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  1. FHIR Specification Feedback
  2. FHIR-43031

Clarifications and guidance on polling rules for Claim Inquiry

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci PAS (FHIR)
    • current
    • Financial Mgmt
    • Use Cases and Overview
    • 2.4.6 Monitor for Resolution
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      Include guidance with the Inquiry that is the same as was used for the "polling" option in V1.0  – SHOULD poll no more frequently than once every 5 minutes for the first 30 minutes and once an hour thereafter. 

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      Include guidance with the Inquiry that is the same as was used for the "polling" option in V1.0  – SHOULD poll no more frequently than once every 5 minutes for the first 30 minutes and once an hour thereafter. 
    • Clarification
    • Compatible, substantive

    Description

      Primarily this ticket is raised to seek guidance around scenarios where a provider is ineligible to create a subscription to the Claim Topic.  In these scenarios the provider is expected to perform Claim Inquiries in order to determine current state of a Claim Response.  This is a de facto polling model, so guidance is being sought with respect to controls that should be applied in order to avoid uncontrolled polling and resulting impacts to payer systems.  For example, in earlier PAS IG releases, we had discussed a rule where an inquiry could occur once every 5 minutes in the first half hour after a claim was submitted, and once an hour after that first half hour.

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            tkakanowski Tom Kakanowski
            Tom Kakanowski
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