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  1. FHIR Specification Feedback
  2. FHIR-34953

Payer Intermediary and FHIR-X12 Translators

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci Patient Cost Transparency (PCT) (FHIR)
    • 0.1.0 [deprecated]
    • Financial Mgmt
    • STU
    • Use Case and Actors
    • 1.1 and 2
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      The entire column referencing "payer's intermediary" and "FHIR-X12 translators" will be removed from the diagrams in sections 1.1, 2.1.1 and 2.2.2 as we agreed they are unclear and potentially confusing.

      These references will be removed from flows as requested. 

       

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        The entire column referencing "payer's intermediary" and "FHIR-X12 translators" will be removed from the diagrams in sections 1.1, 2.1.1 and 2.2.2 as we agreed they are unclear and potentially confusing. These references will be removed from flows as requested.   
    • Corey Spears / Rachel Foerster : 14-0-0
    • Clarification
    • Non-substantive

    Description

      The references to "payer's intermediary" and "FHIR-X12 translators" as outlined in the flows in sections 1.1 and section 2 are unclear and potentially confusing.

      In general, intermediaries do not have a relationship with only the payer. They may have a relationship with a payer, a provider, both, or neither. Further, when intermediaries are involved, they would not be formally embedded within the payer's infrastructure. They would be outside of and connected to it. Further, if an intermediary is used, they would be considered an agent

      Similarly, the illustration of a FHIR-X12 translator within the payer infrastructure is likely not needed. Payer infrastructures in general will use their own local encoding that can be translated to and from the X12 and FHIR formats. It is unlikely that a payer would specifically translate from FHIR to X12 within their system when the initial transaction is received within FHIR.

      It is recommended that these references be either removed from all flows or that they be reviewed and clarified to show clear value within the IG.

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            Unassigned Unassigned
            sundine Sam Undine (Inactive)
            Patricia Taylor, Sam Undine (Inactive)
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              Created:
              Updated:
              Resolved: