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Specification:

US Post Acute Orders (FHIR)
Raised in Version:

0.1.1
Work Group:

Orders & Observations
Related URL:
http://hl7.org/fhir/us/dme-orders/2020MAY/Background.html#background
Related Page(s):

(NA)
Related Section(s):
2.1
Grouping:
- Block-Vote-2
Resolution Description:

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will include a new "bullet" to indicate communication of documentation to satisfy payer requirements for prior authorization (when required to be submitted by the performing provider) or to establish the medical necessity for covered services/devices.

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will include a new "bullet" to indicate communication of documentation to satisfy payer requirements for prior authorization (when required to be submitted by the performing provider) or to establish the medical necessity for covered services/devices.
Resolution Vote:
Bob Dieterle / Marti Velezis : 7-0-8
Change Category:
Clarification
Change Impact:
Non-substantive

This would be good place to invoke payer – “ . . .fulfill a payer’s medical necessity/prior authorization requir”ments"

Communicate documentation to correct the order and/or establish medical necessity

is voted on by

BALLOT-12843 Negative - Celine Lefebvre : 2020-May-DME R1 STU