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  1. FHIR Specification Feedback
  2. FHIR-33964

Can we discuss implication for turn around time reporting and notification requirements?

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Medium Medium
    • US Da Vinci PAS (FHIR)
    • current
    • Financial Mgmt
    • Formal Specification
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      TATs are subject to law, regulation and contractual commitments.  Since these can change at any time, adding the current state, assuming that we could even summarize all of the specific requirements, is not appropriate in a "fixed" published standard and will be misleading as the requirements change.

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      TATs are subject to law, regulation and contractual commitments.  Since these can change at any time, adding the current state, assuming that we could even summarize all of the specific requirements, is not appropriate in a "fixed" published standard and will be misleading as the requirements change.
    • Bob Dieterle / Rachael Forester : 16-0-1

    Description

      PAS is a vehicle for electronic prior authorization. In the prior authorization workflow, many payors have various turn around time reporting requirements. Similarly rules/laws put various notification requirements to the patient and to the requesting provider. 

      Can the PAS IG cover the various turn around time clocks that start/stop ticking at various points in the PAS workflow (and perhaps CRD/DTR if relevant) so that this does not become a point of contention in implementing PAS? 

      Similarly, does a ClaimResponse coming back to the provider side constitute as "notification" for the provider? How does PAS IG impact notification requirements? Can this be captured in the IG? 

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            m_varghese Varghese Mathew
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