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  1. FHIR Specification Feedback
  2. FHIR-34940

Process for Sharing Advanced EOBs with Providers

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci Patient Cost Transparency (PCT) (FHIR)
    • 0.1.0 [deprecated]
    • Financial Mgmt
    • STU
    • Use Case and Actors
    • 2.1.1
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      It has been determined for this first version of the IG, that the GFE submitter will optionally have access to the same information via the FHIR API as the member has access to for the AEOB Bundles that are created as a result of GFE Bundles they submitted. 

       

      Will add guidance to the "Use Cases and Overview" section 2.1 Use Cases section (as identified in the resolution to FHIR-35217:

      The primary use case for this guide is to enable the patient to have access to AEOBs for potential future medical services. Sharing this information with the original submitting provider may also be useful in facilitating conversations between patients and providers about their care and options. If this capability is supported by the implementer, the patient’s AEOB will be provided to the submitting provider using the same profiles in this guide. 

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      It has been determined for this first version of the IG, that the GFE submitter will optionally have access to the same information via the FHIR API as the member has access to for the AEOB Bundles that are created as a result of GFE Bundles they submitted.    Will add guidance to the "Use Cases and Overview" section 2.1 Use Cases section (as identified in the resolution to FHIR-35217 : The primary use case for this guide is to enable the patient to have access to AEOBs for potential future medical services. Sharing this information with the original submitting provider may also be useful in facilitating conversations between patients and providers about their care and options. If this capability is supported by the implementer, the patient’s AEOB will be provided to the submitting provider using the same profiles in this guide. 
    • Rachel Foerster/Rick Geimer: 11-0-0
    • Clarification
    • Non-substantive

    Description

      Additional discussion is needed on process and expectations for transmission of Advanced EOBs from payers to providers. Speficially, more time needs be committed to discussion of which of the following are intended to be supported:

      • all 835 equivalents will go to the convening provider
      • individual 835 equivalents for each GFE in the bundle will be sent to the respective provider as a separate transaction

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            rgeimer Rick Geimer
            sundine Sam Undine (Inactive)
            Patricia Taylor, Sam Undine (Inactive)
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              Created:
              Updated:
              Resolved: