Enhance description of claim.referral

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    • Type: Change Request
    • Resolution: Persuasive
    • Priority: Medium
    • FHIR Core (FHIR)
    • STU3
    • Financial Mgmt
    • Claim
    • Hide

      Definition and Requirements Update:

      Definition Currently:  A reference to a referral resource.

      Change to: A reference to a referral resource, i.e., referral information received by the claim author.

      Requirements Currently:  Some insurers require proof of referral to pay for services or to pay specialist rates for services.

      Change to:  This is the referral information received by the claim author, it is not to be used when the author generates a referral for a patient. A copy of that referral may be provided as supporting information. Some insurers require proof of referral to pay for services or to pay specialist rates for services.

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      Definition and Requirements Update: Definition Currently:  A reference to a referral resource. Change to: A reference to a referral resource, i.e., referral information received by the claim author. Requirements Currently:  Some insurers require proof of referral to pay for services or to pay specialist rates for services. Change to:   This is the referral information received by the claim author, it is not to be used when the author generates a referral for a patient. A copy of that referral may be provided as supporting information. Some insurers require proof of referral to pay for services or to pay specialist rates for services.
    • Andy Stechishin / Kathleen Connor : 5-0-0
    • Enhancement
    • Non-substantive
    • R5

      add clarity to the short and long descriptions to indicate this is the referral information received by the claim author - NOT to be used when the author generates a referral for a patient. A copy of that referral may be provided as supporting information.

            Assignee:
            Unassigned
            Reporter:
            Mary Kay McDaniel
            Watchers:
            1 Start watching this issue

              Created:
              Updated:
              Resolved: