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  1. FHIR Specification Feedback
  2. FHIR-40602

give guidance on calling hooks when you've already received a response

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci CRD (FHIR)
    • 1.1.0-ballot [deprecated]
    • Financial Mgmt
    • Supported Hooks
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      Will update the spec to include the following:

      Systems MAY fire calls related to orders even if there is already a coverage assertion recorded on the order.  There is always the possibility that context has changed or new information available in the order will result in a new decision or additional guidance. The payer may also have other useful information not related to coverage/authorization.

      However, payers SHALL NOT send a system action to update the order unless something is new.  Payers SHOULD take into account the previous decision in deciding how much processing is necessary before returning a response.

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      Will update the spec to include the following: Systems MAY fire calls related to orders even if there is already a coverage assertion recorded on the order.  There is always the possibility that context has changed or new information available in the order will result in a new decision or additional guidance. The payer may also have other useful information not related to coverage/authorization. However, payers SHALL NOT send a system action to update the order unless something is new.  Payers SHOULD take into account the previous decision in deciding how much processing is necessary before returning a response.
    • Bob Dieterle / Mark Scrimshire : 4-0-1
    • Clarification
    • Compatible, substantive
    • Yes

    Description

      We are planning to require support for receiving guidance during order-sign, order-dispatch, and appointment-book- however we haven't talked about if you actually need those subsequent calls if you already have a good response.

      We should add some guidance to https://build.fhir.org/ig/HL7/davinci-crd/hooks.html#cds-hooks-1 :

      "If the CRD client has already received coverage guidance from a CRD Service during an earlier hook (which may have already been discussed between the provider and patient), the CRD client SHOULD suppress later calls to that service unless there is an expectation the guidance may change (e.g. auth-out-network-only was initially returned and now a performer is known)."

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            Unassigned Unassigned
            kjohnsen Kyle Johnsen
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              Updated:
              Resolved: