Details
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Change Request
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Resolution: Persuasive with Modification
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Highest
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US Da Vinci DTR (FHIR)
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1.0.0 [deprecated]
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Clinical Decision Support
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STU
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Technical Background and Underlying Technologies [deprecated]
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Bob Dieterle / Jeff Brown : 12-0-2
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Correction
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Compatible, substantive
Description
Same comments made in CRD specification.
The point of this section is to show functionality of CRD, DTR, and PAS independent of prior auth and/or each of the guides. Sending providers to manual 'solutions' isn't a functionality. Need to revise and deleted any references to the aforementioned. Bolded below.
See following Content:
CRD can provide information unrelated to prior authorization and 'special documentation'. For example, providing an estimate of patient cost, suggesting appropriate use criteria, identifying duplicate therapies, etc.
CRD can identify a need for prior authorization and/or special documentation but, instead of linking to a DTR solution, *might simply point to a website or other documentation with guidance on the appropriate forms to complete *
DTR might be invoked directly by a clinician who either knows or is informed by means other than CRD about the requirement to gather additional documentation
Information gathered by DTR might be used for direct submission of prior authorizations to support X12 278 transactions or using alternative submission means (*e.g. fax, mail) if supported/required by the relevant payer *
PAS can be used for prior authorization submissions where the need to submit a prior authorization was identified without CRD (either known in advance or identified by other means) *and/or the supplemental information to be provided was identified and gathered outside of or in addition to DTR. *
Attachments
Issue Links
- is voted on by
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BALLOT-32540 Negative - Celine Lefebvre : 2022-May-FHIR IG DTR R2 STU
- Balloted