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 PAS (FHIR)
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1.2.0-ballot [deprecated]
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Financial Mgmt
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Use Cases and Overview
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2.3.7
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Description
This section contains the following:
If additional information is needed, the payer can request the information in a number of means:
- Respond with an FAX or upload to a portal
- An X12 275 response (by provider) to a X12 278 response (as represented in the response FHIR bundle)
- A CDex “Push” transition based on an X12 278 response
- Resubmission of the PA request with additional information
- A FHIR based request for additional information using DTR. The note that would be returned would be “please launch DTR with a context of this authorization request.”
These are not ways a payer can request additional information (with the exception of #5), they are methods that can be used to respond to requests for information.
It is not exactly clear if this is attempting to detail how a payer should be requesting additional documentation and what needs to be returned in the ClaimResponse or this is just defining the methods that can be used to respond to the payer's requests.
If it is the former, then more details about what should be expected from the payer systems should be detailed and the listed methods for responding to requests should be separate.
Otherwise, the sentence preceding the list should be updated to more accurately describe that these are the methods that can be used to respond to payer requests for additional information.
Attachments
Issue Links
- duplicates
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- Published
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- is voted on by
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BALLOT-32452 Negative - Christopher Schaut : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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- Withdrawn
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- Withdrawn
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- Withdrawn
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- Withdrawn
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- Withdrawn
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- Withdrawn
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- Withdrawn
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- Withdrawn
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- Balloted
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- Balloted
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- Balloted
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- Balloted
- mentioned in
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