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 CRD (FHIR)
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1.1.0-ballot [deprecated]
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Financial Mgmt
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Use Cases and Overview
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2.2.1
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Bob Dieterle / Rachael Foerster : 8-0-0
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Clarification
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Compatible, substantive
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Yes
Description
In the "use-cases" overview, 2.2.1 Scenario 1, IG says
Dr. Good completes the necessary paperwork to initiate a prior authorization and sends the relevant supporting information to the imaging center as part of the referral.
However, it is not clear from the IG how this supporting information about prior auth is sent to the imaging center as part of the referral. As I understand, this is necessary for the imaging center to submit a claim for reimbursement.
So I request that the IG detail the technical specifications / methodologies for how the prior authorization related information available on the ordering side is transferred to the performing side for purposes of claim submission.
Especially considering the IG deliberately moves the authorization workflow from the performing side to the ordering side, I feel strongly that this is a major gap in the IG which will cause financial burden for performing organizations unless appropriately addressed.
Attachments
Issue Links
- is voted on by
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BALLOT-32419 Negative - Christopher Schaut : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33522 Negative - Daniel Rutz : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33544 Negative - Thanos Tsiolis : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33566 Negative - Chris Courville : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33610 Negative - Daniel Zhang : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33654 Negative - David Sundaram-Stukel : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33676 Negative - Isaac Vetter : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33698 Negative - Amit Popat : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33720 Negative - Cooper Thompson : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33742 Negative - Danielle Friend : 2022-May-FHIR IG COVREQDISC R2 STU
- Withdrawn
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BALLOT-33588 Negative - Peter DeVault : 2022-May-FHIR IG COVREQDISC R2 STU
- Balloted
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BALLOT-33632 Negative - Michael Clifton : 2022-May-FHIR IG COVREQDISC R2 STU
- Balloted
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BALLOT-33764 Negative - Vassil Peytchev : 2022-May-FHIR IG COVREQDISC R2 STU
- Balloted
- relates to
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FHIR-36253 DTR Spec needs a way to pass a questionnaire / response across organizations
- Published
- mentioned in
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