Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0 - STU 2.2 United States of America flag

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Table of Contents

Page standards status: Informative
.. 0 Table of Contents
... 1 Prior Authorization Implementation Guide Home Page
... 2 Technical Background
... 3 Use Cases and Overview
... 4 Credits
... 5 PAS ePA Coordinator Information
... 6 Conformance
... 7 Conformance Expectations
... 8 Formal Specification
... 9 Request for Additional Information
... 10 HIPAA Regulations
... 11 Privacy & Security
... 12 PAS Metrics
... 13 Artifacts Overview
... 14 PAS Terminology
... 15 Downloads
... 16 Change Log
... 17 Artifacts Summary
.... 17.1 PAS Client
.... 17.2 PAS Payer
.... 17.3 EHR PAS Capabilities
.... 17.4 Intermediary PAS Capabilities
.... 17.5 Search for a Prior Authorization Response by example
.... 17.6 Submit a Prior Authorization Request for adjudication
.... 17.7 PAS Subscription Topic
.... 17.8 PAS Metric Data
.... 17.9 PAS Claim Base
.... 17.10 PAS Claim Response Base
.... 17.11 PAS Organization Base Profile
.... 17.12 PAS Beneficiary Patient
.... 17.13 PAS Claim
.... 17.14 PAS Claim Inquiry
.... 17.15 PAS Claim Inquiry Response
.... 17.16 PAS Claim Response
.... 17.17 PAS Claim Update
.... 17.18 PAS CommunicationRequest
.... 17.19 PAS Coverage
.... 17.20 PAS Device Request
.... 17.21 PAS Document Reference
.... 17.22 PAS Encounter
.... 17.23 PAS Inquiry Request Bundle
.... 17.24 PAS Inquiry Response Bundle
.... 17.25 PAS Insurer Organization
.... 17.26 PAS Location Profile
.... 17.27 PAS Medication Request
.... 17.28 PAS Nutrition Order
.... 17.29 PAS Practitioner
.... 17.30 PAS PractitionerRole
.... 17.31 PAS Request Bundle
.... 17.32 PAS Requestor Organization
.... 17.33 PAS Response Bundle
.... 17.34 PAS Service Request
.... 17.35 PAS Subscriber Patient
.... 17.36 PAS Subscription
.... 17.37 PAS Task
.... 17.38 PAS Identifier
.... 17.39 PAS Quantity
.... 17.40 PAS Timing
.... 17.41 Administration Reference Number
.... 17.42 Admission Dates
.... 17.43 Authorization Number
.... 17.44 Authorized Provider Type
.... 17.45 Calendar Pattern
.... 17.46 Care Team Claim Scope
.... 17.47 Certification Effective Date
.... 17.48 Certification Expiration Date
.... 17.49 Certification Issue Date
.... 17.50 Certification Type
.... 17.51 Claim Response Item Category
.... 17.52 Claim Response Reviewer
.... 17.53 Communicated Diagnosis
.... 17.54 Condition Code
.... 17.55 Content Modifier
.... 17.56 Delivery Pattern
.... 17.57 Diagnosis Recorded Date
.... 17.58 Discharge Date
.... 17.59 Document Information
.... 17.60 EPSDT Indicator
.... 17.61 Error Element
.... 17.62 Error Follow-up Action
.... 17.63 Error Path
.... 17.64 Home Health Care Information
.... 17.65 Identifier Jurisdiction
.... 17.66 Identifier Sub-Department
.... 17.67 Information Cancelled Flag
.... 17.68 Information Change Mode
.... 17.69 Item Authorized Detail
.... 17.70 Item Authorized Provider
.... 17.71 Item Preauthorization Issue Date
.... 17.72 Item Preauthorization Period
.... 17.73 Item Requested Service Date
.... 17.74 Item Trace Number
.... 17.75 Level of Service Code
.... 17.76 Military Status
.... 17.77 Nursing Home Level of Care
.... 17.78 Nursing Home Residential Status
.... 17.79 Patient Status
.... 17.80 Product or Service Code End
.... 17.81 Requested Service
.... 17.82 Revenue Code
.... 17.83 Revenue Unit Rate Limit
.... 17.84 Review Action
.... 17.85 Review Action Code
.... 17.86 Service Item Request Type
.... 17.87 Service Line Number
.... 17.88 Transmission Identifiers
.... 17.89 AHA NUBC Revenue Value Set
.... 17.90 Claim Response Outcome
.... 17.91 Claim Types
.... 17.92 Metric Data Source
.... 17.93 PAS Communication Medium Value Set
.... 17.94 PAS Conformance Statement Categories
.... 17.95 PAS Information Change Mode Value Set
.... 17.96 PAS LOINC Attachment Codes Value Set
.... 17.97 PAS PWK01 Attachment Report Type Code Value Set
.... 17.98 PAS Supporting Info Type Value Set
.... 17.99 PAS Task Codes
.... 17.100 X12 278 CRC Condition Category
.... 17.101 X12 278 CRC Condition Code
.... 17.102 X12 278 Diagnosis Code Value Set
.... 17.103 X12 278 Diagnosis Information Type
.... 17.104 X12 278 Diagnosis Type Value Set
.... 17.105 X12 278 Follow Up Action Value Set
.... 17.106 X12 278 Health Care Service Location Type Value Set
.... 17.107 X12 278 Nutrition Enteral Formula Type
.... 17.108 X12 278 Nutrition Oral Diet Type
.... 17.109 X12 278 Reject Reason Value Set
.... 17.110 X12 278 Requested Service Modifier Type
.... 17.111 X12 278 Requested Service Type
.... 17.112 X12 278 Review Decision Reason Codes
.... 17.113 PAS Temporary Codes
.... 17.114 Additional Information Task Example
.... 17.115 Authorization Response with Practitioner Requestor and Additional Content Example
.... 17.116 Authorization Response with Practitioner Requestor Example
.... 17.117 Communication Request Example
.... 17.118 Device Request Example
.... 17.119 Encounter Example
.... 17.120 Error Response Bundle Example
.... 17.121 Error Response Example
.... 17.122 Homecare Authorization Bundle Example
.... 17.123 Homecare Authorization Example
.... 17.124 Homecare Authorization Update Bundle Example
.... 17.125 Homecare Authorization Update Example
.... 17.126 Invalid Request Response
.... 17.127 Medical Services Authorization Bundle Example
.... 17.128 Medical Services Authorization Example
.... 17.129 Medication Request Example
.... 17.130 Nutrition Order Example
.... 17.131 PAS Claim Inquiry Example
.... 17.132 PAS Claim Inquiry ResponseExample
.... 17.133 PAS Document Reference Example
.... 17.134 PAS Inquiry Operation Response Example
.... 17.135 PAS Inquiry Request Bundle Example
.... 17.136 PAS Inquiry Response Bundle Example
.... 17.137 PAS Subscription example for a specific provider
.... 17.138 PAS Subscription Notification example
.... 17.139 PAS Subscription Notification Parameters
.... 17.140 Pending Authorization Response with Practitioner Requestor Example
.... 17.141 Referral Authorization Bundle Example
.... 17.142 Referral Authorization Example
.... 17.143 Referral Authorization Response Bundle Example
.... 17.144 Referral Pending Authorization Response Bundle Example
.... 17.145 Rejection Response Bundle Example
.... 17.146 Rejection Response Example
.... 17.147 Submit Claim Beneficiary Example
.... 17.148 Submit Claim Insurance Example
.... 17.149 Submit Claim Insurer Example
.... 17.150 Submit Claim Referral Location Example
.... 17.151 Submit Claim Referral Practitioner Example
.... 17.152 Submit Claim Referral Practitioner Role Example
.... 17.153 Submit Claim Referral Request Example
.... 17.154 Submit Claim Requestor Example
.... 17.155 Submit Claim Subscriber Example
.... 17.156 Submit Claim Surgical Location Example
.... 17.157 Submit Claim Surgical Practitioner Example
.... 17.158 Submit Claim Surgical Practitioner Role Example
.... 17.159 Surgical Admission Request Bundle Example
.... 17.160 Surgical Request Authorization Example