{
  "niche": "healthcare-embed",
  "formKey": "insurance",
  "title": "Insurance, Billing & Authorization Setup (Embed)",
  "type": "up",
  "formId": "2unNagokLE7rgsvNZ",
  "resolved": {
    "Insurance Use Intent": "c87a1b06-2ec2-439e-92f7-4b6b13abc350",
    "Payment Method Preference (health)": "bfbd7d19-a1ce-46c3-bb05-491b681b080a",
    "Insurance Payer Name (health)": "b375e829-962b-4b30-8452-4738fe23d26b",
    "Insurance Verification Status": "040549ea-13c0-4df6-892b-d6905c2d57be",
    "Co-Pay / Co-Insurance Band": "6e0e3409-e4b2-4912-a34f-1af169980771",
    "Sliding Scale Interest": "5a3d846b-0647-4942-97f4-c3c1f30138a5",
    "EAP Program Name (if any)": "438592c0-a8fb-40dc-9dae-3b49501a6a30",
    "Referral Authorization Required": "5a77b41a-540f-44ad-87ed-2bb6ebe98931",
    "Referral/Authorization Reference (link)": "c525099d-5307-4306-8420-71e5d9d9001e",
    "Superbill Delivery Preference": "9a368b3c-d66e-4c89-b1ce-35fa1a7fd85f",
    "Insurance Documents Location (ref)": "d63d4c01-8f3e-4d18-8206-cf702bdb3462"
  },
  "arranged": {
    "report": [
      "dropdown \"Insurance Use Intent\" order 2",
      "dropdown \"Payment Method Preference (health)\" order 3",
      "textfield \"Insurance Payer Name (health)\" order 5",
      "dropdown \"Insurance Verification Status\" order 6",
      "dropdown \"Co-Pay / Co-Insurance Band\" order 7",
      "radio \"Sliding Scale Interest\" order 8",
      "textfield \"EAP Program Name (if any)\" order 9",
      "dropdown \"Referral Authorization Required\" order 11",
      "textfield \"Referral/Authorization Reference (link)\" order 12",
      "dropdown \"Superbill Delivery Preference\" order 13",
      "textfield \"Insurance Documents Location (ref)\" order 14"
    ],
    "count": 15
  }
}