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  1. FHIR Specification Feedback
  2. FHIR-37577

Change use of _profile to ExplanationOfBenefit.use to filter on "preauthorization"

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci PDex (FHIR)
    • 2.0.0-ballot
    • Financial Mgmt
    • PDex Prior Authorization
    • 12.13.1
    • Hide

      Changed to: 

      A slice has been defined for meta.profile that makes the URI for the Structure Definition a required field. The ExplanationOfBenefit resource is used to express claims information to members in accordance with the [Carin Blue Button Implementation Guide](http://hl7.org/fhir/us/carin-bb/). By setting the value of ExplanationOfBenefit.Use to "preauthorization" in Prior Authorization resources a Payer will be able to exclude, or include, Prior Authorization records, dependent upon the use case. For the PDex IG it would be a case of setting “use=preauthorization” as a search parameter to include only Prior Authorization records.

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      Changed to:  A slice has been defined for meta.profile that makes the URI for the Structure Definition a required field. The ExplanationOfBenefit resource is used to express claims information to members in accordance with the [Carin Blue Button Implementation Guide] ( http://hl7.org/fhir/us/carin-bb/ ). By setting the value of ExplanationOfBenefit.Use to "preauthorization" in Prior Authorization resources a Payer will be able to exclude, or include, Prior Authorization records, dependent upon the use case. For the PDex IG it would be a case of setting “use=preauthorization” as a search parameter to include only Prior Authorization records.
    • Bob Dieterle / Mark Scrimshire : 9-0-0
    • Clarification
    • Compatible, substantive
    • Yes
    • 2.0.0-ballot

      Change:

      By including the profile reference in Prior Authorization resources a Payer will be able to exclude, or include, Prior Authorization records, dependent upon the use case. For the PDex IG it would be a case of adding the “_profile” search parameter to include only Prior Authorization records.

      To:

      By setting the value of ExplanationOfBenefit.Use to "preauthorization" in Prior Authorization resources a Payer will be able to exclude, or include, Prior Authorization records, dependent upon the use case. For the PDex IG it would be a case of setting “use=preauthorization” as a search parameter to include only Prior Authorization records.

            Unassigned Unassigned
            ekivemark Mark Scrimshire
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              Created:
              Updated:
              Resolved: