Note: This release is in preview. Features described here don’t become generally available until the latest general availability date that Salesforce announces for this release. Before then, and where features are noted as beta, pilot, or developer preview, we can’t guarantee general availability within any particular time frame or at all. Make your purchase decisions only on the basis of generally available products and features.
Care Request
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 prior authorizations for drugs and
services, admission notifications, concurrent review of admissions, appeals, complaints, and
grievances.
| Property Name | Type | Description | Filter Group and Version | Available Version |
|---|---|---|---|---|
| acknowledgementLetterSentDate | String | Date and time when an acknowledgment letter was sent to the requester. Maps to: CareRequest.AcknowledgementLetterSentDate | Big, 46.0 | 46.0 |
| actualAdmissionDate | String | Actual admission date for the patient. Maps to: CareRequest.ActualAdmissionDate | Big, 46.0 | 46.0 |
| actualDischargeDate | String | Actual discharge date for the patient. Maps to: CareRequest.ActualDischargeDate | Big, 46.0 | 46.0 |
| admissionNotes | String | Notes related to the admission. Maps to: CareRequest.AdmissionNotes | Big, 46.0 | 46.0 |
| admissionSource | String | Where the patient was admitted from, for example, a clinic or an emergency room. Maps to: CareRequest.AdmissionSource | Big, 46.0 | 46.0 |
| admissionType | String | Type of admission, for example, emergency or elective. Maps to: CareRequest.AdmissionType | Big, 46.0 | 46.0 |
| ambulanceTransportDistance | Integer | Ambulance Transport Distance | Big, 46.0 | 46.0 |
| ambulanceTransportReason | String | Reason for ambulance transport. Maps to: CareRequestExtention.AmbulanceTransportReason | Big, 46.0 | 46.0 |
| ambulanceTransportType | String | Type of ambulance transport. Maps to: CareRequestExtention.AmbulanceTransportType | Big, 46.0 | 46.0 |
| aorReceivedDate | String | Date and time when the Appointment of Representative (AOR) form was received. Maps to: CareRequest.AorReceivedDate | Big, 46.0 | 46.0 |
| aorRequestedDate | String | Date and time when the AOR form was requested. Maps to: CareRequest.AorRequestedDate | Big, 46.0 | 46.0 |
| appealEffectuationDateTime | String | The effective date of the outcome of the appeal request. For example, if a claim was successfully appealed, this field displays the date when the claim was paid. Maps to: CareRequestExtension.AppealEffectuationDateTime | Big, 52.0 | 52.0 |
| appealRequestReasonType | String | Specifies the reason for raising the appeal request. Maps to: CareRequest.AppealRequestReasonType | Big, 52.0 | 52.0 |
| appointedRepVerbalContactDate | String | Date and time of verbal contact with the member's appointed representative. Maps to: CareRequest.AppointedRepVerbalContactDate | Big, 46.0 | 46.0 |
| appointedRepWrittenContactDate | String | Date and time correspondence was sent to the member's appointed representative. Maps to: CareRequest.AppointedRepWrittenContactDate | Big, 46.0 | 46.0 |
| appointedRepresentative | Appointed Representative | Appointed representative for the member. | Big, 46.0 | 46.0 |
| approvedLengthofStay | Integer | Approved number of days for the admission. Maps to: CareRequest.ApprovedLengthOfStay | Big, 46.0 | 46.0 |
| approvedLevelofCare | String | Approved level of care for the patient, for example, Hospital-Observaton or SNF-Rehabilitation. Maps to: CareRequest.ApprovedLevelOfCare | Big, 46.0 | 46.0 |
| authorizationRefIdentifier | String | The unique identifier of the authorization request. Maps to: CareRequestExtension.AuthorizationRefIdentifier | Big, 57.0 | 57.0 |
| careRequestReviewers | Care Request Reviewer Output[] | The care request associated with the care request reviewer. Maps to: CareRequest.CareRequestReviewers | Big, 52.0 | 52.0 |
| caseSubStatus | String | Sub status of care request in each stage of care request. Maps to: CareRequest.CaseSubStatus | Big, 57.0 | 57.0 |
| claimNumber | String | Claim number for the medical service or medication, if one exists. Maps to: CareRequest.ClaimNumber | Big, 46.0 | 46.0 |
| clinicalCaseType | String | Clinical case type for the patient, for example, High Risk Fall or Adult Diabetes. Maps to: CareRequest.ClinicalCaseType | Big, 46.0 | 46.0 |
| criteriaMet | String | Indicates whether criteria for care was met. Maps to: CareRequest.CriteriaMet | Big, 46.0 | 46.0 |
| cumulativeLengthofStay | Integer | Total number of days for the admission. Maps to: CareRequest.CumulativeLengthOfStay | Big, 46.0 | 46.0 |
| currentLevelofCare | String | Level of care that the patient is receiving. Maps to: CareRequest.CurrentLevelOfCare | Big, 46.0 | 46.0 |
| decisionDate | String | Date by which the decision must be made for the request. Maps to: CareRequest.DecisionDate | Big, 46.0 | 46.0 |
| decisionDaysRemaining | Integer | Number of days remaining for a decision or resolution. Maps to: CareRequest.DecisionDaysRemaining | Big, 46.0 | 46.0 |
| decisionLetter | String | The text of the determination letter sent to the member and provider. Maps to: CareRequest.DecisionLetter | Big, 46.0 | 46.0 |
| decisionNotes | String | Notes related to the decision. Maps to: CareRequest.DecisionNotes | Big, 46.0 | 46.0 |
| decisionReason | String | Reason for the decision. Maps to: CareRequest.DecisionReason | Big, 46.0 | 46.0 |
| decisionReasonDescription | String | Text describing the reason for the decision. Maps to: CareRequest.DecisionReasonDescription | Big, 46.0 | 46.0 |
| deniedLengthofStay | Integer | Number of days denied for the admission. Maps to: CareRequest.DeniedLengthOfStay | Big, 46.0 | 46.0 |
| deniedLevelofCare | String | Level of care denied for the patient. Maps to: CareRequest.DeniedLevelOfCare | Big, 46.0 | 46.0 |
| dispositionNotes | String | Notes related to the disposition of the request. Maps to: CareRequest.DispositionNotes | Big, 46.0 | 46.0 |
| documentAttachmentStatus | String | The status of the document upload based on the checklist provided to the
reviewers. Maps to: CareRequestExtension.DocumentAttachmentStatus Valid values are:
|
Big, 55.0 | 55.0 |
| dueDate | String | Date the request is due for completion. Maps to: CareRequest.DueDate | Big, 46.0 | 46.0 |
| effectiveFrom | String | The start date for an effective-date range. Maps to: CareRequest.EffectiveFrom | Big, 46.0 | 46.0 |
| effectiveTo | String | The end date for an effective-date range. Maps to: CareRequest.EffectiveTo | Big, 46.0 | 46.0 |
| expirationDate | String | Expiration date for the request. Maps to: CareRequest.ExpirationDate | Big, 46.0 | 46.0 |
| extendedRequest | Boolean | Extended Request Maps to: CareRequest. | Big, 46.0 | 46.0 |
| extensionRequestReceivedDate | String | Date and time an extension was requested. Maps to: CareRequest.ExtensionRequestReceivedDate | Big, 46.0 | 46.0 |
| externalComplaintID | String | Complaint ID number. Maps to: CareRequest.ExternalComplaintIdentifier | Big, 46.0 | 46.0 |
| facilityRecordNumber | String | The medical record number used to identify a patient. Maps to: CareRequest.FacilityRecordNumber | Big, 46.0 | 46.0 |
| facilityRoomBedType | String | Type of facility bed for the patient. Maps to: CareRequest.FacilityRoomBedType | Big, 46.0 | 46.0 |
| facilityRoomNumber | String | The facility room number for the patient. Maps to: CareRequest.FacilityRoomNumber | Big, 46.0 | 46.0 |
| finalLevelofCare | String | Final level of care the patient. Maps to: CareRequest.FinalLevelOfCare | Big, 46.0 | 46.0 |
| firstReviewer | First Reviewer | The person who reviewed the request. | Big, 46.0 | 46.0 |
| firstReviewerNotes | String | Notes from the first reviewer related to the case. Maps to: CareRequest.FirstReviewerNotes | Big, 46.0 | 46.0 |
| generalPractitioner | General Practitioner | Member's primary or general care practitioner. | Big, 46.0 | 46.0 |
| generalPractitionerVerbalNotificationDate | String | Date when the primary care practitioner was verbally notified of the decision. Maps to: CareRequest.GeneralPractitionerVerbalNotifiedDate | Big, 46.0 | 46.0 |
| generalPractitionerWrittenNotificationDate | String | Date when the primary care practitioner was notified of the decision by written correspondence. Maps to: CareRequest.GeneralPractitionerWrittenNotifiedDate | Big, 46.0 | 46.0 |
| grievanceType | String | Specifies the type of grievance. Maps to: CareRequest.GrievanceType | Big, 52.0 | 52.0 |
| healthcareProvider | String | The healthcare provider associated with the care request against whom the Grievance is filed. Maps toCareRequestExtension.HealthCareProvider | Big, 52.0 | 52.0 |
| homeHealthCertificationEndDate | String | Certification end date for home health care. Maps to: CareRequestExtension.HomeHealthCertificationEndDate | Big, 46.0 | 46.0 |
| homeHealthCertificationStartDate | String | Certification start date for home health care. Maps to: CareRequestExtension.HomeHealthCertificationStartDate | Big, 46.0 | 46.0 |
| homeHealthStartDate | String | Date that home health services are scheduled or anticipated to start. Maps to: CareRequestExtension.HomeHealthStartDate | Big, 46.0 | 46.0 |
| id | String | ID of the Care Request. | Big, 46.0 | 46.0 |
| independentReviewDetermination | String | The determination made by the independent review. Maps to: CareRequestExtension.IndependentReviewDetermination | Big, 52.0 | 52.0 |
| independentReviewDeterminationDate | String | The date when the determination was made by the independent review. Maps to: CareRequestExtension.IndependentReviewDeterminationDate | Big, 52.0 | 52.0 |
| independentReviewSubmissionDate | String | The date when the review request was submitted for independent review. Maps to: CareRequestExtension.IndependentReviewSubmissionDate | Big, 52.0 | 52.0 |
| infoReceievedDate | String | Date and time when additional information was received from the provider or member. Maps to: CareRequest.InfoReceivedDate | Big, 46.0 | 46.0 |
| infoRequestedDate | String | Date and time when additional information was requested from the provider or member. Maps to: CareRequest.InfoRequestedDate | Big, 46.0 | 46.0 |
| initialDenialNotificationDate | String | Date of initial denial notification. Maps to: CareRequest.InitialDenialNotificationDate | Big, 46.0 | 46.0 |
| initialDenialNotificationTime | String | The time when the initial care request was denied. Maps to CareRequest.InitialDenialNotificationTime | Big, 52.0 | 52.0 |
| isIndependentReviewRequired | Boolean | Indicates whether independent review is required. Maps to CareRequestExtension.IsIndependentReviewRequired | Big, 52.0 | 52.0 |
| isReadmission | Boolean | Indicates whether the care request is for a readmission. Maps to CareRequest.IsReadmission | Big, 52.0 | 52.0 |
| lastModifiedDate | String | Last Modified Date | Big, 46.0 | 46.0 |
| medicalDirector | Medical Director | The medical director who reviewed the request. | Big, 46.0 | 46.0 |
| medicalDirectorNotes | String | Notes from the medical director related to the request. Maps to: CareRequest.MedicalDirectorNotes | Big, 46.0 | 46.0 |
| member | String | Insurance identifier for the member. Maps to: CareRequest.MemberId | Big, 46.0 | 46.0 |
| memberContactDate | String | Member Contact Date Maps to: CareRequest. | Big, 46.0 | 46.0 |
| memberGroupNumber | String | Insurance group number for the member. Maps to: CareRequest.MemberGroupNumber | Big, 46.0 | 46.0 |
| memberPrimaryPlan | String | The primary insurance plan of a member associated with the care request when the member is insured under multiple plans. Maps to: CareRequest.MemberPrimaryPlan | Big, 52.0 | 52.0 |
| memberSecondaryPlan | String | The secondary insurance plan of a member associated with the care request when the member is insured under multiple plans. Maps to: CareRequest.MemberSecondaryPlan | Big, 52.0 | 52.0 |
| memberVerbalNotificationDate | String | Date when the member was verbally notified of the decision. Maps to: CareRequest.MemberVerbalNotificationDate | Big, 46.0 | 46.0 |
| memberWrittenNotificationDate | String | Date when the member was notified of the decision by written correspondence. Maps to: CareRequest.MemberWrittenNotificationDate | Big, 46.0 | 46.0 |
| modificationDate | String | Date the case was modified. Maps to: CareRequest.ModificationDate | Big, 46.0 | 46.0 |
| modifiedLengthofStay | Integer | Modified number of days for the admission. Maps to: CareRequest.ModifiedLengthOfStay | Big, 46.0 | 46.0 |
| modifiedLevelofCare | String | Modified level of care for the patient. Maps to: CareRequest.ModifiedLevelOfCare | Big, 46.0 | 46.0 |
| nextReviewDate | String | Date the next review is scheduled for completion. Maps to: CareRequest.NextReviewDate | Big, 46.0 | 46.0 |
| nursingHomeResidentialStatus | String | Nursing home resident status at the time of service. Maps to: CareRequestExtension.NursingHomeResidentialStatus | Big, 46.0 | 46.0 |
| originalDenialMedicalDirector | Original Denial Medical Director | The medical director who denied the original request. | Big, 46.0 | 46.0 |
| parProvider | String | Indicator of whether this provider has entered into an agreement with the insurance carrier. Maps to: CareRequest.ParProvider | Big, 46.0 | 46.0 |
| placeofService | String | Place of service for the member's care such as an inpatient hospital or an ambulatory surgery center. Maps to: CareRequest.PlaceOfService | Big, 46.0 | 46.0 |
| practitionerContactDate | String | Date and time when the provider was contacted. Maps to: CareRequest.PractitionerContactDateTime | Big, 46.0 | 46.0 |
| priorDischargeStatus | String | Specifies the previous discharge status of the member. Maps to: CareRequestExtension.PriorDischargeStatus | Big, 52.0 | 52.0 |
| quantity | Integer | Quantity of the request. | Big, 46.0 | 46.0 |
| quantityType | String | Quantity type for the request such as days, units, or visits. Maps to: CareRequest.QuantityType | Big, 46.0 | 46.0 |
| receivedDate | String | Date the request was received. Maps to: CareRequest.ReceivedDate | Big, 46.0 | 46.0 |
| reconsiderationDenialNotificationDate | String | Date of reconsideration denial notification. Maps to: CareRequest.ReconsiderationDenialNotificationDate | Big, 46.0 | 46.0 |
| reconsiderationDenialNotificationTime | String | The time of reconsideration denial notification. Maps to: CareRequest.ReconsiderationDenialNotificationTime | Big, 52.0 | 52.0 |
| recordType | String | Record type of the care request object. | Big, 46.0 | 46.0 |
| referenceCareRequestCase | String | The reference care request case number associated with the care request. Maps to: CareRequest.ReferenceCareRequestCase | Big, 52.0 | 52.0 |
| referenceCaseNumber | String | Reference authorization number for an appeal, complaint, or grievance. Maps to: CareRequest.ReferenceCaseNumber | Big, 46.0 | 46.0 |
| reopenDecisionDateTime | String | Date and time the request was reopened. Maps to: CareRequest.ReopenDecisionDateTime | Big, 52.0 | 52.0 |
| reopenReason | String | Reason the request was reopened. Maps to: CareRequest.ReopenReason | Big, 46.0 | 46.0 |
| reopenReasonDescription | String | Description of why the request was reopened. Maps to: CareRequest.ReopenReasonDescription | Big, 46.0 | 46.0 |
| reopenRequestOutcome | String | The result of the reopen request. Maps to: CareRequestExtension.ReopenRequestOutcome | Big, 52.0 | 52.0 |
| reopenRequestType | String | The type of reopen request. Maps to: CareRequestExtension.ReopenRequestType | Big, 52.0 | 52.0 |
| reopenedBy | Reopened By Output | The user who reopened the care request. Maps to: CareRequestExtension.ReopenedBy | Big, 52.0 | 52.0 |
| reopenedDate | String | Date the request was reopened. Maps to: CareRequest.ReopenedDate | Big, 46.0 | 46.0 |
| requestExtensionReason | String | The reason for requesting the care extension. Maps to: CareRequestExtension.RequestExtensionReason | Big, 52.0 | 52.0 |
| requestExtnDecisionDateTime | String | The date when the decision to extend the care request extension was made. Maps to: CareRequestExtension.RequestExtnDecisionDateTime | Big, 52.0 | 52.0 |
| requestOutcome | String | Specifies the outcome of the request. Maps to: CareRequestExtension.RequestOutcome | Big, 52.0 | 52.0 |
| requestOutcomeDesc | String | The description of the request outcome. Maps to: CareRequestExtension.RequestOutcomeDesc | Big, 52.0 | 52.0 |
| requestType | String | Category type of the request. Maps to: CareRequestExtension.RequestType | Big, 46.0 | 46.0 |
| requestedDate | String | Date the request was originally requested. Maps to: CareRequest.RequestedDate | Big, 46.0 | 46.0 |
| requestedLengthOfStay | Integer | Requested length of stay for the patient. Maps to: CareRequest.RequestedLengthOfStay | Big, 57.0 | 57.0 |
| requestedLevelofCare | String | Requested level of care for the patient. Maps to: CareRequest.RequestedLevelOfCare | Big, 46.0 | 46.0 |
| requesterType | String | Indicates the role of the individual initiating the request. Maps to: CareRequest.RequesterType | Big, 46.0 | 46.0 |
| requestingPractitioner | Requesting Practitioner | Ordering or referring practitioner for the request. | Big, 46.0 | 46.0 |
| requestingPractitionerLicense | String | Requesting Practitioner License Maps to: CareRequest.RequestingPractitionerLicense | Big, 46.0 | 46.0 |
| requestingPractitionerSpecialty | String | Specialty of the practitioner, for example, Family Practice or General Surgery. Maps to: CareRequest.RequestingPractitionerSpecialty | Big, 46.0 | 46.0 |
| requestingPractitionerVerbalNotificationDate | String | Date when the practitioner was verbally notified of the decision. Maps to: CareRequest.RequestingPractitionerVerbalNotifiedDate | Big, 46.0 | 46.0 |
| requestingPractitionerWrittenNotificationDate | String | Date when the practitioner was notified of the decision by written correspondence. Maps to: CareRequest.RequestingPractitionerWrittenNotifiedDate | Big, 46.0 | 46.0 |
| resolutionDate | String | Date when the complaint, appeal, or grievance was resolved. Maps to: CareRequest.ResolutionDate | Big, 46.0 | 46.0 |
| resolutionDescription | String | The resolution details provided for the complaint, appeal, or grievance. Maps to: CareRequestExtension.ResolutionDescription | Big, 52.0 | 52.0 |
| resolutionLetterSentDate | String | Date and time when a resolution letter was sent to the requester. Maps to: CareRequest.ResolutionLetterSentDate | Big, 46.0 | 46.0 |
| resolutionNotes | String | Resolution notes for the request. Maps to: CareRequest.ResolutionNotes | Big, 46.0 | 46.0 |
| reviewDate | String | Date the review was completed. Maps to: CareRequest.ReviewDate | Big, 46.0 | 46.0 |
| rootCauseNotes | String | Field for notes related to the root cause for the request. Maps to: CareRequest.RootCauseNotes | Big, 46.0 | 46.0 |
| scheduledAdmissionDate | String | Anticipated admission date for the patient. Maps to: CareRequest.ScheduledAdmissionDate | Big, 46.0 | 46.0 |
| scheduledDischargeDate | String | Scheduled discharge date for the patient. Maps to: CareRequest.ScheduledDischargeDate | Big, 46.0 | 46.0 |
| serviceDate | String | Date when patient received the service. Maps to: CareRequest.ServiceDate | Big, 46.0 | 46.0 |
| serviceLevel | String | The level of service rendered. Maps to: CareRequestExtension.ServiceLevel | Big, 46.0 | 46.0 |
| serviceType | String | Classification of the type of service. Maps to: CareRequestExtention.ServiceType | Big, 46.0 | 46.0 |
| serviceorMedicationReceived | Boolean | Indicates whether the member has already received the medial service or medication. Maps to: CareRequest.IsServiceOrMedicationReceived | Big, 46.0 | 46.0 |
| servicingFacility | Servicing Facility | Facility where the service is being provided. | Big, 46.0 | 46.0 |
| servicingPractitioner | Servicing Practitioner | Practitioner administering the service. | Big, 46.0 | 46.0 |
| servicingPractitionerLicense | String | License type of the practitioner. Maps to: CareRequest.ServicingPractitionerLicense | Big, 46.0 | 46.0 |
| servicingPractitionerSpecialty | String | Specialty of the practitioner. Maps to: CareRequest.ServicingPractitionerSpecialty | Big, 46.0 | 46.0 |
| sourceSystem | String | System from which this request was sourced. Maps to: CareRequest.SourceSystem | Big, 46.0 | 46.0 |
| sourceSystemIdentifier | String | ID of the system from which the request was sourced. Maps to: CareRequest.SourceSystemIdentifier | Big, 46.0 | 46.0 |
| sourceSystemModified | String | Timestamp of the most recent update from the source system. Maps to: CareRequest.SourceSystemModified | Big, 46.0 | 46.0 |
| unitOfMeasure | String | The unit of measure associated with the prior authorization request. Maps to: CareRequestExtension.UnitofMeasure | Big, 55.0 | 55.0 |