@rawctx/sf-health-care-request

The gatekeepers of appropriate care. Manages utilization review requests, drug authorizations, reviewer assignments, exchange information, and the supporting content that drives authorization decisions.

Overview

Objects

• CareRequest — Represents the general details of a care-related request including member information, admission date, decision reason, and so on. A single request can contain multiple diagnoses, services, or drugs. Care requests include preauthorizations for drugs and services, admission notifications, concurrent review of admissions, appeals, complaints, and grievances.
• CareRequestConfiguration — Represents the details for a record type such as service request, drug request, or admission request. One or more record types can be associated with a care request.
• CareRequestDrug — Represents the details of a requested drug including name, strength, frequency, and instructions for administration. One or more drug requests can be associated with a care request.
• CareRequestExchangeInfo — Represents information about a care request exchange.
• CareRequestExtension — Represents extra details for a care request such as the subscriber details for the member's health plan, home healthcare status, and ambulance transportation details.
• CareRequestItem — Represents the details of a care service request, including name, modifiers, and the effective date. One or more care service requests can be associated with a care request.
• CareRequestReviewer — Represents the details of a care request reviewer including name, reviewer type, status of the care request at the end of the review, the reviewer’s notes, and date of review. A care request, care request item, care request drug, or care diagnosis can be associated with a care request reviewer.
• CareRequestSupportingCntnt — Represents details about supporting content of a care request such as assessments or content documents.

Install

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