We need to assure that this document works in concert with the X12 transactions. - CDex #212

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    • Type: Change Request
    • Resolution: Not Persuasive
    • Priority: Medium
    • US Da Vinci CDex (FHIR)
    • Financial Mgmt
    • (many)
    • Use Case Descriptoin
    • Hide

      Could not find documentation in the Feb 24 PC conference call minutes indicating the reason for this tracker item to be pulled.

      We have already agreed elsewhere to add language indicating that all implementations must adhere to state and federal rules and regulations.  If new rules come out around X12 attachments, the expectation to adhere to those would fall under that broader language.  We see no reason to specifically call out the possibility of this particular regulation.

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      Could not find documentation in the Feb 24 PC conference call minutes indicating the reason for this tracker item to be pulled. We have already agreed elsewhere to add language indicating that all implementations must adhere to state and federal rules and regulations.  If new rules come out around X12 attachments, the expectation to adhere to those would fall under that broader language.  We see no reason to specifically call out the possibility of this particular regulation.
    • Eric Haas/Jay Lyle: 7-0-0

      Existing Wording: To gather information necessary to complete a review, the Payer may request the patients medical record from the provider. When requesting documentation, the payer must specify the claim and member (patient) details including PHI. Therefore, both the secure channel used to send the request and the destination to which the request is being sent need to be agreed upon by the Payer and Provider in advance.

      Comment:

      The X12 Claims attachment transaction is built to allow payors to request clinical info and for providers to respond to those request. We need to assure that this document works in concert with the X12 transactions.

      Summary:

      We need to assure that this document works in concert with the X12 transactions.

            Assignee:
            Unassigned
            Reporter:
            mrocca
            Watchers:
            4 Start watching this issue

              Created:
              Updated:
              Resolved: