OmniStudio Components for the Payer Authorization Request Process

Utilization Management is built using a predefined suite of OmniStudio components, which combine to provide a smooth, guided user interaction that empowers your payer users to easily handle the complex authorization process.

Available in: Lightning Experience

Available in: Enterprise and Unlimited Editions with Health Cloud

The built-in OmniScripts contain the user-interaction logic that takes users through the authorization process with consistent responses. Your users can easily review the requests using these OmniScript processes.

OmniScript	Use
HealthCloudUM/AuthorizationRequest	Create and submit an authorization request
HealthCloudUM/AdminReview	Conduct an admin review of an authorization request
HealthCloudUM/UMNurse	Conduct a nurse review of an authorization request
HealthCloudUM/MedicalDirectorReview	Conduct a medical director review of an authorization request
HealthCloudUM/P2PScheduling	Schedule a peer-to-peer review meeting between the medical director and requesting provider
HealthCloudUM/P2PReview	Conduct a peer-to-peer review with the requesting provider

Each of these OmniScripts includes a number of:

DataRaptors—Transfer and transform data between Salesforce and the OmniScripts, FlexCards, and Integration Procedures tools.
Integration Procedures—Bundle server-side data integration operations for efficiency and reuse.
FlexCards—Display data and launch actions for reviewing the requests.

The predefined OmniStudio components are ready to use, however, we recommend using a cloned version of these components. Simply clone each OmniScript and the associated FlexCards, DataRaptors, and Integration Procedures, retain the settings, save with a different name, activate the cloned version, and relink the components. Similarly, clone and activate the FlexCards that launch these OmniScripts and relink them to the corresponding cloned OmniScripts. Cloning ensures that you don’t face any process disruptions when predefined components are updated during automatic upgrades.

Note

FlexCard to Clone	OmniScript to Clone
HealthCloudUMPriorAuthIntakeLaunch	HealthCloudUM/AuthorizationRequest
HealthCloudUMAdminFlowLaunch	HealthCloudUM/AdminReview
HealthCloudUMNurseFlowLaunch	HealthCloudUM/UMNurse
HealthCloudUMAuthReviewsLaunch	HealthCloudUM/MedicalDirectorReview
HealthCloudUMAuthReviewsLaunch	HealthCloudUM/P2PScheduling
HealthCloudUMAuthReviewsLaunch	HealthCloudUM/P2PReview
HealthCloudUMConcurrentReviewLaunch	HealthCloudUM/AuthorizationRequest

Health Cloud Administration

OmniStudio Components for the Payer Authorization Request Process