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            Configure the Partial Request Outcome for Authorization Requests

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            Configure the Partial Request Outcome for Authorization Requests

            The outcomes of authorization requests vary depending on factors such as the patient’s member plans or the payer’s clinical review guidelines. To help your authorization coordinators successfully manage the authorization request process, define a request outcome named Partial. The other required outcomes, Queued, Error, and Complete, are available by default.

            Required Editions

            Request outcome is closely tied with case status. Based on the outcome received from the payer, Health Cloud updates the case status. Ensure you have these exact request outcomes and case statuses in your org.

            Request OutcomeCase Status
            QueuedPended
            ErrorErrored
            PartialPended
            CompleteApproved
            CompleteDenied

            Available in: Lightning Experience

            Available in: Enterprise and Unlimited Editions with Health Cloud
            User Permissions Needed
            To add request outcomes: Update on care request extensions
            1. From Setup, open the Object Manager, and click Care Request Extension.
            2. Select Fields & Relationships, then click Request Outcome.
            3. Click New in the Request Outcome Picklist Values section.
            4. Enter Partial.
              Important
              Important Enter the exact value to ensure your users don’t face issues when processing authorization requests.
            5. Save your changes.
              Your users can now easily track the outcome of authorization requests.

            See Also

             
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