---
schema_version: "1"
id: 68ff492780d5ba403a185f5e456c9f8c992ea2171078b001ee0d2a4d37bcb0f1
title: Set Up Permissions and Data for Utilization Management
collection: admin
version: current
locale: en-us
portal_url: https://docs.salesforce.com/admin/current/en-us/ind/264-0-0/admin_utilization_management_prereq.md
canonical_url: https://help.salesforce.com/s/articleView?id=ind.admin_utilization_management_prereq.htm&release=264.0.0&type=5
source_site: help.salesforce.com
content_type: documentation
content_hash: 85058acf69933574e849d66005419be1fbeb71ec495fce34f6ed6024d76ba60e
description: To use Utilization Management, complete these prerequisites.
products:
  - Health
release: "264"
---
# Set Up Permissions and Data for Utilization Management

To use Utilization Management, complete these prerequisites.

### Required Editions

<table class="slds-table slds-table_bordered slds-max-medium-table_stacked slds-m-bottom_small edition">
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            <p>Available in: Lightning Experience</p>
            <p style="margin-bottom:0;">Available in: <strong>Enterprise</strong> and <strong>Unlimited</strong> Editions with Health
              Cloud</p>
          </td>

        </tr>
      </tbody>
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- Complete the basic setup for Health Cloud.
- Ensure system admins have these permission sets and permission set licenses:
    - Health Cloud Platform permission set license, which includes the Health Cloud Foundation and Health Cloud Utilization Management permission sets
    - Omnistudio Admin permission set, which also includes the permissions granted by the Omnistudio User permission set
    - RuleEngine Designer permission set, which also includes the permissions granted by the RuleEngine Runtime permission set
- Assign these permission sets to your users:
    - Health Cloud Foundation
    - Health Cloud Utilization Management
    - Omnistudio User permission set
    - RuleEngine Runtime permission set
- For payers, ensure you have the MuleSoft - Salesforce Healthcare APIs SKU to use the payer inbound API: Prior Authorization API
- For providers:
    - Enable the Health Cloud: Utilization Management for providers org permission.
    - Enable the IndustriesServiceExcellence add-on license or the IndustriesServiceExcellence platform license.
    - Enable the FHIR-aligned Clinical Data Model.
    - Ensure you have the MuleSoft add-on product called MuleSoft Direct for Health Cloud to use the provider APIs: Prior Authorization EMR Retrieval API and Prior Authorization Claim Submission API
- Ensure your org data is set up using these objects:
    
    | Object | Type of Data |
    | --- | --- |
    | Account (business accounts and person accounts) | Member and provider details |
    | Purchaser Plan and Member Plan | Member’s insurance plan details |
    | Healthcare Payer Network (business account) | Payer details |
    | Healthcare Provider (business accounts and person accounts), Healthcare Provider NPI, Board Certification, Healthcare Provider Taxonomy, Contact | Requesting and servicing provider details |
    | Healthcare Facility (for business accounts) and Healthcare Practitioner Facility (for person account’s contact) | Payer and provider facility details |
    | Code Sets | Service code, diagnosis code, and care processing error code details. These are industry-standard ICD-10 codes. |
- Add care request type values to the Type field picklist on the Case object. For example, Initial Request, Extension or Amendment.