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            Create and Submit Authorization Requests to Payers

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            Create and Submit Authorization Requests to Payers

            As an authorization coordinator at the provider’s office, you play a central role in handling the end-to-end authorization process for a patient’s services. But, manually gathering information from the EHR system and passing it on to the payer system can be time consuming and result in unintended errors. Utilization Management’s centralized, guided workflow for request submission, with seamless integration to EHR and payer systems, helps you to easily create and submit error-free requests.

            Required Editions

            Available in: Lightning Experience

            Available in: Enterprise and Unlimited Editions with Health Cloud
            1. Select a Patient for the Authorization Request
              Select the patient who you’re creating the authorization request for. You can search for a patient either by their Patient ID or name.
            2. Select a Service Request for the Authorization Request
              Select the services that the patient needs and add them to the authorization request.
            3. Add Documentation and Submit an Authorization Request
              Add clinical documentation to support the authorization request. Before submitting the authorization request, review the details to ensure everything is correct.
            4. View a Summary of a Submitted Authorization Request
              After submitting an authorization request, you can quickly review the request sent to the payer by viewing the summary.
             
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            Salesforce Help | Article