorization Pend Event integration point supports two related notification events:

• Pend Event – sent when an authorization is placed in a pending state.

• Pend Done Event – sent when a previously pended authorization is resolved (for example, approved, denied, or resubmitted after edits).

These events allow an external workflow or case management system to:

• Receive notifications when authorizations require manual review.

• Track the resolution of those pended authorizations.

While an authorization is processed, pend rules can be triggered. If at least one attached pend reason has Publish Message? set to Yes, Oracle Health Insurance Authorizations publishes a notification to an external system. This outbound integration supports manual review workflows in external systems.

Pend Event

When a Pend Event Is Sent?

The system publishes a pend event when:

• An authorization is placed in pend status and the Publish message indicator is selected for the pend reason.

• An authorization pends again at the same process step that contains unresolved pend reasons.

• The user submits the authorization without resolving all pend reasons. In this case, the pend event is still sent.

Pend Event Contents

Element	Description
Type	PEND
Link rel="oi:operator-subject"	Provides information about the authorization and its status in XML format.
Link rel="page"	Opens the corresponding authorization page in Oracle Health Insurance Authorizations.
Fields	Contains the name-value pairs returned by the dynamic logic function configured in Authorization Fields on the pend reason. If multiple published pend reasons produce the same name-value pair, the event includes that pair only once.
Pend reasons	Contains one or more pend reasons for which Publish Message? is set to Yes. The pend reason external code is included for each published reason.
Timestamp	The time at which the pend rule was triggered.

Verify the exact literal value for the type field. If event types are enumerations, use the precise, case-sensitive value as implemented (for example, PEND and PEND_DONE).

Endpoint and authentication

To enable pend events, configure the following application properties:

ohi.pend.endpoint.request={Env}/notification/pend
ohi.service.pendDone.client.authentication=None | Basic Auth | Oauth

Pend Done Event

When a Pend Done Event Is Sent?

A Pend Done Event is published to the external system when:

• A pend reason, for which Publish Message Indicator = Yes, is resolved, and

• The authorization is:

  • Submitted for further processing after resolving the pends, or

  • Denied, or

  • Re-submitted for processing after making edits that resolve the pends.

When one or more publishable pend reasons are resolved and the authorization moves forward (approved, denied, or resubmitted), a pend done event is sent.

Pend Done Event Contents

Element	Description
Type	Pend Done
Link rel="oi:operator-subject"	Provides information about the authorization and its status in XML format. For the same authorization, this subject link matches the subject link from the corresponding pend event.
Link rel="page"	Opens the corresponding authorization page in Oracle Health Insurance Authorizations.
Timestamp	The time at which the pend reason was resolved or removed.

Verify the exact literal value for the type field. If event types are enumerations, use the precise, case-sensitive value as implemented (for example, PEND and PEND_DONE).

Endpoint and Authentication

To enable pend done events, configure the following application properties:

ohi.pendDone.endpoint.request={Env}/notification/pendDone
ohi.service.pendDone.client.authentication=None | Basic Auth | Oauth

If Basic Auth or Oauth is used:

• Configure the necessary credentials.

• Associate them with the pend done event client or service in your web service client configuration.

See Application Properties for details on configuring these properties.

Property keys, authentication values, and event type literals are case sensitive. Use the exact casing defined in the product. If multiple pend reasons exist, shared name-value pairs from dynamic logic appear only once in the event payload.