A provider is looking to implement Utilization Management in Health Cloud and submit and track...

Health Cloud supportsUtilization Management (UM)through the Service Request object, which tracks prior authorization requests, and through integration with electronic prior authorization systems using MuleSoft.

Customize the Service Request object:

Extract:

“The Service Request object is at the core of the Utilization Management process in Health Cloud. You can customize fields, page layouts, and automation to match your business processes for prior authorization.”

(Source: Administer Health Cloud – Utilization Management)

Integrate using MuleSoft Direct for ePA:

Extract:

“Integrate Health Cloud Utilization Management with external systems using MuleSoft Direct, enabling electronic submission and tracking of prior authorizations.”

(Source: Administer Health Cloud – Utilization Management Integration)

Why not B or D?

There isno standard custom setting called UtilizationManagementSettingsfor this process.

Support Processis more for standard Salesforce Cases and not directly linked to Utilization Management flows in Health Cloud.