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  1. FHIR Specification Feedback
  2. FHIR-36629

change from are expected to SHALL

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Da Vinci PDex (FHIR)
    • 2.0.0-ballot
    • Financial Mgmt
    • STU
    • FHIR Artifacts
    • 12.12.1
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      Change sentence to:

      Payers SHALL make available pending and active prior authorization decisions and related clinical documentation and forms for items and services, not including prescription drugs, including the date the prior authorization was approved, the date the authorization ends, as well as the units and services approved and those used to date, no later than one (1) business day after a provider initiates a prior authorization for the beneficiary or there is a change of status for the prior authorization.

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      Change sentence to: Payers SHALL make available pending and active prior authorization decisions and related clinical documentation and forms for items and services, not including prescription drugs, including the date the prior authorization was approved, the date the authorization ends, as well as the units and services approved and those used to date, no later than one (1) business day after a provider initiates a prior authorization for the beneficiary or there is a change of status for the prior authorization.
    • Bob Dieterle / Mark Scrimshire : 9-0-0
    • Clarification
    • Compatible, substantive
    • Yes
    • 2.0.0-ballot

    Description

      Change sentence to: Payers SHALL communicate pending and active prior authorization decisions and related clinical documentation and forms for items and services, not including prescription drugs, including the date the prior authorization was approved, the date the authorization ends, as well as the units and services approved and those used to date, no later than one (1) business day after a provider initiates a prior authorization for the enrollee or there is a change of status for the prior authorization.

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            celine_lefebvre Celine Lefebvre
            Celine Lefebvre
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              Updated:
              Resolved: