Manage Rules for Automating Authorization Request Workflows

With the help of Expression Set Templates, Expression Sets, and Decision Matrices, you can define, customize, and activate rules for member eligibility check, document checklists, and auto approval of authorization requests.

• Expression Set Templates - Prebuilt, read-only rules. Templates provide an outline for building your expression set.
• Expression Sets - A series of rules created using expression set elements. Each element in an expression set represents a logical step that's run sequentially. Expression sets evaluate conditions, perform mathematical operations, look up decision matrices, and perform multiple transformations simultaneously.
• Decision Matrices - Lookup tables that match your input values to a row in the matrix. When the matrix finds an exact match, it returns the row's output value.

• Automate Workflows with Predefined Rules
  Simplify and expedite reviews of authorization requests by using built-in business rules and logic. Use the predefined expression set templates and define decision matrices to perform automatic validation, reduce administrative errors, and cut down on repetitive tasks.