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Configure Data Streams for Prior Authorization Objects
To pull prior authorization data from external systems via a Data Cloud zero copy connection, configure prior authorization data streams.
Required Editions
| Available in: Lightning Experience |
| Available in: Enterprise, Performance, and Unlimited Editions with the Agentforce for Health Cloud and Agentforce Employee Agent add-on licenses. |
| User Permissions Needed | |
|---|---|
| To access Data Cloud Setup: | System admin profile OR Data Cloud Architect permission set |
| To edit a data stream: | Data Cloud Architect permission set |
For real-time prior authorization visibility, prior authorization data streams directly from external zero copy systems into Data Cloud. Agentforce then accesses this data by using Data Model Objects (DMOs).
- Turn on Data 360.
- If prior authorization data is stored in an external zero copy system, set up a Data 360 zero copy connection.
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Configure data streams for the DMOs that support prior authorizations.
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Configure the data stream for the Case object.
Field Data Type Label (if different than the DMO Label) Case Id Text - Primary Key Case ID Case Number Text External Record Id Text External Case Subject Text Case Details Case Sub Status Text Decision Case Priority Text Priority Escalated Text Escalation Date Datetime Individual Text Requestor Full Name Assigned User Text Request Assigned To -
Configure the data stream for the Care Request object.
Field Data Type Label (if different than the DMO Label) Authorization Reference Identifier Text Prior Auth ID Name Text Prior Auth Name Request Type Text Prior Auth Type Requested Date datetime Recieived Date Datetime Request Received Date Request Due Date Datetime Claim Number Text Associated Claim Number Effective From Date Datetime Prior Auth Effective Start Date Effective To Date Datetime Prior Auth Effective End Date Expiration Date Datetime Prior Auth Expiration Date Requesting Practitioner Text Requesting Provider Name Requesting Practitioner Specialty Text Requesting Provider Specialty Servicing Practitioner Id Text Servicing Provider Name Servicing Practitioner Specialty Text Servicing Provider Specialty Service Date Date Servicing Facility Text Deductible Appointed Representative Text Member Text Member Full Name Member Insurance Identifier Text Member ID Member Primary Plan Text Primary Plan Member Secondary Plan Text Secondary Plan Health Plan Subscriber Text Subscriber Full Name Subcriber Member Identifier Text Subscriber ID Decision Reason Text Decision Reason Description Text Decision Description Decision Date Datetime Decision Notes Text -
Configure the data stream for the Care Request Item object.
Field Data Type Label (if different than the DMO Label) Authorization Ref Identifier Text Prior Auth ID Auth Approval Identifier Text Auth Approval ID Name Text Prior Auth Item Name Reason Code Text Prior Auth Reason Code Reason Status Text Prior Auth Item Status Reason Status Type Id Text Prior Auth Item Status Reason Type Text Prior Auth Item Type Service Category Text Prior Auth Item Service Category Procedure Code Text Prior Auth Item Procedure Code Procedure Code Set Text Prior Auth Item Procedure Code Set FreeFormProcedureDescription Text Prior Auth Item Procedure Description Quantity Number Prior Auth Item Requested Quantity Approved Quantity Number Prior Auth Item Approved Quantity Denied Service Quantity Number Prior Auth Item Denied Quantity Service Effective Date Date Prior Auth Item Rqst Item Effective Date Service End Date Date Prior Auth Item Rqst Item End Date Servicing Facility Text Prior Auth Item Servicing Facility Servicing Provider Text Prior Auth Servicing Provider -
Configure the data stream for the Care Request Drug object.
Field Data Type Label (if different than the DMO Label) Name Text Drug Name AuthorizationRefIdentifier Text Prior Auth ID Priority Text Drug Request Priority Request Type Text Drug Request Type Status Text Drug Request Status Status Reason Text Drug Request Status Reason Drug Code Text Requested Units Number Drug Requested Units Therapy Duration Number Approved Units Number Drug Request Approved Units Denied Units Number Drug Request Denied Units Dose Text Drug Request Dose Days Supply Number Drug Request Days Supply Frequency Text Dispenser Name Text Dispensing Pharmacy Text Dispener Address Text Dispenser Phone Number Text -
Configure the data stream for the Healthcare Provider object.
Field Data Type Label (if different than the DMO Label) Healthcare Provider Id Text Provider ID Full Name Text Provider Name -
Configure the data stream for the Healthcare Provider NPI object.
Field Data Type Label (if different than the DMO Label) Healthcare Provider Text Provider ID Healthcare Provider NPI ID Text Provider NPI ID National Provider Identifier Text Provider NPI -
Configure the data stream for the Healthcare Facility object.
Field Data Type Label (if different than the DMO Label) Healthcare Provider Text Provider ID Id Text Facility ID Name Text Facility Name -
Configure the data stream for the Individual object.
Field Data Type Individual ID Text - Primary Key First Name Text Last Name Text Birth Date Date External Record ID Text
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Configure the data stream for the Case object.
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