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CareRequestExtension

Represents extra details for a care request such as the subscriber details for the member's health plan, home healthcare status, and ambulance transportation details.

Supported Calls

create(), delete(), describeLayout(), describeSObjects(), getDeleted(), getUpdated(), query(), retrieve(), search(), undelete(), update(), upsert()

Fields

AmbulanceTransportReason

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Reason for ambulance transport.

AmbulanceTransportType

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Type of ambulance transport.

AppealEffectuationDateTime

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The effective date of the outcome of the appeal request. For example, if a claim was successfully appealed, this field displays the date when the claim was paid.

AuthorizationRefIdentifier

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The unique identifier of the authorization request.

    This field is available in API version 57.0 and later.

CareRequestCaseId

  • Type: reference
  • Properties: Create, Filter, Group, Sort
  • Description: Case related to the care request extension.

    This is a relationship field.

  • Relationship Name: CareRequestCase
  • Relationship Type: Lookup
  • Refers To: Case

CareRequestId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Care request related to the care request extension.

    This is a relationship field.

  • Relationship Name: CareRequest
  • Relationship Type: Lookup
  • Refers To: CareRequest

CaseSubStatus

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The substatus of a case related to a care request.

    This field is available in API version 56.0 and later.

  • Possible values:
    • Approved
    • Auto Approved
    • Denied
    • More Information Requested
    • More Information Required
    • New Request
    • Partially Approved
    • Peer to Peer Review Scheduled
    • Pending Review
    • Schedule Peer to Peer Review

ClientSourceSysIdentifier

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: An identifier of the client's source system that sent the care request.

CoveragePlanTypeId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Specifies the type of plan the member is covered by.

    This field is a relationship field.

  • Relationship Name: CoveragePlanType
  • Refers To: CodeSetBundle

DocumentAttachmentStatus

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: The status of a clinical document upload.

    This field is available in API version 55.0 and later.

  • Possible values:
    • Complete
    • Incomplete

HealthcareProviderId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The healthcare provider associated with the care request against whom the Grievance is filed

    This is a relationship field.

  • Relationship Name: HealthcareProvider
  • Relationship Type: Lookup
  • Refers To: HealthcareProvider

HomeHealthCertificationEndDate

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Certification end date for home healthcare.

HomeHealthCertificationStartDate

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Certification start date for home healthcare.

HomeHealthStartDate

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Date that home health services are scheduled or anticipated to start.

IndependentReviewDetermination

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: The determination made by the independent review.
  • Possible values:
    • Other
    • Overturned
    • Upheld

IndependentReviewDeterminationDate

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The date when the determination was made by the independent review.

IndependentReviewSubmissionDate

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The date when the review request was submitted for independent review.

IsIndependentReviewRequired

  • Type: boolean
  • Properties: Create, Defaulted on create, Filter, Group, Sort, Update
  • Description: Indicates whether an independent review is required
  • Default value: false

IsMedicareCoverage

  • Type: boolean
  • Properties: Create, Defaulted on create, Filter, Group, Sort, Update
  • Description: Indicates whether the member has Medicare coverage.

LastReferencedDate

  • Type: dateTime
  • Properties: Filter, Nillable, Sort
  • Description: The timestamp for when the current user last viewed a record related to this record.

LastViewedDate

  • Type: dateTime
  • Properties: Filter, Nillable, Sort
  • Description: The timestamp for when the current user last viewed this record. If this value is null, it’s possible that this record was referenced (LastReferencedDate) and not viewed.

Name

  • Type: string
  • Properties: Create, Filter, Group, idLookup, Sort, Update
  • Description: Name of the care request extension.

NursingHomeResidentialStatus

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Nursing home-resident status at the time of service.

PriorDischargeStatus

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: Specifies the previous discharge status of the member.
  • Possible values:
    • Discharged to court/law enforcement.
    • Discharged to home with home health.
    • Discharged to home/self care.
    • Discharged to hospice care.
    • Discharged/transferred to LTACC.
    • Discharged/transferred to Psychiatric facility.
    • Discharged/transferred to SNF.
    • Discharged/transferred to other acute care facility.
    • Expired
    • Left against medical advice (AMA).

RecordTypeId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Category type of the request.

    This is a relationship field.

  • Relationship Name: RecordType
  • Relationship Type: Lookup
  • Refers To: RecordType

ReferenceCaseType

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: Specifies the type of reference case that's associated with the care request extension.

    This field is available in API version 58.0 and later.

  • Possible values:
    • Associated Case
    • Prior Case

ReopenDecisionDateTime

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The date when the decision on the reopen request was made.

ReopenRequestOutcome

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: The result of the reopen request.
  • Possible values:
    • Overturned
    • Upheld

ReopenRequestType

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: The type of reopen request.
  • Possible values:
    • Peer-to-Peer Review
    • Reconsideration

RequestExtensionReason

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: The reason for requesting the care extension.

RequestExtnDecisionDateTime

  • Type: dateTime
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The date when the decision to extend the care request extension was made.

RequestOutcome

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: Specifies the outcome of the request.
  • Possible values:
    • Overturned
    • Partially Pending
    • Partially Upheld
    • Upheld
    • Voided
    • Queued
    • Complete
    • Error

RequestOutcomeDesc

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: The description of the request outcome.

RequestType

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Category type of the request.
  • Possible values:
    • Admission Review
    • Concurrent Review
    • Health Services Review
    • Individual
    • Inpatient - Behavioral Health Review
    • Inpatient - Physical Health Review
    • Outpatient - Behavioral Health Review
    • Outpatient - Physical Health Review
    • Specialty Care Review

RequestingProviderId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The provider who requested a prior authorization for a care request. This field is available in API version 55.0 and later.

    This field is a relationship field.

  • Relationship Name: RequestingProvider
  • Relationship Type: Lookup
  • Refers To: HealthcareProvider

ResolutionDescription

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: The description of the care request.

ServiceLevel

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The level of service rendered.

ServiceType

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Classification of the type of service.

ServicingFacilityId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The facility where a patient receives service for a care request. This field is available in API version 55.0 and later.

    This field is a polymorphic relationship field.

  • Relationship Name: ServicingFacility
  • Relationship Type: Lookup
  • Refers To: HealthcareFacility, HealthcarePractitionerFacility

ServicingProviderId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The provider who provides the service for a care request. This field is available in API version 55.0 and later.

    This field is a relationship field.

  • Relationship Name: ServicingProvider
  • Relationship Type: Lookup
  • Refers To: HealthcareProvider

SubscriberId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Identifier for the person who has subscribed to the health plan.

    This is a relationship field.

  • Relationship Name: Subscriber
  • Relationship Type: Lookup
  • Refers To: Account

SubscriberMemberIdentifier

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: Member ID for the subscriber.

SupportingDocUrl

  • Type: url
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The URL of supporting documentation such as a questionnaire.

TotalAmbulanceTransportDistance

  • Type: double
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: Total distance traveled during ambulance transport.

UnitofMeasureId

  • Type: reference
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The unit of measure for the quantity associated with a prior authorization request. This field is available in API version 55.0 and later.

    This field is a relationship field.

  • Relationship Name: UnitofMeasure
  • Relationship Type: Lookup
  • Refers To: UnitOfMeasure

Associated Objects

This object has the following associated objects. If the API version isn’t specified, they’re available in the same API versions as this object. Otherwise, they’re available in the specified API version and later.

CareRequestExtensionChangeEvent (API Version 62.0)
Change events are available for the object.
CareRequestExtensionFeed
Feed tracking is available for the object.
CareRequestExtensionHistory
History is available for tracked fields of the object.