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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Highest Highest
    • US Da Vinci PAS (FHIR)
    • 1.2.0-ballot [deprecated]
    • Financial Mgmt
    • Use Cases and Overview
    • 2.1
    • Hide

      We will update this section with the most recent surveys prior to publication as well as remove the WEDI survey.

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      We will update this section with the most recent surveys prior to publication as well as remove the WEDI survey.
    • Bob Dieterle / Jeff Brown : 9-0-1
    • Clarification
    • Non-substantive

    Description

      Suggest revising this section with better more up to date information:

      "However, adoption of X12 Authorization and Attachment transactions by EHR implementers has been low. Surveys from CAQH & WEDI indicate that, for 2018, less than 12% of prior authorizations are processed using the 278 request & response. For details, see the WEDI survey from January 2020. The 2019 CAQH Index survey indicated that <13% of Prior Authorization transactions are fully automated X12 278. Clinicians and their office staff spend hours each week trying to verify coverage requirements for specific treatments, submitting prior authorization requests, following up on prior authorization requests, transmitting supporting documentation to support follow-up requests for information and then communicating the prior authorization final decision within the care team and the patient."

      Recommend updating this section by removing the WEDI survey, adding a reference to the AMA 2021 PA Survey https://www.ama-assn.org/system/files/prior-authorization-survey.pdf and updating the CAQH reference to the 2021 index which is 26% (not 13%) https://www.caqh.org/sites/default/files/explorations/index/2021-caqh-index.pdf

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            Unassigned Unassigned
            celine_lefebvre Celine Lefebvre
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              Updated:
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