---
schema_version: "1"
id: 43b9d025bf8bb5b0f901065f91ca0509f529c810ad7280a2536fe427004fcc80
title: Automate Workflows with Predefined Rules
collection: admin
version: current
locale: en-us
portal_url: https://docs.salesforce.com/admin/current/en-us/ind/264-0-0/admin_utlization_management_define_rules.md
canonical_url: https://help.salesforce.com/s/articleView?id=ind.admin_utlization_management_define_rules.htm&release=264.0.0&type=5
source_site: help.salesforce.com
content_type: documentation
content_hash: d09c216e41f64fa7320b4eca754c8c06dff27cf05f88746fdf5a3e5849151b20
description: Simplify and expedite reviews of authorization requests by using built-in business rules and logic. Use the predefined expression set templates and define decision matrices to perform automatic validation, reduce administrative errors, and cut down on repetitive tasks.
products:
  - Health
release: "264"
---
# Automate Workflows with Predefined Rules

Simplify and expedite reviews of authorization requests by using built-in business rules and logic. Use the predefined expression set templates and define decision matrices to perform automatic validation, reduce administrative errors, and cut down on repetitive tasks.

### Required Editions

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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>
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            <th scope="colgroup" class="slds-cell-wrap" colspan="2" style="text-align:center;vertical-align:top;" id="d175327e66">User Permissions Needed</th>
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            <td data-label="User Permissions Needed" class="slds-cell-wrap" style="vertical-align:top;" headers="d175327e66 ">To define decision matrices and expression sets:</td>

            <td class="slds-cell-wrap" style="vertical-align:top;" headers="d175327e66 ">RuleEngine Designer permission set</td>

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Utilization Management provides these prebuilt expression set templates that are readily integrated with the Omniscript processes:

- HealthCloudUM\_AutoApproval - Validates if an authorization request can be auto-approved without reviews
- HealthCloudUM\_DocsChecklist - Validates if an authorization request includes the required clinical documents
- HealthCloudUM\_NeedAssessment - Validates if the diagnostic and service codes requested in an authorization require approval

In tandem with these predefined expression set templates, you must define a set of decision matrices to obtain rule-based workflow automation.

1. From the App Launcher, find and select **Lookup Tables**.
2. Click **New**, select **Decision Matrix**, and then click **Next**.
3. Use the following table to define the required decision matrices:
    1. Enter the name for the decision matrix.
    2. Set the Type as Standard.
    3. Click **Save**.
    4. Select the Related tab and then open the decision matrix version.
    5. Click **Add Column** to add input and output columns for each decision matrix as specified, and then save your changes.
        
        <table class="slds-table slds-table_bordered slds-max-medium-table_stacked slds-m-bottom_small ">
                <thead class="slds-text-title_caps ">
                  <tr><th class="slds-cell-wrap" scope="col" id="d175327e178"> Decision Matrix Name</th>
                  <th class="slds-cell-wrap" scope="col" id="d175327e181"> Purpose </th>
                  <th class="slds-cell-wrap" scope="col" id="d175327e184">Columns for Input Data </th>
                  <th class="slds-cell-wrap" scope="col" id="d175327e187">Columns for Output Data</th>
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                  <td class="slds-cell-wrap" data-label="Decision Matrix Name" headers="d175327e178"> HealthCloudUM_DocsChecklist </td>
                  <td class="slds-cell-wrap" data-label="Purpose" headers="d175327e181">Defines the list of mandatory documents required for a request type and
                    region.</td>
                  <td class="slds-cell-wrap" data-label="Columns for Input Data" headers="d175327e184">
                    <ul>
                      <li>RequestType (Text)</li>

                      <li> Region (Text)</li>

                    </ul>

                  </td>
                  <td class="slds-cell-wrap" data-label="Columns for Output Data" headers="d175327e187">Files (Text) <div class="slds-box slds-box_x-small slds-theme_shade slds-m-top_medium slds-m-bottom_medium">
                      <div class="slds-media slds-media_responsive">
                        <div class="slds-media__figure"><span class="slds-icon_container slds-icon_container_circle slds-icon-note-note"><img style="margin-bottom:0;" src="https://sf-zdocs-cdn-prod.zoominsoftware.com/tdta-ind-health-264-0-0-production-enus/90a9f828-79ab-49cd-ac8c-86e58ef7478e/images/icon_note.png" alt="Note"></span></div>
                        <div class="slds-media__body" style="padding-top:.5rem;padding-bottom:.5rem;"><span class="slds-text-title_caps">Note</span> Provide a comma-separated list of document
                          names.</div>
                      </div>
                    </div>
                  </td>
                </tr>
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                  <td class="slds-cell-wrap" data-label="Decision Matrix Name" headers="d175327e178">NeedAssessmentRuleIndividualPlanConditions</td>
                  <td class="slds-cell-wrap" data-label="Purpose" headers="d175327e181">Indicates if authorization is required for a member who has an individual member
                    plan.</td>
                  <td class="slds-cell-wrap" data-label="Columns for Input Data" headers="d175327e184">
                    <ul>
                      <li>ServiceCode (Text)</li>

                      <li>RequestType (Text)</li>

                      <li> PlanName (Text) </li>

                      <li>City (Text) </li>

                      <li>State (Text)</li>

                    </ul>

                  </td>
                  <td class="slds-cell-wrap" data-label="Columns for Output Data" headers="d175327e187">Output (Text)<ul>
                      <li>Required</li>
                      <li>NotRequired</li>
                    </ul>
                  </td>
                </tr>
                <tr class="">
                  <td class="slds-cell-wrap" data-label="Decision Matrix Name" headers="d175327e178">NeedAssessmentRuleGroupPlanConditions</td>
                  <td class="slds-cell-wrap" data-label="Purpose" headers="d175327e181">Indicates if authorization is required for a member who has a group member
                    plan.</td>
                  <td class="slds-cell-wrap" data-label="Columns for Input Data" headers="d175327e184">
                    <ul>
                      <li>ServiceCode (Text)</li>

                      <li> RequestType (Text)</li>

                      <li> PlanName (Text) </li>

                      <li>City (Text) </li>

                      <li>State (Text)</li>

                    </ul>

                  </td>
                  <td class="slds-cell-wrap" data-label="Columns for Output Data" headers="d175327e187">Output (Text)<ul>
                      <li>Required</li>
                      <li>NotRequired</li>
                    </ul>
                  </td>
                </tr>
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                  <td class="slds-cell-wrap" data-label="Decision Matrix Name" headers="d175327e178">HealthCloudUM_AutoApproval </td>
                  <td class="slds-cell-wrap" data-label="Purpose" headers="d175327e181">Indicates if authorization requests with a combination of specific input
                    parameters can be automatically approved.</td>
                  <td class="slds-cell-wrap" data-label="Columns for Input Data" headers="d175327e184">
                    <ul>
                      <li>RequestType (Text)</li>

                      <li>ServicingProviderInNetwork (Boolean)</li>

                      <li>ServiceCode (Text)</li>

                      <li> IsMemberActive (Boolean)</li>

                      <li> MemberPlanLOB (Text)</li>

                    </ul>

                  </td>
                  <td class="slds-cell-wrap" data-label="Columns for Output Data" headers="d175327e187">IsAutoApproved (Boolean)</td>
                </tr>
              </tbody></table>
4. Add rows and values for each decision matrix, and then save your changes.
5. Edit the decision matrix version and set it to **Active**.
6. Save your work.
7. From the App Launcher, find and select **Expression Set Templates**.
8. Save new versions of each of these predefined expression set templates with the same name: HealthCloudUM\_AutoApproval, HealthCloudUM\_DocsChecklist, and HealthCloudUM\_NeedAssessment.
9. From the Expression Set Properties, set the rank as **1**.
10. Save and activate the expression set.
    
    ![Important](https://sf-zdocs-cdn-prod.zoominsoftware.com/tdta-ind-health-264-0-0-production-enus/90a9f828-79ab-49cd-ac8c-86e58ef7478e/images/icon_important.png)
    
    Important Use the same name and input and output structure of the expression sets for accurate integration with the predefined Omniscripts.

Now, when your users create and review authorization requests, the Omniscript process refers to the predefined rules and validates the request details.

#### See Also

- [_Salesforce Help_: Business Rules Engine](https://help.salesforce.com/s/articleView?id=ind.business_rules_engine.htm&type=5&language=en_US)