Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions

Using CDex Attachments with DaVinci PAS

Introduction

The Da Vinci Burden Reduction Implementation Guides (IGs), Da Vinci Coverage Requirements Discovery (CRD), Da Vinci Documentation Templates and Rules (DTR), and Da Vinci Prior Authorization Support (PAS), support an integrated workflow to enable automated submission of required documentation and prior authorization from EHR and payer systems respectively. In Da Vinci Prior Authorization Support (PAS), a final decision is typically generated immediately and automatically. However, a payer may request additional information (aka attachments) from the Provider to support a prior authorization request. See the Request for Additional Information section in the PAS Implementation Guide. Use PAS when requesting more data via X12 278 Response or PAS Claim Response Bundle. Use CDex only when the Provider requests prior authorization through non-standard channels (e.g., fax, portal, or phone).

Differences between PAS and CDex

This section highlights the similarities and differences between PAS and CDex in how they use the $submit-attachment operation to exchange attachments for prior authorization.

• PAS and CDex use the $submit-attachment operation to push the attachments to the Payer.
• PAS and CDex request attachments using Codes or Questionnaires.
• PAS and CDex Use Task as a context parameter to launch a Smart on FHIR DTR app.

However, there are several key differences: