EMR data fetch for prior authorization

Prior authorization (PA) is a process used in the United States that requires providers to receive advanced approval from payers before care delivery to ensure that patients/members receive treatments, testing, referrals, and devices appropriate for their specific conditions and that are covered by the specific health plan in which the member is enrolled.

The Integrations that are part of this asset, help provider systems (Salesforce Health Cloud) to automatically retrieve all relevant datasets from the EMR to prepare a DaVinci (an HL7 FHIR accelerator) aligned prior authorization request. The Integration is EMR agnostic and works out of the box with EMR vendors that support FHIR APIs for all the prior-authorization relevant resources (for ex: Coverage, Procedure, Condition etc) and use OAuth 2.0 as authorization protocol. For details visit MuleSoft Exchange