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            Set Up Automatic Approval of Prior Authorization Requests

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            Set Up Automatic Approval of Prior Authorization Requests

            To enable instant approval of qualifying prior authorization requests, turn on the Automatic Approval of Prior Authorization Requests setting. Then, clone and configure the Automatically Approve Prior Authorization Requests flow.

            Required Editions

            Available in: Lightning Experience

            Available in: Enterprise and Unlimited Editions
            User Permissions Needed
            To use Utilization Management: Health Cloud Utilization Management permission set
            To clone and configure flows: Health Cloud Admin permission set
            1. From Setup, in the Quick Find box, enter Utilization Management Settings and select Utilization Management Settings.
            2. Turn on Automatic Approval of Prior Authorization Requests.
              This gives you access to the Automatically Approve Prior Authorization Requests flow.
            3. From Setup, in the Quick Find box, enter Flows and select Flows.
            4. Find and select Automatically Approve Prior Authorization Requests.
            5. To clone the flow, click Save As New Flow.
            6. Enter the label and API name of the flow.
            7. Save your work.
              The newly cloned flow opens in Flow Builder.
            8. Review the flow components and configure the flow to set the conditions for autoapproval based on your business requirements.
            9. Save and activate your cloned flow.

            After a care request of type PreAuthorization is created, the flow runs and checks if the request meets the specified conditions. If the request qualifies for automatic approval, the status of the associated case is updated to Closed and the request outcome of the associated care request extension is updated to Complete.

             
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