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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
    • 1.1
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      Maintain the solid line, but add narrative language to the IG to confirm use of a FHIR API for this data flow is not required by law.

      8/5/2022, the community approved this revised language to be included in the Overview to address this ticket:

      To ensure the IG supports all potential flows of information, the IG supports an AEOB being sent from the payer to the provider, in addition to a FHIR-based approach for the required flow from the payer to the patient. In this way, the IG can support providers and payers as they work to develop and implement a flow of information that allows them to meet the legislative and future regulatory requirement as well as enable information sharing valuable to supporting patient care. The IG is thus meant to facilitate the necessary data sharing without limiting provider and payer implementation options. law does not require the use of an API to share these data. This IG provides an option for how to meet the requirements of the law, but the method used to share the required information – an API, a portal, e-mail, etc. – is the decision of the parties engaged in the process. Should future rulemaking mandate a specific scenario, this IG can be revised IG accordingly.

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      Maintain the solid line, but add narrative language to the IG to confirm use of a FHIR API for this data flow is not required by law. 8/5/2022, the community approved this revised language to be included in the Overview to address this ticket: To ensure the IG supports all potential flows of information, the IG supports an AEOB being sent from the payer to the provider, in addition to a FHIR-based approach for the required flow from the payer to the patient. In this way, the IG can support providers and payers as they work to develop and implement a flow of information that allows them to meet the legislative and future regulatory requirement as well as enable information sharing valuable to supporting patient care. The IG is thus meant to facilitate the necessary data sharing without limiting provider and payer implementation options. law does not require the use of an API to share these data. This IG provides an option for how to meet the requirements of the law, but the method used to share the required information – an API, a portal, e-mail, etc. – is the decision of the parties engaged in the process. Should future rulemaking mandate a specific scenario, this IG can be revised IG accordingly.
    • Corey Spears / Vanessa Candelora : 20-0-1
    • Clarification
    • Non-substantive

    Description

      The flow in section 1.1 should be updated to reflect the following:

      • An alternate return flow for non-FHIR pathways from payer to member (via mail or electronic member portal)
      • The flows for member requests and responses via FHIR should be dashed lines as support for this approach is optional

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            Unassigned Unassigned
            sundine Sam Undine (Inactive)
            Patricia Taylor, Sam Undine (Inactive)
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            Dates

              Created:
              Updated:
              Resolved: