Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-44677

.processNote.number and .text need to be MS to better align with regulation

XMLWordPrintableJSON

    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci PAS (FHIR)
    • 2.0.1
    • Financial Mgmt
    • PAS Claim Response
    • Hide

      Make processNote.number and processNote.text MS and make processNote.number 1..1

      Show
      Make processNote.number and processNote.text MS and make processNote.number 1..1
    • Bob Dieterle / Jeff Brown : 12-0-1
    • Correction
    • Compatible, substantive

      In CMS-0057-F, prior authorization denial reason notification must 

      • When denial information is sent to a provider by any communication method, including existing notices, the content of a denial should be sufficiently specific to enable a provider to understand why a prior authorization has been denied and what actions must be taken to resubmit or appeal. 

      To ensure that this explanatory text is available to PAS submitters, the following changes are needed:
      PASClaimResponse.processNote.number * Cardinality should be 1..1

      • Should be Must Support

       
      PASClaimResponse.processNote.text * Should be Must Support

            Unassigned Unassigned
            chris_cioffi Chris Cioffi
            Watchers:
            1 Start watching this issue

              Created:
              Updated:
              Resolved: