Pre-authorization request table
The Pre-authorization request [sn_hcls_pre_auth_header] table stores the authorization request details for a healthcare service provided by a payer organization.
Key features
- Stores the pre-authorization request details for a healthcare service provided by a payer organization.
- Enables pre-authorizing healthcare service for a patient.
- Includes the pre-authorization number, pre-authorization type, pre-authorization effective dates, and healthcare service order details.
Role required to configure the table: sn_hcls.admin.
For more information, see Healthcare and Life Sciences data model.
| Field | Data type | Description |
|---|---|---|
| Case | Reference | Healthcare case associated with the ordered healthcare service for the patient. |
| Review type | Choice list | Category of the healthcare service. The following types are available by default: - Routine: A healthcare service customarily administered by a practitioner and can be scheduled in advance based on the patient’s and practitioner’s preference. - Elective: An optional healthcare service that can be scheduled at any time in the future based on the patient’s and practitioner’s preference. - Urgent: A required healthcare service that is considered urgent and must be scheduled immediately. - Non urgent: A healthcare service that isn't considered urgent and can be scheduled in the near future. |
| Date approved | Date | Date when the pre-authorization request was approved by the payer organization. |
| Date fax received | Date/Time | Date and timestamp on a fax received for the pre-authorization request. |
| Insurance | Reference | Member plan associated with the patient. |
| Patient | Reference | Patient on whose behalf the pre-authorization request was submitted. |
| Place of service | Reference | Location of service rendered. |
| Primary pre-auth number | String | Primary pre-authorization number generated by the payer organization. |
| Reason | String | Reason for the pre-authorization request. |
| Referring practitioner | Reference | Practitioner who recommended the healthcare service associated with the pre-authorization request. |
| Remarks | String | Comments or additional information about the pre-authorization request. |
| Rendering practitioner | Reference | Provider rendering the service. |
| Secondary pre-auth number | String | Secondary pre-authorization number generated by the payer organization. |
| Short description | String | A short description of this pre-authorization request. |
| Source | Reference | Source system details of an external healthcare system in a ServiceNow instance. |
| Status | Choice list | Approval status of the pre-authorization request. The following types are available by default: - Draft: Pre-authorization request is yet to be submitted. - Pending: Pre-authorization request is submitted for review to the payer organization. - Approved: Pre-authorization request was approved by the payer organization. - Denied: Pre-authorization request was denied by the payer organization. - Completed: Pre-authorization request was completed with one or more items were denied in the request. |
| Review type | String | Type of the healthcare service requested in the pre-authorization request. The following types are available by default: - Medical - Prescription - New |
| Valid from | Date | Start date of the pre-authorization request validity period. |
| Valid until | Date | End date of the pre-authorization request validity period. |
Parent Topic:Healthcare and Life Sciences data model tables