Built-In MuleSoft Integration to Manage Authorization Requests

Set up and use Integrations to implement digital workflows and create seamless user experiences. Health Cloud’s comprehensive solution gives you:

• Predefined integration procedures, Omnistudio Data Mappers, and Apex classes that help you retrieve member information from EHR and submit authorization requests to payers.
• Pre-built integration applications, built using the FHIR standards, that enable Health Cloud to interact with external EHR and payer systems. These out-of-the-box integration applications help providers by reducing the time and cost to go live. These apps are available to users who have the MulesSoft add-on product called MuleSoft Direct for Health cloud.
  • Prior Authorization EMR Retrieval API helps provider systems to automatically retrieve all the relevant datasets from the EMR to prepare a Da Vinci (an HL7 FHIR accelerator) aligned prior authorization request.
  • Prior Authorization Claim Submission API helps provider systems to send a Da Vinci (an HL7 FHIR accelerator) aligned prior authorization request to a clearing house or a payer endpoint. It handles the submission of the request and inquiry about the request status.
  Use the EHR connector MuleSoft Direct for Health Cloud to directly pull patient and clinical information, greatly simplifying the information gathering process. MuleSoft Direct for Health Cloud allows providers to easily pull patient and clinical information to quickly create authorization requests. Then, providers can submit the request electronically in a Da Vinci FHIR API format where it can be sent to the payer’s FHIR endpoint via Mule Connector.