Health Cloud Administration
jManage Rules for Automating Authorization Request Workflows
Use Business Rules Engine components and features to speed up and streamline approval
processes, simplify complex lookups, and automate business decisions in your authorization
request workflows.
|
Available in: Lightning Experience Available in: Enterprise and Unlimited Editions with Health Cloud |
With the help of Expression Set Templates, Expression Sets, and Decision Matrices, you can define, customize, and activate rules for member eligibility check, document checklists, and auto approval of authorization requests.
- Expression Set Templates - Prebuilt, read-only rules. Templates provide an outline for building your expression set.
- Expression Sets - A series of rules created using expression set elements. Each element in an expression set represents a logical step that's run sequentially. Expression sets evaluate conditions, perform mathematical operations, look up decision matrices, and perform multiple transformations simultaneously.
- Decision Matrices - Lookup tables that match your input values to a row in the matrix. When the matrix finds an exact match, it returns the row's output value.