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  1. FHIR Specification Feedback
  2. FHIR-30847

Cite evidence for this claim.

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Da Vinci CDex (FHIR)
    • current
    • Patient Care
    • Background
    • 2.2
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      change:

      "Payers also require clinical data from the provider ordering or providing services to document prior authorization, claims processing, audit submitted claims, to confirm medical necessity and appropriateness. Clinical data is also used by Payers to create complete, accurate risk profiles for members for value-based care contracts and population health adjustments. Quality reporting requirements and quality care scoring all require clinical data. Importantly, this data helps to reduce preventable medical errors. Payers review member information to identify gaps in care. They work with providers and hunt down information showing the gap in care has been closed. Improving HEDIS measure scores has a positive impact on revenue for payers and reimbursements for providers. "

      to:

      "Payers also require clinical data from the provider ordering or providing services to document prior authorization, claims processing, audit submitted claims, to confirm medical necessity and appropriateness.  Clinical data is used by Payers to create risk profiles for members for value-based care contracts and population health adjustments. Quality reporting requirements and quality care scoring all require clinical data for evaluating clinical performance and outcomes.

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      change: "Payers also require clinical data from the provider ordering or providing services to document prior authorization, claims processing, audit submitted claims, to confirm medical necessity and appropriateness. Clinical data is also used by Payers to create complete, accurate risk profiles for members for value-based care contracts and population health adjustments. Quality reporting requirements and quality care scoring all require clinical data. Importantly, this data helps to reduce preventable medical errors. Payers review member information to identify gaps in care. They work with providers and hunt down information showing the gap in care has been closed. Improving HEDIS measure scores has a positive impact on revenue for payers and reimbursements for providers. " to: "Payers also require clinical data from the provider ordering or providing services to document prior authorization, claims processing, audit submitted claims, to confirm medical necessity and appropriateness.  Clinical data is used by Payers to create risk profiles for members for value-based care contracts and population health adjustments. Quality reporting requirements and quality care scoring all require clinical data for evaluating clinical performance and outcomes.
    • Eric Haas/Jay Lyle : 9-0-5
    • Clarification
    • Non-substantive

    Description

      Cite evidence for this claim.

      Existing Wording:

      Importantly, this data helps to reduce preventable medical errors

      (Comment 45 - imported by: Jean Duteau)

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            Thomson.Kuhn Thomson Kuhn (Inactive)
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              Created:
              Updated:
              Resolved: