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Specification:

US Da Vinci Patient Cost Transparency (PCT) (FHIR)
Raised in Version:

0.1.0 [deprecated]
Work Group:

Financial Mgmt
Related URL:
https://build.fhir.org/ig/HL7/davinci-pct/formal_specification.html#aeob-response
Related Page(s):

Formal Specification
Grouping:
Resolution Description:

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Will create a new OperationOutcome profile called AEOBCompleteOperationOutcome indicating that the AEOB process completed successfully, that the AEOB will be provided to the patient, but not back to the provider. This will be returned on success (200 OK) after polling once the AEOB process is complete, and will be the only content in the returned Bundle (type = batch) per the async pattern. This is represented in the latest workflow diagram.

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Will create a new OperationOutcome profile called AEOBCompleteOperationOutcome indicating that the AEOB process completed successfully, that the AEOB will be provided to the patient, but not back to the provider. This will be returned on success (200 OK) after polling once the AEOB process is complete, and will be the only content in the returned Bundle (type = batch) per the async pattern. This is represented in the latest workflow diagram.
Resolution Vote:
Rick Geimer/Jeff Brown: 9-0-0
Change Category:
Enhancement
Change Impact:
Compatible, substantive

Add clarity to the PCT IG with expectation of payer to return an operation outcome to the gfe submitter when the optional AEOB is not being provided.