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  1. FHIR Specification Feedback
  2. FHIR-36509

will CRD Clients be informed of failure to meet the complete documentation requirements?

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Da Vinci CRD (FHIR)
    • 1.1.0-ballot [deprecated]
    • Financial Mgmt
    • STU
    • Supported Hooks
    • 4.2.1
    • Hide

      Will add a note to the existing notes section under "PHI and Hook Invocation" that says:

      "In situations where a CRD service's access to PHI is limited due to patient consent and/or provider policy, the CRD service may have greater difficulty providing decision support and will be more likely to indicate 'Unable to determine coverage/prior authorization requirements' and potentially prompt for data collection using DTR."

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      Will add a note to the existing notes section under "PHI and Hook Invocation" that says: "In situations where a CRD service's access to PHI is limited due to patient consent and/or provider policy, the CRD service may have greater difficulty providing decision support and will be more likely to indicate 'Unable to determine coverage/prior authorization requirements' and potentially prompt for data collection using DTR."
    • Bob Dieterle / Chris Cioffi : 8-0-0
    • Clarification
    • Non-substantive

    Description

      Will CRD Clients be informed of failure to meet the complete documentation requirements? Suggest adding something that the CRD Service SHALL indicate that not all the info needed to provide full advice was provided. Around this sentence "Nevertheless, there are situations where PHI will not be shared with a CRD Service because a patient has withheld consent to share information with the payer, the provider has concerns about sharing sensitive data with the payer or because a payer offers only a single plan with coverage requirements that can be evaluated without the use of PHI."

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            celine_lefebvre Celine Lefebvre
            Celine Lefebvre
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              Updated:
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