Details
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Change Request
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Resolution: Not Persuasive with Modification
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Medium
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US Da Vinci Patient Cost Transparency (PCT) (FHIR)
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current
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Financial Mgmt
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STU
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GFE Reference
PCT Advanced EOB
PCT-GFE-Institutional-1 -
Formal Specification
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4.2.1
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Rachel Foerster/Rick Geimer: 11-0-0
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Clarification
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Non-substantive
Description
In the implementation guide, AEOB Bundles are given an unique identifier to pull the status and updates to the AEOB bundle. However, this implementation guide does not have anything defined related to updating or cancelling the AEOB request after it has been submitted.
In a real-world scenario, there will likely be many changes to the scheduled service throughout the time period leading up to the date of the service. Change in provider, date of service, and location could be enough to invalidate the previous AEOB. There could even be small changes to the service performed or additional services added on. The provider or institution could send this modification to the payers and give transparency of the changes to the patient.
If there was a way to cancel or modify these requests, then the payer could potentially use the AEOB request to reliably keep track of scheduled services and pre-accumulate benefits across multiple future services. For example, hitting deductibles/MOOPs/insurance maximums across multiple AEOBs could significantly change the patient portion. Keeping track of these limits will give patients significantly more accurate estimates.
Attachments
Issue Links
- is voted on by
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BALLOT-27545 Negative - Christopher Schaut : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29055 Negative - Vassil Peytchev : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29084 Negative - Chris Courville : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29107 Negative - David Sundaram-Stukel : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29110 Negative - Daniel Zhang : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29132 Negative - Thanos Tsiolis : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29134 Negative - Amit Popat : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29136 Negative - Daniel Rutz : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29138 Negative - Michael Clifton : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
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BALLOT-29140 Negative - Isaac Vetter : 2022-Jan-FHIR IG DAVINCI PCT R1 STU
- Balloted
- mentioned in
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