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Redox Data Models
Referral
Query

Referral

This data model communicates patient demographic and clinical information from a referring provider to send the patient's case to another provider.

This typically differs from a consultation, where a provider may review a patient without assuming authority over the patient’s care. Referrals can be internal to an organization (e.g., from one department to another) or external between organizations.

A referral is useful to maintain the administrative aspects of a referral order. You can receive notifications when:

  • A new referral order is placed.
  • An existing referral order is modified or canceled.
  • An authorization review is requested or responded to.

Or, you can search for referral orders based on a patient's demographic and insurance information.

Query

Query for referral orders with a subset of patient demographic and insurance information.

Beta

Request Body Schema

  • Meta
    required, object
    • DataModel
      required, string
      Reliable

      Referral

    • EventType
      required, string
      Reliable

      Query

    • EventDateTime
      string, null
      Reliable

      Displays the UTC date and time that an outgoing request is delivered or an incoming request is received.
      ISO 8601 Format

    • Test
      boolean, null
      Reliable

      Indicates whether the request is a test or not.

    • Source
      object

      Contains the information for the system initiating the message, including the source ID and name.
      Included in messages from Redox

      • ID
        string, null
        Reliable

        Identifies the system initiating the message. If you have multiple OAuth API keys per environment type, this value is required. If you have only one OAuth API key per environment type, or you're using legacy API keys, this value is optional.
        UUID

      • Name
        string, null
        Reliable

        Displays the name of the system initiating the message.

    • Destinations
      Array of object

      Contains the information for the endpoint(s) receiving the request. A request must contain at least one destination, but asynchronous requests can have more than one destination. Synchronous requests like queries can only support one destination.
      Required when sending data to Redox.

      • ID
        string, null
        Reliable

        Identifies the endpoint that the request is directed to.
        UUID

      • Name
        string, null
        Reliable

        Displays the name of the endpoint that the request is directed to.

    • Logs
      Array of object

      Contains the log identifier(s) for the request.

      • ID
        string, null
        Reliable

        Identifies the request log(s) that correspond to this request. You can use this value to locate the relevant log in the Redox dashboard for support and reference.
        UUID

      • AttemptID
        string, null
        Reliable

        Identifies the request log attempt value, which is useful when retries are possible.
        UUID

    • FacilityCode
      string, null
      Possible

      Code for the facility related to the message.
      Only use this field if a health system indicates you should. The code is specific to the health system's EHR and might not be unique across health systems. In general, the facility fields within the data models (e.g. OrderingFacility) are more reliable and informative.

  • Patient
    required, object
    • Identifiers
      required, Array of object

      List of IDs and ID types that identify the patient

      • ID
        required, string
        Reliable

        ID for the patient

      • IDType
        required, string
        Reliable

        Type of ID.
        E.g. MRN, EPI

    • Insurances
      Array of object

      List of insurance coverages for the patient

      • Plan
        object
        • ID
          string, null
          Probable

          Identifier of insurance plan

        • IDType
          string, null
          Probable

          ID type of insurance plan

        • Name
          string, null
          Probable

          Name of insurance plan

        • Type
          string, null
          Possible

          Type of insurance plan

      • MemberNumber
        string, null
        Possible

        Patient member number

      • Company
        object
        • ID
          string, null
          Probable

          ID of insurance company (payor)

        • IDType
          string, null
          Probable

          ID type of insurance company (payor)

        • Name
          string, null
          Probable

          Name of insurance company (payor)

        • Address
          object

          Insurance company's address

          • StreetAddress
            string, null
            Probable

            Street address

          • City
            string, null
            Probable

            City

          • State
            string, null
            Probable

            State

          • ZIP
            string, null
            Probable

            ZIP

          • County
            string, null
            Possible

            County

          • Country
            string, null
            Possible
            Value Set

            Country

        • PhoneNumber
          string, null
          Probable

          Insurance companys phone number.
          In E. 164 Format (i.e. +16085551234)

      • GroupNumber
        string, null
        Probable

        Insurance policy group number

      • GroupName
        string, null
        Probable

        Insurance policy group name

      • EffectiveDate
        string, null
        Probable

        Effect date of this insurance policy.
        In YYYY-MM-DD format

      • ExpirationDate
        string, null
        Probable

        Expiration date of this insurance policy.
        In YYYY-MM-DD format

      • PolicyNumber
        string, null
        Probable

        Insurance policy number

      • Priority
        string, null
        Possible
        Value Set

        The insurance priority sequence.
        If the insurance works in conjunction with other insurance plans, this field contains priority sequence.

      • AgreementType
        string, null
        Probable
        Value Set

        Type of insurance agreement.

      • CoverageType
        string, null
        Probable
        Value Set

        Type of insurance agreement.
        Indicates who will be receiving the bill for the service.

      • Insured
        object

        Individual who has the agreement with the insurance company for the related policy

        • Identifiers
          Array of object

          List of IDs and ID types that identify the insured

          • ID
            string, null
            Possible

            ID for the insured

          • IDType
            string, null
            Possible

            Type of ID.
            E.g. MRN, EPI

        • LastName
          string, null
          Possible

          Last name of the insured

        • MiddleName
          string, null
          Possible

          Middle name of the insured

        • FirstName
          string, null
          Possible

          First name of the insured

        • SSN
          string, null
          Possible

          Insured's social security number

        • Relationship
          string, null
          Possible
          Value Set

          Relationship of the insured to the patient

        • DOB
          string, null
          Possible

          Date of birth of the insured.
          In YYYY-MM-DD format

        • Sex
          string, null
          Possible
          Value Set

          Sex of the insured

        • Address
          object

          Address of the insured

          • StreetAddress
            string, null
            Probable

            Street address

          • City
            string, null
            Probable

            City

          • State
            string, null
            Probable

            State

          • ZIP
            string, null
            Probable

            ZIP

          • County
            string, null
            Possible

            County

          • Country
            string, null
            Possible
            Value Set

            Country

Example
json
1
{
2
  "Meta": {
3
    "DataModel": "Referral",
4
    "EventType": "Query",
5
    "EventDateTime": "2024-11-20T14:08:29.777Z",
6
    "Test": true,
7
    "Source": {
8
      "ID": "7ce6f387-c33c-417d-8682-81e83628cbd9",
9
      "Name": "Redox Dev Tools"
10
    },
11
    "Destinations": [
12
      {
13
        "ID": "af394f14-b34a-464f-8d24-895f370af4c9",
14
        "Name": "Redox EMR"
15
      }
16
    ],
17
    "Logs": [
18
      {
19
        "ID": "d9f5d293-7110-461e-a875-3beb089e79f3",
20
        "AttemptID": "925d1617-2fe0-468c-a14c-f8c04b572c54"
21
      }
22
    ],
23
    "FacilityCode": null
24
  },
25
  "Patient": {
26
    "Identifiers": [
27
      {
28
        "ID": "0000000001",
29
        "IDType": "MR"
30
      },
31
      {
32
        "ID": "e167267c-16c9-4fe3-96ae-9cff5703e90a",
33
        "IDType": "EHRID"
34
      },
35
      {
36
        "ID": "a1d4ee8aba494ca",
37
        "IDType": "NIST"
38
      }
39
    ],
40
    "Insurances": [
41
      {
42
        "Plan": {
43
          "ID": "31572",
44
          "IDType": "Payor ID",
45
          "Name": "HMO Deductible Plan",
46
          "Type": null
47
        },
48
        "MemberNumber": null,
49
        "Company": {
50
          "ID": "60054",
51
          "IDType": null,
52
          "Name": "aetna (60054 0131)",
53
          "Address": {
54
            "StreetAddress": "PO Box 14080",
55
            "City": "Lexington",
56
            "State": "KY",
57
            "ZIP": "40512-4079",
58
            "County": "Fayette",
59
            "Country": "US"
60
          },
61
          "PhoneNumber": "+18089541123"
62
        },
63
        "GroupNumber": "847025-024-0009",
64
        "GroupName": "Accelerator Labs",
65
        "EffectiveDate": "2015-01-01",
66
        "ExpirationDate": "2020-12-31",
67
        "PolicyNumber": "9140860055",
68
        "Priority": null,
69
        "AgreementType": null,
70
        "CoverageType": null,
71
        "Insured": {
72
          "Identifiers": [],
73
          "LastName": null,
74
          "MiddleName": null,
75
          "FirstName": null,
76
          "SSN": null,
77
          "Relationship": null,
78
          "DOB": null,
79
          "Sex": null,
80
          "Address": {
81
            "StreetAddress": null,
82
            "City": null,
83
            "State": null,
84
            "ZIP": null,
85
            "County": null,
86
            "Country": null
87
          }
88
        }
89
      }
90
    ]
91
  }
92
}