CareRequestExtension

Represents extra details for a care request such as the subscriber details for the member’s health plan, home healthcare status, and ambulance transportation details.

Supported Calls

create(), delete(), describeLayout(), describeSObjects(), getDeleted(), getUpdated(), query(), retrieve(), search(), undelete(), update(), upsert()

Fields

AmbulanceTransportReason

Type: picklist
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Reason for ambulance transport.

AmbulanceTransportType

Type: picklist
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Type of ambulance transport.

AppealEffectuationDateTime

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: 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.

AuthorizationRefIdentifier

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The unique identifier of the authorization request.

This field is available in API version 57.0 and later.

CareRequestCaseId

Type: reference
Properties: Create, Filter, Group, Sort
Description: Case related to the care request extension.

This is a relationship field.
Relationship Name: CareRequestCase
Relationship Type: Lookup
Refers To: Case

CareRequestId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Care request related to the care request extension.

This is a relationship field.
Relationship Name: CareRequest
Relationship Type: Lookup
Refers To: CareRequest

CaseSubStatus

Type: picklist
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The substatus of a case related to a care request.

This field is available in API version 56.0 and later.
Possible values:
- Approved
- Auto Approved
- Denied
- More Information Requested
- More Information Required
- New Request
- Partially Approved
- Peer to Peer Review Scheduled
- Pending Review
- Schedule Peer to Peer Review

ClientSourceSysIdentifier

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: An identifier of the client’s source system that sent the care request.

CoveragePlanTypeId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Specifies the type of plan the member is covered by.

This field is a relationship field.
Relationship Name: CoveragePlanType
Refers To: CodeSetBundle

DocumentAttachmentStatus

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: The status of a clinical document upload.

This field is available in API version 55.0 and later.
Possible values:
- Complete
- Incomplete

HealthcareProviderId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The healthcare provider associated with the care request against whom the Grievance is filed

This is a relationship field.
Relationship Name: HealthcareProvider
Relationship Type: Lookup
Refers To: HealthcareProvider

HomeHealthCertificationEndDate

Type: date
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Certification end date for home healthcare.

HomeHealthCertificationStartDate

Type: date
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Certification start date for home healthcare.

HomeHealthStartDate

Type: date
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Date that home health services are scheduled or anticipated to start.

IndependentReviewDetermination

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: The determination made by the independent review.
Possible values:
- Other
- Overturned
- Upheld

IndependentReviewDeterminationDate

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: The date when the determination was made by the independent review.

IndependentReviewSubmissionDate

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: The date when the review request was submitted for independent review.

IsIndependentReviewRequired

Type: boolean
Properties: Create, Defaulted on create, Filter, Group, Sort, Update
Description: Indicates whether an independent review is required
Default value: false

IsMedicareCoverage

Type: boolean
Properties: Create, Defaulted on create, Filter, Group, Sort, Update
Description: Indicates whether the member has Medicare coverage.

LastReferencedDate

Type: dateTime
Properties: Filter, Nillable, Sort
Description: The timestamp for when the current user last viewed a record related to this record.

LastViewedDate

Type: dateTime
Properties: Filter, Nillable, Sort
Description: The timestamp for when the current user last viewed this record. If this value is null, it’s possible that this record was referenced (LastReferencedDate) and not viewed.

Name

Type: string
Properties: Create, Filter, Group, idLookup, Sort, Update
Description: Name of the care request extension.

NursingHomeResidentialStatus

Type: picklist
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Nursing home-resident status at the time of service.

PriorDischargeStatus

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: Specifies the previous discharge status of the member.
Possible values:
- Discharged to court/law enforcement.
- Discharged to home with home health.
- Discharged to home/self care.
- Discharged to hospice care.
- Discharged/transferred to LTACC.
- Discharged/transferred to Psychiatric facility.
- Discharged/transferred to SNF.
- Discharged/transferred to other acute care facility.
- Expired
- Left against medical advice (AMA).

RecordTypeId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Category type of the request.

This is a relationship field.
Relationship Name: RecordType
Relationship Type: Lookup
Refers To: RecordType

ReferenceCaseType

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: Specifies the type of reference case that’s associated with the care request extension.

This field is available in API version 58.0 and later.
Possible values:
- Associated Case
- Prior Case

ReopenDecisionDateTime

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: The date when the decision on the reopen request was made.

ReopenRequestOutcome

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: The result of the reopen request.
Possible values:
- Overturned
- Upheld

ReopenRequestType

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: The type of reopen request.
Possible values:
- Peer-to-Peer Review
- Reconsideration

RequestExtensionReason

Type: textarea
Properties: Create, Nillable, Update
Description: The reason for requesting the care extension.

RequestExtnDecisionDateTime

Type: dateTime
Properties: Create, Filter, Nillable, Sort, Update
Description: The date when the decision to extend the care request extension was made.

RequestOutcome

Type: picklist
Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
Description: Specifies the outcome of the request.
Possible values:
- Overturned
- Partially Pending
- Partially Upheld
- Upheld
- Voided
- Queued
- Complete
- Error

RequestOutcomeDesc

Type: textarea
Properties: Create, Nillable, Update
Description: The description of the request outcome.

RequestType

Type: picklist
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Category type of the request.
Possible values:
- Admission Review
- Concurrent Review
- Health Services Review
- Individual
- Inpatient - Behavioral Health Review
- Inpatient - Physical Health Review
- Outpatient - Behavioral Health Review
- Outpatient - Physical Health Review
- Specialty Care Review

RequestingProviderId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The provider who requested a prior authorization for a care request. This field is available in API version 55.0 and later.

This field is a relationship field.
Relationship Name: RequestingProvider
Relationship Type: Lookup
Refers To: HealthcareProvider

ResolutionDescription

Type: textarea
Properties: Create, Nillable, Update
Description: The description of the care request.

ServiceLevel

Type: picklist
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The level of service rendered.

ServiceType

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Classification of the type of service.

ServicingFacilityId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The facility where a patient receives service for a care request. This field is available in API version 55.0 and later.

This field is a polymorphic relationship field.
Relationship Name: ServicingFacility
Relationship Type: Lookup
Refers To: HealthcareFacility, HealthcarePractitionerFacility

ServicingProviderId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The provider who provides the service for a care request. This field is available in API version 55.0 and later.

This field is a relationship field.
Relationship Name: ServicingProvider
Relationship Type: Lookup
Refers To: HealthcareProvider

SubscriberId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Identifier for the person who has subscribed to the health plan.

This is a relationship field.
Relationship Name: Subscriber
Relationship Type: Lookup
Refers To: Account

SubscriberMemberIdentifier

Type: string
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: Member ID for the subscriber.

SupportingDocUrl

Type: url
Properties: Create, Filter, Nillable, Sort, Update
Description: The URL of supporting documentation such as a questionnaire.

TotalAmbulanceTransportDistance

Type: double
Properties: Create, Filter, Nillable, Sort, Update
Description: Total distance traveled during ambulance transport.

UnitofMeasureId

Type: reference
Properties: Create, Filter, Group, Nillable, Sort, Update
Description: The unit of measure for the quantity associated with a prior authorization request. This field is available in API version 55.0 and later.

This field is a relationship field.
Relationship Name: UnitofMeasure
Relationship Type: Lookup
Refers To: UnitOfMeasure

Associated Objects

This object has the following associated objects. If the API version isn’t specified, they’re available in the same API versions as this object. Otherwise, they’re available in the specified API version and later.

CareRequestExtensionChangeEvent (API Version 62.0): Change events are available for the object.
CareRequestExtensionFeed: Feed tracking is available for the object.
CareRequestExtensionHistory: History is available for tracked fields of the object.