Existing Wording: However, adoption of X12 by EHR implementers has been low. Clinicians and their office staff spend hours each week trying to verify coverage requirements for specific treatments, submitting prior authorization requests, following up on prior authorization requests, transmitting supporting documentation to support follow-up requests for information and then communicating the prior authorization final decision within the care team and the patient. Mechanisms include phone, fax, custom portals, but rarely automated data feeds. Automating even a few steps of the prior authorization process could make the work of healthcare team members across the country much easier.

Proposed Wording: However, adoption of X12 Authorization and Attachment transactions by EHR implementers has been low. Clinicians and their office staff spend hours each week trying to verify coverage requirements for specific treatments, submitting prior authorization requests, following up on prior authorization requests, transmitting supporting documentation to support follow-up requests for information and then communicating the prior authorization final decision within the care team and the patient. Mechanisms include phone, fax, custom portals, but rarely automated data feeds. Automating even a few steps of the prior authorization process could make the work of healthcare team members across the country much easier.

Comment:

Minor suggestion to clarify it is the Authorization (278) and Attachment (275) X12 transactions that have low adoption rate. Other transactions, such as claims, have high adoption.

Summary:

Clarify it is the Authorization (278) and Attachment (275) X12 transactions that have low adoption rate.