Patient Cost Transparency Implementation Guide
0.1.0 - ci-build

Patient Cost Transparency Implementation Guide, published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Technical Background and Underlying Technologies

Da Vinci

Da Vinci is an HL7-sponsored project that brings together the U.S. payer, providers, and technology suppliers (including Billing Management System vendors) to help payers and providers to positively impact clinical, quality, cost, and care management outcomes using FHIR-related technologies. The project organizes meetings (face-to-face and conference calls) as well as Connectathons to find ways to leverage FHIR technologies to support and integrate value-based care (VBC) data exchange across communities. Da Vinci identifies value-based care use cases of interest to its member and the community as a whole.

The process that Da Vinci has adopted includes:

  1. identify business, clinical, technical and testing requirements,
  2. develop and ballot a FHIR based implementation guide (IG),
  3. develop a reference implementation (RI) that is used to demonstrate that the concepts in the IG are possible to implement,
  4. pilot the standard
  5. support the production use of the IG to enable exchange of data to support interoperability for value-based care.

Additional information about Da Vinci, its members, the use cases and the implementation guides being developed can all be found on the HL7 website. Meeting minutes and other materials can be found on the Da Vinci Confluence page.

FHIR

This IG uses terminology, notations and design principles that are specific to FHIR. It’s important to be familiar with some of the basic principles of FHIR as well as general guidance on how to read FHIR specifications. Readers who are unfamiliar with FHIR are encouraged to read the following prior to reading the rest of this IG.

FHIR Version

FHIR R4 US Core

Implementers should also familiarize themselves with the FHIR resources used within this IG.

US Core

Provider billing and payer claims adjudication systems SHALL use the specification defined by US Core in exchanging information with payers. Implementers should be familiar with this specification.

Da Vinci PCT implementations SHALL conform to the US Core IG Must Support Guidance where US Core IG resources are used.