Details
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Change Request
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Resolution: Persuasive
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Highest
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US Da Vinci Drug Formulary (FHIR)
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current
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Pharmacy
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Payer Insurance Plan
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Scott Robertson / Corey Spears: 14-0-1
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Correction
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Non-compatible
Description
The profile reasonably represents copay and coinsurance as distinct, but the codes for the two different copay and coinsurance-specific code systems use essentially the same mnemonic codes from two distinct code systems that differ in definition only by substituting the two context-aligned words "copay" or "coinsurance." this will lead to confusion and demand that the profile element be kept in mind when reviewing instance information that I suspect will often only be one or the other. Please merge the two code systems into one and change the overlapping code definitions to say "copy or coinsurance" where one or the other word appears. For example, the code after-deductible would be used for either copay and coinsurance by making the definition say "The consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the copay or coinsurance (this indicates that this benefit is subject to the deductible)."
Attachments
Issue Links
- is voted on by
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BALLOT-26885 Affirmative - Rob McClure : 2022-Jan-FHIR IG PDex FORMULARY R1 STU
- Balloted