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  1. FHIR Specification Feedback
  2. FHIR-22659

Preauthorization claims for procedures need a reference to a ServiceRequest

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • STU3
    • Financial Mgmt
    • Claim
    • Hide

      Add to Claim and EOB .item and ClaimResponse and EOB .addItem 

      .request 0..* Reference(DeviceRequest | MedicationRequest  | NutritionOrder  | ServiceRequest | SupplyRequest | VisionPrescription )  Request or Referral for Service

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      Add to Claim and EOB .item and ClaimResponse and EOB .addItem  .request 0..* Reference(DeviceRequest | MedicationRequest  | NutritionOrder  | ServiceRequest | SupplyRequest | VisionPrescription )  Request or Referral for Service
    • Chris Cioffi / Rachel Foerster : 6-0-1
    • Enhancement
    • Compatible, substantive
    • R5

    Description

      When the Claim resource is being used for a pre-authorization request, there is no means to specify any procedures that are being asked for authorization as the 'procedures' section has a reference to Procedure but not to ServiceRequest. You could "fake it" by using the Procedure resource to indicate what is being requested, but the scope of the Procedure resource makes it clear that this is for procedures that have or are happening and not for ones that will happen.

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            Unassigned Unassigned
            jduteau Jean Duteau
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            Dates

              Created:
              Updated:
              Resolved: