Configure Action Buttons for Processing Authorization Request Reviews

Help your users to launch Omniscripts and handle authorization requests in an efficient and timely manner by adding Flexcard-based action buttons to the Case record page or the Home page in the Utilization Management for Payers app. Conditionalize the visibility of the buttons based on the case status, case substatus, and request type.

Required Editions

Available in: Lightning Experience

Available in: Enterprise and Unlimited Editions with Health Cloud

User Permissions Needed
To add action buttons: Update on Case object

Each Flexcard contains an action button that triggers the launch of the integrated Omniscript based on how you configure the visibility rules. For example:

  • The HealthCloudUMAdminFlowLaunch Flexcard contains the Start Admin Review button.
  • The Start Admin Review button launches the HealthCloudUM/AdminReview Omniscript, which initiates an admin review of the authorization request.
  • The Start Admin Review button is available only when the case status is Admin Review. Setting visibility rules using case status helps you to achieve this conditional display.
Note
Note Before you add the buttons, make sure you’ve configured the necessary case status values.
  1. From the App Launcher, go to the Utilization Management for Payers app, select the Cases tab and then select a case record.
  2. Select Gear icon, and then select Edit Page.
  3. In the Lightning App Builder, drag Flexcard components onto the page to add action buttons for each case status:
    1. Place Flexcard components on the record page layout.
    2. In the Properties pane for each Flexcard, select the Flexcard name and configure visibility rules as shown.
      FlexCard Name Visibility Rule Shows This Action Button Launches This OmniScript
      HealthCloudUMPriorAuthIntakeLaunch No action is required to set the visibility rules. Add Authorization Request Details HealthCloudUM/AuthorizationRequest
      HealthCloudUMAdminFlowLaunch Record Field > Status Equal Admin Review Start Admin Review HealthCloudUM/AdminReview
      HealthCloudUMNurseFlowLaunch Record Field > Status Equal Nurse Review Start Utilization Management Nurse Review HealthCloudUM/UMNurse
      HealthCloudUMAuthReviewsLaunch No action is required to set the visibility rules as they’re predefined based on Case Status equals MD Review and Substatus doesn’t equal Peer to Peer Review Scheduled. Start Medical Director Review HealthCloudUM/MedicalDirectorReview
      HealthCloudUMAuthReviewsLaunch No action is required to set the visibility rules as they’re predefined based on Case Status equals Nurse Review and Substatus equals Schedule Peer to Peer Review. Schedule Peer-to-Peer Review HealthCloudUM/P2PScheduling
      HealthCloudUMAuthReviewsLaunch No action is required to set the visibility rules as they’re predefined based on Case Status equals MD Review and Substatus equals Peer to Peer Review Scheduled. Start Peer-to-Peer Review HealthCloudUM/P2PReview
      HealthCloudUMConcurrentReviewLaunch No action is required to set the visibility rules as they’re predefined based on Request Type equals Inpatient - Physical Health Review or Outpatient - Physical Health Review. Create Concurrent Review HealthCloudUM/AuthorizationRequest
      Note
      Note 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. To do so, save a new version of each Omniscript and clone the associated Data Mappers and Integration Procedures. Retain the settings, save the new version or clone with a different name, activate the new version or the clone, and then relink the components. Similarly, clone and activate the Flexcards that launch these Omniscripts and relink them to the corresponding new versions of the Omniscripts. Cloning ensures that you don’t face any process disruptions when predefined components are updated during automatic upgrades.
  4. Save and activate your changes.
    Now, when your users access the Case record page, the page shows the action button that matches with the current status and substatus of the case.
    Note
    Note Edit the home page of the Utilization Management for Payers app to add a Flexcard component for the Add Authorization Request Details button.