Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.1 - 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 2.2.1 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 Reading This IG
... 3 Use Cases and Overview
... 4 Project and Participants
... 5 PAS ePA Coordinator Information
... 6 Conformance Expectations
... 7 Technical Specification
... 8 Request for Additional Information
... 9 HIPAA Regulations
... 10 Privacy, Safety, and Security
... 11 PAS Metrics
... 12 Conformance Details
... 13 Artifacts Overview
... 14 PAS Terminology
... 15 Downloads
... 16 Change Log
... 17 Artifacts Summary
.... 17.1 PAS Client
.... 17.2 PAS Payer
.... 17.3 Narrative Conformance Statements
.... 17.4 EHR PAS Capabilities
.... 17.5 Intermediary PAS Capabilities
.... 17.6 Search for a Prior Authorization Response by example
.... 17.7 Submit a Prior Authorization Request for adjudication
.... 17.8 PAS Subscription Topic
.... 17.9 PAS Metric Data
.... 17.10 PAS Claim Base
.... 17.11 PAS Claim Response Base
.... 17.12 PAS Organization Base Profile
.... 17.13 PAS Beneficiary Patient
.... 17.14 PAS Claim
.... 17.15 PAS Claim Inquiry
.... 17.16 PAS Claim Inquiry Response
.... 17.17 PAS Claim Response
.... 17.18 PAS Claim Update
.... 17.19 PAS CommunicationRequest
.... 17.20 PAS Coverage
.... 17.21 PAS Device Request
.... 17.22 PAS Document Reference
.... 17.23 PAS Encounter
.... 17.24 PAS Inquiry Request Bundle
.... 17.25 PAS Inquiry Response Bundle
.... 17.26 PAS Insurer Organization
.... 17.27 PAS Location Profile
.... 17.28 PAS Medication Request
.... 17.29 PAS Nutrition Order
.... 17.30 PAS Practitioner
.... 17.31 PAS PractitionerRole
.... 17.32 PAS Request Bundle
.... 17.33 PAS Requestor Organization
.... 17.34 PAS Response Bundle
.... 17.35 PAS Service Request
.... 17.36 PAS Subscriber Patient
.... 17.37 PAS Subscription
.... 17.38 PAS Task
.... 17.39 PAS Identifier
.... 17.40 PAS Quantity
.... 17.41 PAS Timing
.... 17.42 Administration Reference Number
.... 17.43 Admission Dates
.... 17.44 Authorization Number
.... 17.45 Authorized Provider Type
.... 17.46 Calendar Pattern
.... 17.47 Care Team Claim Scope
.... 17.48 Certification Effective Date
.... 17.49 Certification Expiration Date
.... 17.50 Certification Issue Date
.... 17.51 Certification Type
.... 17.52 Claim Response Item Category
.... 17.53 Claim Response Reviewer
.... 17.54 Communicated Diagnosis
.... 17.55 Condition Code
.... 17.56 Content Modifier
.... 17.57 Delivery Pattern
.... 17.58 Diagnosis Recorded Date
.... 17.59 Discharge Date
.... 17.60 Document Information
.... 17.61 EPSDT Indicator
.... 17.62 Error Element
.... 17.63 Error Follow-up Action
.... 17.64 Error Path
.... 17.65 Home Health Care Information
.... 17.66 Identifier Jurisdiction
.... 17.67 Identifier Sub-Department
.... 17.68 Information Cancelled Flag
.... 17.69 Information Change Mode
.... 17.70 Item Authorized Detail
.... 17.71 Item Authorized Provider
.... 17.72 Item Preauthorization Issue Date
.... 17.73 Item Preauthorization Period
.... 17.74 Item Requested Service Date
.... 17.75 Item Trace Number
.... 17.76 Level of Service Code
.... 17.77 Military Status
.... 17.78 Nursing Home Level of Care
.... 17.79 Nursing Home Residential Status
.... 17.80 Outcome BHT06 Code
.... 17.81 Patient Status
.... 17.82 Product or Service Code End
.... 17.83 Requested Service
.... 17.84 Revenue Code
.... 17.85 Revenue Unit Rate Limit
.... 17.86 Review Action
.... 17.87 Review Action Code
.... 17.88 Service Item Request Type
.... 17.89 Service Line Number
.... 17.90 Transmission Identifiers
.... 17.91 AHA NUBC Revenue Value Set
.... 17.92 Attachment Codes
.... 17.93 Claim Response Outcome
.... 17.94 Claim Types
.... 17.95 Metric Data Source
.... 17.96 PAS Communication Medium Value Set
.... 17.97 PAS Conformance Statement Categories
.... 17.98 PAS Information Change Mode Value Set
.... 17.99 PAS LOINC Attachment Codes Value Set
.... 17.100 PAS PWK01 Attachment Report Type Code Value Set
.... 17.101 PAS Supporting Info Type Value Set
.... 17.102 PAS Task Codes
.... 17.103 X12 278 CRC Condition Category
.... 17.104 X12 278 CRC Condition Code
.... 17.105 X12 278 Diagnosis Code Value Set
.... 17.106 X12 278 Diagnosis Information Type
.... 17.107 X12 278 Diagnosis Type Value Set
.... 17.108 X12 278 Follow Up Action Value Set
.... 17.109 X12 278 Health Care Service Location Type Value Set
.... 17.110 X12 278 Nutrition Enteral Formula Type
.... 17.111 X12 278 Nutrition Oral Diet Type
.... 17.112 X12 278 Reject Reason Value Set
.... 17.113 X12 278 Requested Service Modifier Type
.... 17.114 X12 278 Requested Service Type
.... 17.115 X12 278 Review Decision Reason Codes
.... 17.116 PAS Temporary Codes
.... 17.117 Additional Information Task Example
.... 17.118 Authorization Response with Practitioner Requestor and Additional Content Example
.... 17.119 Authorization Response with Practitioner Requestor Example
.... 17.120 Communication Request Example
.... 17.121 Device Request Example
.... 17.122 Encounter Example
.... 17.123 Error Response Bundle Example
.... 17.124 Error Response Example
.... 17.125 Homecare Authorization Bundle Example
.... 17.126 Homecare Authorization Example
.... 17.127 Homecare Authorization Update Bundle Example
.... 17.128 Homecare Authorization Update Example
.... 17.129 Invalid Request Response
.... 17.130 Medical Services Authorization Bundle Example
.... 17.131 Medical Services Authorization Example
.... 17.132 Medication Request Example
.... 17.133 Nutrition Order Example
.... 17.134 PAS Claim Inquiry Example
.... 17.135 PAS Claim Inquiry ResponseExample
.... 17.136 PAS Document Reference Example
.... 17.137 PAS Inquiry Operation Response Example
.... 17.138 PAS Inquiry Request Bundle Example
.... 17.139 PAS Inquiry Response Bundle Example
.... 17.140 PAS Subscription example for a specific provider
.... 17.141 PAS Subscription Notification example
.... 17.142 PAS Subscription Notification Parameters
.... 17.143 Pending Authorization Response with Practitioner Requestor Example
.... 17.144 Referral Authorization Bundle Example
.... 17.145 Referral Authorization Example
.... 17.146 Referral Authorization Response Bundle Example
.... 17.147 Referral Pending Authorization Response Bundle Example
.... 17.148 Rejection Response Bundle Example
.... 17.149 Rejection Response Example
.... 17.150 Submit Claim Beneficiary Example
.... 17.151 Submit Claim Insurance Example
.... 17.152 Submit Claim Insurer Example
.... 17.153 Submit Claim Referral Location Example
.... 17.154 Submit Claim Referral Practitioner Example
.... 17.155 Submit Claim Referral Practitioner Role Example
.... 17.156 Submit Claim Referral Request Example
.... 17.157 Submit Claim Requestor Example
.... 17.158 Submit Claim Subscriber Example
.... 17.159 Submit Claim Surgical Location Example
.... 17.160 Submit Claim Surgical Practitioner Example
.... 17.161 Submit Claim Surgical Practitioner Role Example
.... 17.162 Surgical Admission Request Bundle Example
.... 17.163 Surgical Request Authorization Example