Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US Da Vinci CRD (FHIR)
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1.0.0 [deprecated]
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Financial Mgmt
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Supported Hooks
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Bob Dieterle / Mark Scrimshire : 4-0-1
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Correction
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Non-compatible
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Yes
Description
The specification currently says "For requests on information related to prior auth, in order to reduce complexity CRD clients SHOULD only invoke the hook on the payer service associated with their best guess of which coverage will be primary."
Discussion on calls has raised questions about whether we should tighten this to SHALL.
SHOULD means there's the possibility of getting responses back seeking DTR use from multiple payers (which means DTR would need to deal with that). It also creates challenges for payers in terms of understanding whether they're primary or secondary.
On the other hand, SHOULD means that EHRs don't have to worry about embedding logic or external calls to figure out primary coverage in order-entry systems that typically don't have any knowledge of coverage.
Attachments
Issue Links
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