Health Cloud Administration
jConfigure Statuses for Authorization Requests
Care requests move through a series of steps from submission to approval. To get a clear
understanding of the progress and assignment of requests, it’s critical to track the real-time
status.
At a high-level, a typical authorization care request transitions through each of these stages:
- Intake Specialist or Coordinator creates authorization requests based on the details shared by the provider or member.
- Admin Reviewer performs the first level of review.
- Utilization Management Nurse performs a clinical review of the request.
- Medical Director reviews and provides the final determination of the requests they receive.
To help your users efficiently use Utilization Management’s highly refined technological workflows, define appropriate case statuses. To make things easy for you, Case substatuses are already predefined.
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Available in: Lightning Experience Available in: Enterprise and Unlimited Editions with Health Cloud |
| User Permissions Needed | |
|---|---|
| To add case status: | Update on Case object |
- From Setup, open the Object Manager, and go to the Case object.
- Under Fields & Relationships, click Status.
- Click New in the Status Picklist Values section.
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Enter the authorization request statuses, as shown. Enter each value on its own line.
- Intake
- Admin Review
- Nurse Review
- MD Review
- Determination
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Save your changes.
Now, your users can easily track the progress of authorization requests.
You can now select the case status picklist values that appear in the Path component of
the Case page to help your user view the various stages of a care request process.