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 Patient Status
17.81 Product or Service Code End
17.82 Requested Service
17.83 Revenue Code
17.84 Revenue Unit Rate Limit
17.85 Review Action
17.86 Review Action Code
17.87 Service Item Request Type
17.88 Service Line Number
17.89 Transmission Identifiers
17.90 AHA NUBC Revenue Value Set
17.91 Claim Response Outcome
17.92 Claim Types
17.93 Metric Data Source
17.94 PAS Communication Medium Value Set
17.95 PAS Conformance Statement Categories
17.96 PAS Information Change Mode Value Set
17.97 PAS LOINC Attachment Codes Value Set
17.98 PAS PWK01 Attachment Report Type Code Value Set
17.99 PAS Supporting Info Type Value Set
17.100 PAS Task Codes
17.101 X12 278 CRC Condition Category
17.102 X12 278 CRC Condition Code
17.103 X12 278 Diagnosis Code Value Set
17.104 X12 278 Diagnosis Information Type
17.105 X12 278 Diagnosis Type Value Set
17.106 X12 278 Follow Up Action Value Set
17.107 X12 278 Health Care Service Location Type Value Set
17.108 X12 278 Nutrition Enteral Formula Type
17.109 X12 278 Nutrition Oral Diet Type
17.110 X12 278 Reject Reason Value Set
17.111 X12 278 Requested Service Modifier Type
17.112 X12 278 Requested Service Type
17.113 X12 278 Review Decision Reason Codes
17.114 PAS Temporary Codes
17.115 Additional Information Task Example
17.116 Authorization Response with Practitioner Requestor and Additional Content Example
17.117 Authorization Response with Practitioner Requestor Example
17.118 Communication Request Example
17.119 Device Request Example
17.120 Encounter Example
17.121 Error Response Bundle Example
17.122 Error Response Example
17.123 Homecare Authorization Bundle Example
17.124 Homecare Authorization Example
17.125 Homecare Authorization Update Bundle Example
17.126 Homecare Authorization Update Example
17.127 Invalid Request Response
17.128 Medical Services Authorization Bundle Example
17.129 Medical Services Authorization Example
17.130 Medication Request Example
17.131 Nutrition Order Example
17.132 PAS Claim Inquiry Example
17.133 PAS Claim Inquiry ResponseExample
17.134 PAS Document Reference Example
17.135 PAS Inquiry Operation Response Example
17.136 PAS Inquiry Request Bundle Example
17.137 PAS Inquiry Response Bundle Example
17.138 PAS Subscription example for a specific provider
17.139 PAS Subscription Notification example
17.140 PAS Subscription Notification Parameters
17.141 Pending Authorization Response with Practitioner Requestor Example
17.142 Referral Authorization Bundle Example
17.143 Referral Authorization Example
17.144 Referral Authorization Response Bundle Example
17.145 Referral Pending Authorization Response Bundle Example
17.146 Rejection Response Bundle Example
17.147 Rejection Response Example
17.148 Submit Claim Beneficiary Example
17.149 Submit Claim Insurance Example
17.150 Submit Claim Insurer Example
17.151 Submit Claim Referral Location Example
17.152 Submit Claim Referral Practitioner Example
17.153 Submit Claim Referral Practitioner Role Example
17.154 Submit Claim Referral Request Example
17.155 Submit Claim Requestor Example
17.156 Submit Claim Subscriber Example
17.157 Submit Claim Surgical Location Example
17.158 Submit Claim Surgical Practitioner Example
17.159 Submit Claim Surgical Practitioner Role Example
17.160 Surgical Admission Request Bundle Example
17.161 Surgical Request Authorization Example