Referral Management

When you send a request to create a patient referral, the API creates records in multiple objects, such as Account, ClinicalServiceRequest, and ClinicalServiceRequestDetail to store the patient referral information.

Resource

/connect/health/referral-management/referrals

Resource Example

Replace {yourInstance} with the My Domain name of your Salesforce org.

https://{yourInstance}.salesforce.com/services/data/v68.0/connect/health/referral-management/referrals

Available Version

59.0

Requires Chatter

No

HTTP Methods

POST

JSON example

Here’s an example request to create an existing patient referral.

{
  "patient": {
    "id": "005S7000001xLk1IAE"
  },
  "referralDetails": [
    {
      "detailType": "Insurance",
      "detailRecordType": "Member Plan",
      "fields": {
        "Name": "Aetna PPO",
        "MemberNumber": "2345678"
      }
    },
    {
      "detailType": "Insurance",
      "detailRecordType": "Member Plan",
      "detailRecordId": "0SqRM0000004F2z0AE"
    }
  ],
  "requester": {
    "id": "0cmS70000004CAuIAM"
  },
  "referralNotes": "This is an urgent request",
  "performers": [
    {
      "id": "0cmRM0000004nAgYAI"
    },
    {
      "id": "0cmRM0000004nAgDZc"
    }
  ],
  "referral": {
    "fields": {
      "PatientInstruction": "Need Appointment ASAP.",
      "Priority": "Urgent"
    }
  },
  "shouldUseHighConfidenceMatch": true
}

Here’s an example request to create a new patient referral.

{
  "patient": {
    "fields": {
      "FirstName": "Joe",
      "LastName": "Clark",
      "Phone": "801XXXXX89"
    }
  },
  "referralDetails": [
    {
      "detailType": "Insurance",
      "detailRecordType": "Member Plan",
      "fields": {
        "Name": "Aetna PPO",
        "MemberNumber": "2345678"
      }
    },
    {
      "detailType": "Insurance",
      "detailRecordType": "Member Plan",
      "detailRecordId": "0SqRM0000004F2z0AE"
    },
    {
      "detailType": "Body Site",
      "detailRecordType": "Health Condition",
      "detailCodeId": "0hsRM000000043aYAA"
    },
    {
      "detailType": "Reason Reference",
      "detailRecordId": "0j4RM0000004MunYAE"
    }
  ],
  "requester": {
    "id": "0cmRM0000004nAgYAI"
  },
  "performers": [
    {
      "id": "0cmRM0000000l2JYAQ"
    },
    {
      "id": "0cmRM0000000tnoYAA"
    }
  ],
  "referralNotes": "This is an urgent request",
  "referral": {
    "fields": {
      "Priority": "Routine",
      "Status": "Draft",
      "Type": "Plan"
    }
  }
}

Properties

Name	Type	Description	Required or Optional	Available Version
`patient`	Record Fields Input[]	Account details of the patient being referred.	Required	59.0
`performers`	Record Fields Input[]	List of healthcare providers who perform the service. You can provide a maximum of 5 provider IDs in a request.	Optional	59.0
`referral`	Record Fields Input[]	Referral information.	Required	59.0
`referralDetails`	Referral Detail Input[]	Patient details, such as, insurance, and health condition.	Optional	59.0
`referralNotes`	String	Referral notes.	Optional	59.0
`requester`	Record Fields Input[]	Information about the provider requesting the service. A requester can be an Account, Asset, Healthcare Provider, or a CareRegisteredDevice object. If the requester is new, provide information to create an account.	Optional	59.0
`shouldUseHighConfidenceMatch`	Boolean	Indicates whether to match a duplicate record that has the highest matching confidence (`true`) or not (`false`).	Optional	59.0

Response Body for POST

Referral Management Output