Auth matching queries and criteria
SCE’s ES process uses 1 of 5 discrete out-of-the-box queries when fetching matching authorization candidates. As indicated above, SCE selects the ES query to run based on the information returned in the RequestedAuthType decision table.
The 5 ES queries are:
- Inpatient Facility
- Outpatient Facility
- Professional
- Referral, and
- Dental
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