Details
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Change Request
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Resolution: Persuasive
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Medium
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US Da Vinci PDex (FHIR)
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current
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Financial Mgmt
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PDex Prior Authorization
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Home
PDex Prior Authorization -
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Mark Scrimshire / Rachael Foerster : 10-0-2
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Clarification
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Compatible, substantive
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Yes
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2.0.0-ballot
Description
In the 0057 proposed rule it includes prior authorization requests and decisions, not only in the Patient Access API and Provider Access API, but the Payer-to-Payer Data Exchange: https://www.cms.gov/newsroom/fact-sheets/advancing-interoperability-and-improving-prior-authorization-processes-proposed-rule-cms-0057-p-fact
Add narrative stating that the Prior Authorization profile also applies to the Payer to Payer use case both in the index.md (Home) page and the Prior auth pages (input\pagecontent\StructureDefinition-pdex-priorauthorization-intro.md, input\pagecontent\PDexPriorAuthorization.md)