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  1. FHIR Specification Feedback
  2. FHIR-37743

Make clear rules around unsolicited authorizations

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci CRD (FHIR)
    • 1.0.0 [deprecated]
    • Clinical Interoperability Council
    • Supported Hooks
    • Bob Dieterle / Jeff Brown : 22-0-1
    • Clarification
    • Compatible, substantive

    Description

      Need to make clear that if payers issue unsolicited authorizations, there is no guarantee that the order that triggered the authorization will ever get signed or become 'real'.  As a result, the issuing of such an authorization SHALL NOT result in any limitation on provision of subsequent services.  There should be no expectation that a provider will 'cancel' the authorization if the order is cancelled (because the authorization was never actually 'requested').

      Also, we need to have a specific card type for "unsolicited authorizations" so that a "what if" app (and possibly other use-cases) can prevent such authorizations from coming back.

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            Unassigned Unassigned
            lloyd Lloyd McKenzie
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            Dates

              Created:
              Updated:
              Resolved: