Need Prior Authorization use case without X12 or clearing house

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    • Type: Change Request
    • Resolution: Not Persuasive
    • Priority: Medium
    • US Da Vinci PAS (FHIR)
    • STU3
    • Financial Mgmt
    • STU
    • methodology [deprecated]
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      HIPAA requirements do not allow for a use case that does not use X12. This IG proposes to simplify the use of X12 by allowing for FHIR to be sent from the EHR and be converted to X12 where required.

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      HIPAA requirements do not allow for a use case that does not use X12. This IG proposes to simplify the use of X12 by allowing for FHIR to be sent from the EHR and be converted to X12 where required.
    • Kathleen Connor / Robert Dieterle: 20-0-1

      "However, adoption of X12 by EHR implementers has been low." and "Discussion with EHR implementers has suggested that a FHIR-based process for submitting prior authorization requests would have significantly higher uptake." but this FHIR proposal still uses X12. Need a use case that does not use X12 and that goes directly from doctor to payer and from payor to doctor without going through a clearing house.

            Assignee:
            Unassigned
            Reporter:
            kathy_walsh
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: