Starting a patient visit is absolutely an appropriate time trigger CRD.  If an authorization is needed before a service is going to be paid for, it's still better to know before the service starts (even if it's a bit late in the game when the patient is already there).  The same thing is true if there's a contraindication, special documentation requirements or other guidance the payer can provide. CRD is appropriate to trigger at any time a payer might have information that could lead to clinicians making decisions that are better for the patient or to let them know about requirements that can be more efficiently met be gathering information when the patient is present than after they've already left.