An outpatient request is a formal recommendation issued by a healthcare provider for services rendered for a person in a setting external from a hospital. Outpatient requests can be submitted prior to the service start date or retrospectively after the episode of care is completed.

This user guide details the steps to enter all information for an outpatient request so that it may be submitted for review. Refer to Reviewing a Request for the review and adjudication process.

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* Access to Utilization Management * Permission to create outpatient requests

When you have a request for outpatient services that needs to be reviewed for medical necessity and provider network requirements, either in advance or retrospectively.

* The Units Calculator is a time saver to help with calculating the correct number of units to be requested. Refer to [Using the Units Calculator](../using-the-units-calculator.md) for help and guidelines. * The outpatient request creation workflow can be started from the UM worklist. You will need to search for the person within the request.

Starting point is the CPV of the person for whom the outpatient request is being created.

Click **New Request**, and then select a **Request Category** from the menu.

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### Requester Information (_Optional)_* Enter the **Requester Name**. * Select the **Requester Type**. * Enter contact information: phone, email, and/or fax.

### Request Details* Change the **Classification,** if needed. * Select the **Outpatient** radio button as the **Request Type**. * Change the **Healthcare Type**, if needed. * Select a **Treatment Setting**. * Select an **Urgency**. * Change the **Request Source,** if needed. * Change the **Notified Date/Time**, if needed. It is automatically set to the current date and time.

Click **Create.**

### Person InformationThe person's demographic and enrollment information is displayed. The individual's primary active enrollment is selected by default.To choose another enrollment, select the radio button for that enrollment.

### Provider InformationA servicing provider is required for an Outpatient request. Additional providers can be added to indicate their roles and involvement in this service.* Click the drop-down to select the type of search to perform. * Enter the search term. * Click +**Add** on the desired provider.

* Select the role for this provider. One role is required for each provider. A provider may have multiple roles on the same request.

* To add more providers, enter a new search term and repeat the same steps. * To delete a provider, click **Remove**. * To add a temporary provider, click **Add Temporary Provider** and refer to [adding-a-new-provider.md](../../../platform-capabilities/adding-a-new-provider.md "mention").

Click **Continue** to move to the Diagnosis and Services page.

### DiagnosesA primary diagnosis is required for all requests. Multiple diagnoses can be added.* Enter the code or keywords for the diagnosis. * Click + **Add** on the desired diagnosis.

* To add more diagnoses, enter a new search term and repeat the same steps. * Click the

icon to indicate the primary diagnosis. * To delete a diagnosis, click the

icon.

### ServicesA primary service is required for all outpatient requests. Outpatient services can have different durations and dates.* Enter the code or keywords for the service. * Click **+Add** on the desired service.

* Enter the expected **Duration** of this service. * Select a unit of measure. * Manually enter the **From Date** or select from the calendar picker.

The **Through Date** automatically calculates based on the entered duration, units, and from date. Changing any of these adjusts the through date.

* (_Optional)_ Change the **Review Type.** * Enter the number of **Units** to be provided within this request. * Select a unit of measure. * _(Optional)_ Change the **Treatment Type.** * _(Optional)_ Enter modifiers. * To add more services, enter a new search term and repeat the same steps. * Click the

icon to indicate the primary service. * To delete a service, click the

icon.

Click **Continue** to move to the **Attachments** page**.**

### Attachments (Optional)Supporting documents can be attached to the created request. Refer to [#adding-a-file-type-attachment](../management/managing-request-attachments.md#adding-a-file-type-attachment "mention").

Click **Continue** to go to the Review page.

### Review and SubmitReview all details of the request prior to submitting it for review. If you need to make changes, click the

icon to be navigated directly to that section.* Confirm that the request is being assigned to the correct user. Click **Change** to select another assignee.

* Click **Submit** to finalize the information entered and route to the assignee. * (_Alternate)_ Click **Delete Draft** to return to the CPV without saving the outpatient request.

After successful submission of the outpatient request for review, a summary dialog box displays. The automated outcome, if any, is provided.