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  1. FHIR Specification Feedback
  2. FHIR-26629

relax EOB.careteam.provider

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    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Persuasive with Modification
    • Specification:
      US CARIN Blue Button (FHIR)
    • Work Group:
      Financial Mgmt
    • Related Page(s):
      (profiles)
    • Resolution Description:
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      The EOB.careTeam.provider will be limited to remove the option to reference a PractitionerRole Resource.  It will only allow reference to a Practitioner Resource that conforms to the CARIN BB Practitioner profile or an Organization Resource that conforms to the CARIN BB Organization profile.

      We will add invariants to the various EOB profiles based on the following business rules:

      For the institutional EOB profiles, when the EOB.careTeam.role element is attending, pcp, referring, or supervising then EOB.careTeam.provider will reference a Practitioner Resource that conforms to the CARIN BB Practitioner profile. When the EOB.careTeam.role element is performing, the EOB.careTeam.provider will reference an Organization Resource that conforms to the CARIN BB Organization profile.

      For the professional and non-clinician EOB profiles, when the EOB.careTeam.role element is performing, pcp, or referring then EOB.careteam.provider will reference a Practitioner Resource that conforms to the CARIN BB Practitioner profile. When the EOB.careTeam.role element is site, the EOB.careTeam.provider will reference an Organization Resource that conforms to the CARIN BB Organization profile.

      For the pharmacy EOB profile, when the EOB.careTeam.role element is pcp, or prescribing then will reference a Practitioner Resource that conforms to the CARIN BB Practitioner profile. When the EOB.careTeam.role element is performing, the EOB.careTeam.provider will reference an Organization Resource that conforms to the CARIN BB Organization profile.

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      The EOB.careTeam.provider will be limited to remove the option to reference a PractitionerRole Resource.  It will only allow reference to a Practitioner Resource that conforms to the CARIN BB Practitioner profile or an Organization Resource that conforms to the CARIN BB Organization profile. We will add invariants to the various EOB profiles based on the following business rules: For the institutional EOB profiles, when the EOB.careTeam.role element is attending, pcp, referring, or supervising then EOB.careTeam.provider will reference a Practitioner Resource that conforms to the CARIN BB Practitioner profile. When the EOB.careTeam.role element is performing, the EOB.careTeam.provider will reference an Organization Resource that conforms to the CARIN BB Organization profile. For the professional and non-clinician EOB profiles, when the EOB.careTeam.role element is performing, pcp, or referring then EOB.careteam.provider will reference a Practitioner Resource that conforms to the CARIN BB Practitioner profile. When the EOB.careTeam.role element is site, the EOB.careTeam.provider will reference an Organization Resource that conforms to the CARIN BB Organization profile. For the pharmacy EOB profile, when the EOB.careTeam.role element is pcp, or prescribing then will reference a Practitioner Resource that conforms to the CARIN BB Practitioner profile. When the EOB.careTeam.role element is performing, the EOB.careTeam.provider will reference an Organization Resource that conforms to the CARIN BB Organization profile.
    • Resolution Vote:
      Mark Roberts/Pat Taylor: 18-0-5
    • Change Category:
      Correction
    • Change Impact:
      Compatible, substantive

      Description

      relax EOB.careteam.provider to be referenced to practitioner or organization or PractitionerRole

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              Assignee:
              Unassigned
              Reporter:
              mark_roberts Mark Roberts
              Watchers:
              2 Start watching this issue

                Dates

                Created:
                Updated:
                Resolved:
                Vote Date: