Existing Wording: Attestation by the provider as to the patient need for a specific treatment or service. In this case, there is no specific clinical data required. Payers indicate that this scenario may account for up to 50% of prior authorization transactions. Such attestations are generally collected as answers to questions as part of QuestionnaireResponses completed within the EHR or via a a SMART on FHIR application.

Comment:

This could simply be handled as a flag, but seriously it is inherent in the PA request as it is a request to perform a service or procedure which the licenced professional has determined they would perform if so authorized.

Summary:

This could simply be handled as a flag