Diagnostic Test Exclusions by Plan
File Name: v2_po_exclusions_by_diagnostic_test.csv
This processor accepts a list of diagnostic tests that must be permanently excluded for an insured individual covered by a specific policy or plan.
The diagnostic test names must exist in Osigu's product catalog. This catalog is provided to each payer during the integration process.
Structure
The required fields are marked in bold.
| # | Field Name | Type | Description |
|---|---|---|---|
| 1 | insurer_slug | String[64] | Slug of the Payer provided by Osigu. |
| 2 | policy_number | String[32] | Policy/plan number must match a record in the v2_policies.csv file. |
| 3 | diagnostic_test_name | String[64] | Name of the diagnostic test. |
Notes
This file defines diagnostic tests that are permanently excluded from coverage for all insured individuals under the specified policy/plan.
- The diagnostic test names must match those in the Osigu product catalog to ensure accurate processing.
- The exclusions defined in this file are enforced during authorization and claims processing.
Updated 5 days ago