Details
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Change Request
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Resolution: Not Persuasive
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Medium
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US Da Vinci PAS (FHIR)
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1.1.0
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Financial Mgmt
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Formal Specification
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Bob Dieterle/Mary Kay McDaniel: 10-1-1
Description
It's evident that the requirement to conform the PAS Claim and ClaimResponse profiles to X12 significantly complicates and confuses the PAS data model, while also not only failing to simplify the interoperability exchange to the elements required, but also carries forward undesirable aspects from X12.
This is too important to get wrong. You're re-creating X12 in json.
The spec clearly and expertly defines the requirements for the use of X12, and describes some mechanisms for working around this requirement, while also pointing to a future without X12 via the current CMS exception.
I propose that the current guide fails to narrowly target the specific X12 requirement, and further, if/when the X12 requirement is lifted, any PAS integrations will still be tied to X12 due to this guide's current data modeling approach. In short, you're defining the long-term data model based upon the short-term, transitory needs.
Since only the "ASC X12N/005010X217 - Health Care Services Review - Request for Review and Response (278)" is actually required, you should use simple FHIR to both transport additional information and to inquire after a request. The 278 request should be simple, and trivial with primarily only a reference to the forthcoming PAS Request Bundle. The PAS Request Bundle should not be modeled after X12, and should not be transformed to X12. Both the provider and the payer should be capable of understanding the PAS FHIR.
Such an approach would enable much needed simplification of the Claim and ClaimResponse resources, and would allow us to not carry forward X12 complexity and mistakes.
Attachments
Issue Links
- is voted on by
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BALLOT-32472 Negative - Christopher Schaut : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32630 Negative - Daniel Rutz : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32653 Negative - Thanos Tsiolis : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32676 Negative - Chris Courville : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32745 Negative - Michael Clifton : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32768 Negative - David Sundaram-Stukel : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32814 Negative - Amit Popat : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32837 Negative - Cooper Thompson : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32860 Negative - Danielle Friend : 2022-May-FHIR IG PAS R2 STU
- Withdrawn
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BALLOT-32393 Affirmative - Chris Cioffi : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32603 Negative - Hans Buitendijk : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32699 Negative - Peter DeVault : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32722 Negative - Daniel Zhang : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32791 Negative - Isaac Vetter : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32883 Negative - Vassil Peytchev : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32917 Negative - Doug Pratt : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-32928 Negative - Dennis Patterson : 2022-May-FHIR IG PAS R2 STU
- Balloted
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BALLOT-33008 Affirmative - Sheryl Turney : 2022-May-FHIR IG PAS R2 STU
- Balloted