Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US Da Vinci Patient Cost Transparency (PCT) (FHIR)
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0.1.0 [deprecated]
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Financial Mgmt
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Use Case and Actors
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Vanessa Candelora / Celine lefebvre : 9-0-0
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Clarification
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Non-substantive
Description
What is "this" in the following statement?
• If a medical management technique, such as Prior Authorization is required, a disclaimer indicating this will be included in the Advanced EOB and does not impact the GFE, per the No Surprises Act (Section 111(a)(f)(1)(F)).
The actual words from the act are better
In the case such item or service is subject to
a medical management technique (including concurrent
review, prior authorization, and step-therapy or fail-first
protocols) for coverage under the plan or coverage, a disclaimers that coverage for such item or service is subject
to such medical management technique.
Attachments
Issue Links
- is voted on by
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BALLOT-27423 Affirmative - Linda Michaelsen : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-28830 Affirmative - Will Winterer : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-28861 Affirmative - Lucas Hearn : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29001 Affirmative - Sheila Connelly : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29032 Affirmative - Michelle Miller : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
- relates to
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FHIR-35101 Edits to MRI scenario
- Resolved - No Change
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FHIR-34927 Update Example
- Published