Salesforce Health Cloud Developer Guide

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Health Cloud Developer Guide
Health Cloud Data Model
Advanced Therapy Management
Adverse Events
Assessment Generation
Benefits Verification
Care Program Management
Claims
Clinical Data Model
Predecessors to Code Sets and Code Set Bundles in Health Cloud
Coverage Requirement Discovery
ServiceInfoRequestDetail
ServiceInformationRequest
ServiceInformationResponse
ServiceInfoResponseAction
ServiceInfoResponseCoverage
SvcInfoRespCoverageDetail
ServiceInfoRespOvrideOpt
ServiceInfoRespResourceUrl
ServiceInfoRespSuggestion
SvcInfoRelatedQuestionnaire
Crisis Support Center Management
Documentation Templates and Rules
Disease Surveillance
Electronic Signatures
Engagement Interaction
FHIR Subscription
Financial Assistance Program
Health Assessments
Health Insurance
Home Health
Integrated Care Management
Intelligent Appointment Management
Intelligent Document Automation
Intelligent Sales
Medication Management
Patient Program Outcome Management
Participant Management
Patient Segmentation
Pharmacy Benefits Verification
Provider Network Management
Provider Relationship Management
Remote Monitoring and Device Registration
Social Determinants
Timeline
Unified Health Scoring
Utilization Management
Health Cloud Associated Objects
Health Cloud Fields on Standard Objects
Working With Electronic Health Records
Emergency Response Management
Apex Reference
Health Cloud Business APIs
Health Cloud Tooling API Objects
Health Cloud Standard Invocable Actions
Metadata Types
API End-of-Life Policy
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Coverage Requirement Discovery

Payer organizations in the healthcare industry can use the FHIR-aligned Coverage Requirement Discovery (CRD) data model to help providers access member and coverage-related information in real time, directly from their Electronic Health Records (EHR) system. The automation of coverage requirement discovery reduces time spent on administrative tasks, improves the chances of coverage approval, and helps in reducing human errors.
Available in: Enterprise and Unlimited editions of Health Cloud

When a provider submits a coverage requirement discovery request, you can use the CRD data model to validate the member and their coverage, assess the need for pre-authorization, and check the required documentation.

Coverage Requirement Discovery objects are available to users with the Hls Clinical Decision Support permission set.

Coverage Requirement Discovery Diagram