1. Telemedicine Platform
  2. Process
  3. Request to clinical authorization
Process · Request to clinical authorization

Request to clinical authorization

Record a care request, verify identity and consent, and take it through an independent clinical decision.

Step by step

  1. Record the request Care Coordinator

    Care Coordinator records the subject, patient and consent references, requested date and units, and an eligible provider. The request starts as Requested with the coordinator as owner.

    • Request created at Requested
    • Updates Care requests, Provider organizations
  2. Verify identity and consent Care Coordinator

    The coordinator verifies the patient and provider identity and the consent, attaches supporting documents and routes the request to Review.

    • Requested → Review
    • Updates Care requests, Record attachments
  3. Decide Clinical Reviewer

    A Clinical Reviewer in the same organization, who did not prepare the request, records Approve, Reject or Return with a reason, the revision and the verified evidence reference. Approval sets the request Authorized with its date; rejection declines it.

    • Review → Authorized with authorized at, or Declined
    • Updates Review decisions, Care requests, Operation receipts
    ApprovalA person approves before the work moves on.
  4. Revise after a return Care Coordinator

    A returned request goes back to the coordinator. A change raises the revision and the request returns to review.

    • Revision raised; back to Review
    • Updates Care requests

Where it usually breaks

And how to keep it from happening.

  • Consent covers fewer units than requested.
  • The provider's eligibility does not cover the patient's age or specialty.
  • A coordinator approves a request they prepared.
  • A decision cites evidence that has not been verified.
Care Coordinator
, Clinical Reviewer, Provider Network Manager.

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