Agentforce Health Developer Guide

Agentforce Health Developer Guide
Health Cloud Data Model
Advanced Therapy Management
Adverse Events
Assessment Generation
Benefits Verification
Care Program Management
Clinical Data Model
Predecessors to Code Sets and Code Set Bundles in Health Cloud
Coverage Requirement Discovery
Crisis Support Center Management
Documentation Templates and Rules
Disease Surveillance
Electronic Signatures
Engagement Interaction
FHIR Subscription
Financial Assistance Program
Health Assessments
Health Insurance
Home Health
Integrated Care Management
Intelligent Appointment Management
Intelligent Document Automation
Intelligent Sales
Medication Management
Patient Program Outcome Management
Participant Management
Patient Segmentation
Pharmacy Benefits Verification
Provider Network Management
Provider Relationship Management
Remote Monitoring and Device Registration
Social Determinants
Timeline
Unified Health Scoring
Utilization Management
CareDiagnosis
CareProcessingError
CareRequest
CareRequestDrug
CareRequestExchangeInfo
CareRequestExtension
CareRequestItem
CareRequestReviewer
CareRequestSupportingCntnt
TrackedCommunication
TrackedCommunicationDetail
ProductRequest
Health Cloud Associated Objects
Health Cloud Fields on Standard Objects
Health Cloud Platform Events
Working With Electronic Health Records
Emergency Response Management
Apex Reference
Health Cloud Business APIs
Health Cloud Tooling API Objects
Health Cloud Standard Invocable Actions
Metadata Types
Health Cloud FHIR APIs
MuleSoft Direct Integrations
API End-of-Life Policy
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Note: This release is in preview. Features described here don’t become generally available until the latest general availability date that Salesforce announces for this release. Before then, and where features are noted as beta, pilot, or developer preview, we can’t guarantee general availability within any particular time frame or at all. Make your purchase decisions only on the basis of generally available products and features.

Utilization Management

Utilization Management (UM) is a health insurance plan's process of interfacing with plan members and contracted medical providers to interpret, administer, and explain the medical policies of the health plan. Health Cloud provides objects you can use to review and evaluate medical care services, communicate about clinical policies, and help health plan members ensure they receive the right care in the right setting at the right time.

Available in: Lightning Experience

Available in: Enterprise and Unlimited Editions with Health Cloud

Utilization Management uses objects in the Discovery Framework data model. To learn more about the Discovery Framework objects, see Discovery Framework Standard Objects.

Diagram of the Utilization Management data model showing the object relationships

For more details and a larger image, visit the Data Model Gallery.