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            Get to Know the Omnistudio Components Related to Coverage Requirement Discovery

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            Get to Know the Omnistudio Components Related to Coverage Requirement Discovery

            When you receive a CRD request, Health Cloud uses pre-built Omnistudio components to process the request, verify the member and coverage information, and send a response. These components power a smooth and swift request management and response workflow.

            Required Editions

            Available in: Lightning Experience

            Available in: Enterprise and Unlimited Editions

            Use the table to understand the pre-built Omnistudio integration procedures used in handling different types of CRD requests. Each integration procedure contains sub-integration procedures and data mappers that process CRD requests and sends responses.

            Integration procedure Name Description use case
            HlsClinicalDecisionSupportProcessAppointmentBook Processes an Appointment Book clinical decision support request and sends a response. Evaluates clinical appointment scheduling requests to ensure certain coverage conditions are met before booking the appointment or triggering further workflows. Validates appointment context and associated Service Requests such as CPT Codes and determines if prior authorization is needed.
            HlsClinicalDecisionSupportProcessOrderEcho Processes Order Select and Order Sign clinical decision support requests and sends responses. Evaluates the coverage requirements of clinical products and services at two different stages of the ordering process - when a provider selects the order and before signing to finalize the order.
            HlsClinicalDecisionSupportProcessOrderDispatch Processes an Order Dispatch clinical decision request and sends a response. Also assigns a performer to an existing order for flexible, partial, or repeated fulfillment using FHIR Task. Manages the fulfillment of clinical or service orders such as lab tests, medications, or referrals. Validates the order after provider approval, extracts and processes relevant FHIR resources, and dispatches it for fulfillment.
            HlsClinicalDecisionSupportProcessPatientEncounter Processes Enounter Start and Encounter Discharge clinical decision support requests and sends responses. Evaluates clinical context at the beginning and end of a patient's healthcare encounter. Checks that the required information related to the patient, provider, and coverage is present before care begins. Also evaluates discharge readiness by checking documentation completeness and if post-discharge services are required.
            Tip
            Tip The predefined Omnistudio components represent a default implementation and are ready to use. However, we recommend you customize these components per your organization's requirements. Cloning ensures that you don’t face any process disruptions when predefined components are updated during automatic upgrades.
             
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