Life Sciences Cloud Developer Guide

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Life Sciences Cloud Overview
Life Sciences Cloud Data Model
Life Sciences Cloud Associated Objects
Life Sciences Cloud Fields on Standard Objects
Life Sciences Cloud Platform Events
Working With Electronic Health Records
Life Sciences Cloud Business APIs
Resources
Request Bodies
Response Bodies
Appointed Representative
Book Slot Chain Output
Care Request Case
Care Request Patient
Care Authorization Request
Care Authorization Request Related Record
Care Authorization Request Result
Create or Update Care Authorization Request Result
Care Diagnosis
Care Program Enrollment Result
Care Request Drug
Care Request Item
Care Request
Care Request Reviewer Output
Care Authorization Request Response
Create Visit Output
Content Document Output
Custom Field Value
Digital Verification Output
Dispenser Address
Document Conflict Field
Document Conflict Field List
Document Management Result
Document Process Output
Error Response Output
Enrollee Product Result
Enrollment Card Result
Error Message
First Reviewer
FHIR Reference
Field Value Output
FHIR Address
FHIR Codeable Concept
FHIR Coding
FHIR Human Name
FHIR Contact Point
FHIR Identifier
FHIR Patient
General Practitioner
Medical Director
Original Denial Medical Director
Object Field
Object Field List
OCR Document Scan Result
OCR Document Scan Result List
Patient Communication Language
Patient Contact Party
Patient Get
Patient Upsert
Patient Update
Payload Output
Program Enrollment Result
Requesting Practitioner
Reopened By Output
Servicing Facility
Servicing Practitioner
Subscriber
Tracked Communication Output
Transport Location
Verifier Output
Work Type Lead Time Output
Life Sciences Cloud Standard Invocable Actions
Life Sciences Cloud Tooling API Objects
Life Sciences Cloud Metadata Types
API End-of-Life Policy
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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
acknowledgement​LetterSentDate String Date and time when an acknowledgment letter was sent to the requester. Maps to: CareRequest.AcknowledgementLetterSentDate Big, 46.0 46.0
actualAdmission​Date String Actual admission date for the patient. Maps to: CareRequest.ActualAdmissionDate Big, 46.0 46.0
actualDischarge​Date 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
ambulanceTransport​Distance Integer Ambulance Transport Distance Big, 46.0 46.0
ambulanceTransport​Reason String Reason for ambulance transport. Maps to: CareRequestExtention.AmbulanceTransportReason Big, 46.0 46.0
ambulanceTransport​Type String Type of ambulance transport. Maps to: CareRequestExtention.AmbulanceTransportType Big, 46.0 46.0
aorReceived​Date String Date and time when the Appointment of Representative (AOR) form was received. Maps to: CareRequest.AorReceivedDate Big, 46.0 46.0
aorRequested​Date String Date and time when the AOR form was requested. Maps to: CareRequest.AorRequestedDate Big, 46.0 46.0
appealEffectuation​DateTime 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
appealRequest​ReasonType String Specifies the reason for raising the appeal request. Maps to: CareRequest.AppealRequestReasonType Big, 52.0 52.0
appointedRep​VerbalContactDate String Date and time of verbal contact with the member's appointed representative. Maps to: CareRequest.AppointedRepVerbalContactDate Big, 46.0 46.0
appointedRep​WrittenContactDate String Date and time correspondence was sent to the member's appointed representative. Maps to: CareRequest.AppointedRepWrittenContactDate Big, 46.0 46.0
appointedRepresen​tative Appointed Representative Appointed representative for the member. Big, 46.0 46.0
approvedLength​ofStay Integer Approved number of days for the admission. Maps to: CareRequest.ApprovedLengthOfStay Big, 46.0 46.0
approvedLevel​ofCare String Approved level of care for the patient, for example, Hospital-Observaton or SNF-Rehabilitation. Maps to: CareRequest.ApprovedLevelOfCare Big, 46.0 46.0
authorization​RefIdentifier String The unique identifier of the authorization request. Maps to: CareRequestExtension.AuthorizationRefIdentifier Big, 57.0 57.0
careRequest​Reviewers 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
clinicalCase​Type 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
cumulativeLength​ofStay Integer Total number of days for the admission. Maps to: CareRequest.CumulativeLengthOfStay Big, 46.0 46.0
currentLevel​ofCare 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
decisionDays​Remaining 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
decisionReason​Description String Text describing the reason for the decision. Maps to: CareRequest.DecisionReasonDescription Big, 46.0 46.0
deniedLength​ofStay Integer Number of days denied for the admission. Maps to: CareRequest.DeniedLengthOfStay Big, 46.0 46.0
deniedLevel​ofCare String Level of care denied for the patient. Maps to: CareRequest.DeniedLevelOfCare Big, 46.0 46.0
disposition​Notes String Notes related to the disposition of the request. Maps to: CareRequest.DispositionNotes Big, 46.0 46.0
documentAttachment​Status String The status of the document upload based on the checklist provided to the reviewers. Maps to: CareRequestExtension.DocumentAttachmentStatus
Valid values are:
  • Complete
  • Incomplete
 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
extensionRequest​ReceivedDate String Date and time an extension was requested. Maps to: CareRequest.ExtensionRequestReceivedDate Big, 46.0 46.0
external​ComplaintID String Complaint ID number. Maps to: CareRequest.ExternalComplaintIdentifier Big, 46.0 46.0
facilityRecord​Number String The medical record number used to identify a patient. Maps to: CareRequest.FacilityRecordNumber Big, 46.0 46.0
facilityRoom​BedType String Type of facility bed for the patient. Maps to: CareRequest.FacilityRoomBedType Big, 46.0 46.0
facilityRoom​Number String The facility room number for the patient. Maps to: CareRequest.FacilityRoomNumber Big, 46.0 46.0
finalLevel​ofCare 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
firstReviewer​Notes 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
generalPractitioner​VerbalNotificationDate String Date when the primary care practitioner was verbally notified of the decision. Maps to: CareRequest.GeneralPractitionerVerbalNotifiedDate Big, 46.0 46.0
generalPractitioner​WrittenNotificationDate 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
homeHealthCertifi​cationEndDate String Certification end date for home health care. Maps to: CareRequestExtension.HomeHealthCertificationEndDate Big, 46.0 46.0
homeHealthCertifi​cationStartDate String Certification start date for home health care. Maps to: CareRequestExtension.HomeHealthCertificationStartDate Big, 46.0 46.0
homeHealth​StartDate 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
independentReview​Determination String The determination made by the independent review. Maps to: CareRequestExtension.IndependentReviewDetermination Big, 52.0 52.0
independentReview​DeterminationDate String The date when the determination was made by the independent review. Maps to: CareRequestExtension.IndependentReviewDeterminationDate Big, 52.0 52.0
independentReview​SubmissionDate String The date when the review request was submitted for independent review. Maps to: CareRequestExtension.IndependentReviewSubmissionDate Big, 52.0 52.0
infoReceieved​Date String Date and time when additional information was received from the provider or member. Maps to: CareRequest.InfoReceivedDate Big, 46.0 46.0
infoRequested​Date String Date and time when additional information was requested from the provider or member. Maps to: CareRequest.InfoRequestedDate Big, 46.0 46.0
initialDenial​NotificationDate String Date of initial denial notification. Maps to: CareRequest.InitialDenialNotificationDate Big, 46.0 46.0
initialDenial​NotificationTime String The time when the initial care request was denied. Maps to CareRequest.InitialDenialNotificationTime Big, 52.0 52.0
isIndependent​ReviewRequired 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
lastModified​Date String Last Modified Date Big, 46.0 46.0
medicalDirector Medical Director The medical director who reviewed the request. Big, 46.0 46.0
medicalDirector​Notes 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
memberContact​Date String Member Contact Date Maps to: CareRequest. Big, 46.0 46.0
memberGroup​Number String Insurance group number for the member. Maps to: CareRequest.MemberGroupNumber Big, 46.0 46.0
memberPrimary​Plan 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
memberSecondary​Plan 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
memberVerbalNotifi​cationDate String Date when the member was verbally notified of the decision. Maps to: CareRequest.MemberVerbalNotificationDate Big, 46.0 46.0
memberWrittenNotifi​cationDate String Date when the member was notified of the decision by written correspondence. Maps to: CareRequest.MemberWrittenNotificationDate Big, 46.0 46.0
modification​Date String Date the case was modified. Maps to: CareRequest.ModificationDate Big, 46.0 46.0
modifiedLength​ofStay Integer Modified number of days for the admission. Maps to: CareRequest.ModifiedLengthOfStay Big, 46.0 46.0
modifiedLevel​ofCare String Modified level of care for the patient. Maps to: CareRequest.ModifiedLevelOfCare Big, 46.0 46.0
nextReview​Date String Date the next review is scheduled for completion. Maps to: CareRequest.NextReviewDate Big, 46.0 46.0
nursingHomeResi​dentialStatus String Nursing home resident status at the time of service. Maps to: CareRequestExtension.NursingHomeResidentialStatus Big, 46.0 46.0
originalDenial​MedicalDirector 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
placeof​Service 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
practitioner​ContactDate String Date and time when the provider was contacted. Maps to: CareRequest.PractitionerContactDateTime Big, 46.0 46.0
priorDischarge​Status 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
reconsiderationDenial​NotificationDate String Date of reconsideration denial notification. Maps to: CareRequest.ReconsiderationDenialNotificationDate Big, 46.0 46.0
reconsiderationDenial​NotificationTime 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
referenceCare​RequestCase String The reference care request case number associated with the care request. Maps to: CareRequest.ReferenceCareRequestCase Big, 52.0 52.0
referenceCase​Number String Reference authorization number for an appeal, complaint, or grievance. Maps to: CareRequest.ReferenceCaseNumber Big, 46.0 46.0
reopenDecision​DateTime 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
reopenReason​Description String Description of why the request was reopened. Maps to: CareRequest.ReopenReasonDescription Big, 46.0 46.0
reopenRequest​Outcome String The result of the reopen request. Maps to: CareRequestExtension.ReopenRequestOutcome Big, 52.0 52.0
reopenRequest​Type 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
requestExtension​Reason String The reason for requesting the care extension. Maps to: CareRequestExtension.RequestExtensionReason Big, 52.0 52.0
requestExtn​DecisionDateTime 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
requestOutcome​Desc 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
requested​Date String Date the request was originally requested. Maps to: CareRequest.RequestedDate Big, 46.0 46.0
requestedLength​OfStay Integer Requested length of stay for the patient. Maps to: CareRequest.RequestedLengthOfStay Big, 57.0 57.0
requestedLevel​ofCare String Requested level of care for the patient. Maps to: CareRequest.RequestedLevelOfCare Big, 46.0 46.0
requester​Type String Indicates the role of the individual initiating the request. Maps to: CareRequest.RequesterType Big, 46.0 46.0
requesting​Practitioner Requesting Practitioner Ordering or referring practitioner for the request. Big, 46.0 46.0
requestingPractitione​rLicense String Requesting Practitioner License Maps to: CareRequest.RequestingPractitionerLicense Big, 46.0 46.0
requestingPractitioner​Specialty String Specialty of the practitioner, for example, Family Practice or General Surgery. Maps to: CareRequest.RequestingPractitionerSpecialty Big, 46.0 46.0
requestingPractitioner​VerbalNotificationDate String Date when the practitioner was verbally notified of the decision. Maps to: CareRequest.RequestingPractitionerVerbalNotifiedDate Big, 46.0 46.0
requestingPractitioner​WrittenNotificationDate 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
resolutionLetter​SentDate 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
scheduledAdmission​Date String Anticipated admission date for the patient. Maps to: CareRequest.ScheduledAdmissionDate Big, 46.0 46.0
scheduledDischarge​Date 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
serviceorMedication​Received 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
servicingPractitioner​License String License type of the practitioner. Maps to: CareRequest.ServicingPractitionerLicense Big, 46.0 46.0
servicingPractitioner​Specialty 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