Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-46383

do not allow launch of PA through a portal

XMLWordPrintableJSON

    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci CRD (FHIR)
    • current
    • Financial Mgmt
    • Use Cases and Overview
    • Hide

      In the card types for External Reference and Information, will add the following: "CRD Services SHALL NOT use these cards to direct users to a portal for the purpose of initiating prior authorization or determining coverage.  Use the [Coverage Information] response instead."

      Will also remove ", or even something as simple as “No special coverage requirements”"

      Show
      In the card types for External Reference and Information, will add the following: "CRD Services SHALL NOT use these cards to direct users to a portal for the purpose of initiating prior authorization or determining coverage.  Use the [Coverage Information] response instead." Will also remove ", or even something as simple as “No special coverage requirements”"
    • Clarification
    • Compatible, substantive
    • Yes

      In the CMS PA proposed rule it plainly says that "portals or website options may be viable solutions until the PARDD API is built, made widely available, and providers gain experience using the tool." Meaning they are a temporary measure. We should be preparing the industry to leverage the CRD spec to the best of its ability and now.

      In line with the disposition in FHIR-42809 we should add to the CRD specification that launching a prior auth via a portal SHALL not be compliant with this specification.

            Unassigned Unassigned
            celine_lefebvre Celine Lefebvre
            Celine Lefebvre
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: