Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot 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-ballot 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 Formal Specification
... 8 Request for Additional Information
... 9 HIPAA Regulations
... 10 Privacy & Security
... 11 PAS Metrics
... 12 Artifacts Overview
... 13 PAS Terminology
... 14 Downloads
... 15 Change Log
... 16 PAS Outstanding Issues
... 17 Artifacts Summary
.... 17.1 EHR PAS Capabilities
.... 17.2 Intermediary PAS Capabilities
.... 17.3 Search for a Prior Authorization Response by example
.... 17.4 Submit a Prior Authorization Request for adjudication
.... 17.5 PAS Subscription Topic
.... 17.6 PAS Metric Data
.... 17.7 PAS Claim Base
.... 17.8 PAS Claim Response Base
.... 17.9 PAS Organization Base Profile
.... 17.10 PAS Beneficiary Patient
.... 17.11 PAS Claim
.... 17.12 PAS Claim Inquiry
.... 17.13 PAS Claim Inquiry Response
.... 17.14 PAS Claim Response
.... 17.15 PAS Claim Update
.... 17.16 PAS CommunicationRequest
.... 17.17 PAS Coverage
.... 17.18 PAS Device Request
.... 17.19 PAS Document Reference
.... 17.20 PAS Encounter
.... 17.21 PAS Inquiry Request Bundle
.... 17.22 PAS Inquiry Response Bundle
.... 17.23 PAS Insurer Organization
.... 17.24 PAS Location Profile
.... 17.25 PAS Medication Request
.... 17.26 PAS Nutrition Order
.... 17.27 PAS Practitioner
.... 17.28 PAS PractitionerRole
.... 17.29 PAS Request Bundle
.... 17.30 PAS Requestor Organization
.... 17.31 PAS Response Bundle
.... 17.32 PAS Service Request
.... 17.33 PAS Subscriber Patient
.... 17.34 PAS Subscription
.... 17.35 PAS Task
.... 17.36 PAS Identifier
.... 17.37 PAS Quantity
.... 17.38 PAS Timing
.... 17.39 AdministrationReferenceNumber
.... 17.40 AuthorizationNumber
.... 17.41 AuthorizedProviderType
.... 17.42 CalendarPattern
.... 17.43 CareTeamClaimScope
.... 17.44 CertificationEffectiveDate
.... 17.45 CertificationExpirationDate
.... 17.46 CertificationIssueDate
.... 17.47 CertificationType
.... 17.48 ClaimResponseItemCategory
.... 17.49 ClaimResponseReviewer
.... 17.50 CommunicatedDiagnosis
.... 17.51 ConditionCode
.... 17.52 ContentModifier
.... 17.53 DeliveryPattern
.... 17.54 DiagnosisRecordedDate
.... 17.55 DocumentInformation
.... 17.56 EPSDTIndicator
.... 17.57 ErrorElement
.... 17.58 ErrorFollowupAction
.... 17.59 ErrorPath
.... 17.60 HomeHealthCareInformation
.... 17.61 IdentifierJurisdiction
.... 17.62 IdentifierSubDepartment
.... 17.63 InfoCancelledFlag
.... 17.64 InfoChanged
.... 17.65 ItemAuthorizedDetail
.... 17.66 ItemAuthorizedProvider
.... 17.67 ItemPreAuthIssueDate
.... 17.68 ItemPreAuthPeriod
.... 17.69 ItemRequestedServiceDate
.... 17.70 ItemTraceNumber
.... 17.71 LevelOfServiceCode
.... 17.72 MilitaryStatus
.... 17.73 NursingHomeLevelOfCare
.... 17.74 NursingHomeResidentialStatus
.... 17.75 PatientStatus
.... 17.76 ProductOrServiceCodeEnd
.... 17.77 RequestedService
.... 17.78 RevenueCode
.... 17.79 RevenueUnitRateLimit
.... 17.80 ReviewAction
.... 17.81 ReviewActionCode
.... 17.82 ServiceItemRequestType
.... 17.83 ServiceLineNumber
.... 17.84 AHA NUBC Revenue Value Set
.... 17.85 Claim Response Outcome
.... 17.86 Claim Types
.... 17.87 Metric Data Source
.... 17.88 PAS Communication Medium Value Set
.... 17.89 PAS Information Change Mode Value Set
.... 17.90 PAS LOINC Attachment Codes Value Set
.... 17.91 PAS PWK01 Attachment Report Type Code Value Set
.... 17.92 PAS Supporting Info Type Value Set
.... 17.93 PAS Task Codes
.... 17.94 X12 278 CRC Condition Category
.... 17.95 X12 278 CRC Condition Code
.... 17.96 X12 278 Diagnosis Code Value Set
.... 17.97 X12 278 Diagnosis Information Type
.... 17.98 X12 278 Diagnosis Type Value Set
.... 17.99 X12 278 Follow Up Action Value Set
.... 17.100 X12 278 Health Care Service Location Type Value Set
.... 17.101 X12 278 Nutrition Enteral Formula Type
.... 17.102 X12 278 Nutrition Oral Diet Type
.... 17.103 X12 278 Reject Reason Value Set
.... 17.104 X12 278 Requested Service Modifier Type
.... 17.105 X12 278 Requested Service Type
.... 17.106 X12 278 Review Decision Reason Codes
.... 17.107 PAS Temporary Codes
.... 17.108 Additional Information Task Example
.... 17.109 Authorization Response with Practitioner Requestor and Additional Content Example
.... 17.110 Authorization Response with Practitioner Requestor Example
.... 17.111 Communication Request Example
.... 17.112 Device Request Example
.... 17.113 Encounter Example
.... 17.114 Error Response Bundle Example
.... 17.115 Error Response Example
.... 17.116 Homecare Authorization Bundle Example
.... 17.117 Homecare Authorization Example
.... 17.118 Homecare Authorization Update Bundle Example
.... 17.119 Homecare Authorization Update Example
.... 17.120 Invalid Request Response
.... 17.121 Medical Services Authorization Bundle Example
.... 17.122 Medical Services Authorization Example
.... 17.123 Medication Request Example
.... 17.124 Nutrition Order Example
.... 17.125 PAS Claim Inquiry Example
.... 17.126 PAS Claim Inquiry ResponseExample
.... 17.127 PAS Document Reference Example
.... 17.128 PAS Inquiry Request Bundle Example
.... 17.129 PAS Inquiry Response Bundle Example
.... 17.130 PAS Subscription example for a specific provider
.... 17.131 PAS Subscription Notification example
.... 17.132 PAS Subscription Notification Parameters
.... 17.133 Pending Authorization Response with Practitioner Requestor Example
.... 17.134 Referral Authorization Bundle Example
.... 17.135 Referral Authorization Example
.... 17.136 Referral Authorization Response Bundle Example
.... 17.137 Referral Pending Authorization Response Bundle Example
.... 17.138 Rejection Response Bundle Example
.... 17.139 Rejection Response Example
.... 17.140 Submit Claim Beneficiary Example
.... 17.141 Submit Claim Insurance Example
.... 17.142 Submit Claim Insurer Example
.... 17.143 Submit Claim Referral Location Example
.... 17.144 Submit Claim Referral Practitioner Example
.... 17.145 Submit Claim Referral Practitioner Role Example
.... 17.146 Submit Claim Referral Request Example
.... 17.147 Submit Claim Requestor Example
.... 17.148 Submit Claim Subscriber Example
.... 17.149 Submit Claim Surgical Location Example
.... 17.150 Submit Claim Surgical Practitioner Example
.... 17.151 Submit Claim Surgical Practitioner Role Example
.... 17.152 Surgical Admission Request Bundle Example
.... 17.153 Surgical Request Authorization Example