Get to Know the Coverage Requirement Discovery Data Model

Coverage Requirement Discovery for Utilization Management uses a FHIR aligned-data model to store records in Health Cloud.

Available in: Lightning Experience

Available in: Enterprise and Unlimited Editions

Here’s the set of objects used to represent coverage requirement discovery (CRD) requests and responses.

Object	Usage
Service Information Request	Represents details of a CRD request, such as the date and time when the request was submitted and the type of service requested.
Service Information Request Detail	Represents additional details about a CRD request, such as the detail type and detail code (operation outcome code).
Service Information Response	Represents a response to a CRD request.
Service Information Response Coverage	Represents coverage details about a CRD response. For example, if additional information or documentation is required for the coverage to be provided.
Service Information Response Coverage Detail	Represents additional coverage details about a CRD response.
Service Information Response Suggestion	Represents suggestions in a CRD response. For example, suggesting a change in medication dosage.
Service Information Response Action	Represents the actions to be performed as suggested by a CRD response.
Service Information Response Resource URL	Represents the URLs of resources relevant to a CRD response.
Service Information Response Override Option	Represents the possible reasons for overriding a CRD response.
Service Information Related Questionnaire	Represents the questionnaire associated with a CRD request or CRD coverage response (Service Information Response Coverage).

Product Area