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            Set Up FHIR-Aligned Picklist Values

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            Set Up FHIR-Aligned Picklist Values

            Clinical Decision Support for Coverage Requirement Discovery processes member and coverage data in alignment with FHIR standards. Configure the picklist values for fields in the Service Information Request, Service Information Response, Service Information Response Coverage, and Service Information Response Resource URL following FHIR specifications.

            Required Editions

            Available in: Lightning Experience

            Available in: Enterprise and Unlimited Editions with Health Cloud

            It’s important that you set up FHIR-aligned picklist values to ensure data accuracy and interoperability. When you have a standardized, uniform data structure, it helps to reduce errors and ensures accurate clinical decisions. This results in cost-effective patient care and improved outcome.

            • Configure Picklist Values for Service Information Request Fields
              Configure the picklist values for the Service Type and Source Type fields in the Service Information Request object. Service Type represents the type of FHIR-specified service that’s requested in the incoming coverage requirement discovery request. Source Type specifies the type of system that captured the request.
            • Configure Picklist Values for Service Information Response Fields
              Configure your own picklist values for the Focus Type, Response Subtype, and Urgency Indicator fields in the Service Information Response object. Focus Type specifies the type of data that the response focuses on such as Medication Request or Service Request. The Response Subtype specifies the subtype of service information response such as coverage information, claims, network, and more. The Urgency Indicator represents how urgent the content of the response is.
            • Configure Picklist Values for Service Information Response Coverage Fields
              Configure the picklist values for the Coverage Indicator, Preapproval Requirement Indicator, and Required Documentation Type fields in the Service Information Response Coverage object. Coverage Indicator specifies if the requested service is covered under the member’s insurance plan. Preapproval Requirement Indicator specifies if pre-authorization is required. Required Documentation Type specifies the type of additional documentation required for coverage to be provided.
            • Configure Picklist Values for Service Information Response Resource URL Fields
              Configure the picklist values for the Type field in the Service Information Response Resource URL object. The resource URL type indicates whether the URL is an absolute URL.
             
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