New Health Cloud Objects

These new standard objects support the health insurance and utilization management data models.

Where: Available in Enterprise, Performance, and Unlimited editions.

Who: To access the objects, admins must install the Health Cloud managed package and assign the Health Cloud Permission Set License and the Health Cloud Platform permission set licenses to users.

CareDiagnosis

Represents the details of a diagnosis, including code type, name, and description. You can associate one or more care diagnoses with a care request.

CarePreauth

Represents the details of a preauthorization for care under a member’s plan.

CarePreauthItem

Represents the details of items included in a preauthorization for care under a member’s plan.

CareRequest

Represents the general details of a care-related request, including member information, admission date, and decision reason. A single request can contain multiple diagnoses, services, or drugs. Care requests include preauthorizations for drugs and services, admission notifications, concurrent review of admissions, appeals, complaints, and grievances.

CareRequestConfiguration

Represents the details for a record type, such as service request, drug request, or admission request. You can associate one or more record types with a care request.

CareRequestDrug

Represents the details of a requested drug, including name, strength, frequency, and instructions for administration. You can associate one or more drug requests with a care request.

CareRequestItem

Represents the details of a care service request, including name, modifiers, and the effective date.

CoverageBenefit

Represents the benefits provided to a covered member by a purchaser’s plan.

CoverageBenefitItem

Represents the benefit items provided to a covered member by a purchaser’s plan.

MemberPlan

Represents details about the insurance coverage for a member or subscriber.

PurchaserPlan

Represents the pay plan that a purchaser makes available to its members and members’ dependents.

PurchaserPlanAssn

Represents the plans that a purchaser offers to its members.

PlanBenefit

Represents the standard benefits available under a purchaser’s plan offered to its members.

PlanBenefitItem

Represents the details of a benefit available under a purchaser’s plan offered to its members.