Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0-preview - STU 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 2.1.0-preview 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 Use Cases and Overview
... 3 Request for Additional Information
... 4 Technical Background
... 5 HIPAA Regulations
... 6 Formal Specification
... 7 Privacy & Security
... 8 PAS ePA Coordinator Information
... 9 PAS Metrics
... 10 Downloads
... 11 Credits
... 12 Artifacts Overview
... 13 Change Log
... 14 Artifacts Summary
.... 14.1 EHR PAS Capabilities
.... 14.2 Intermediary PAS Capabilities
.... 14.3 Search for a Prior Authorization Response by example
.... 14.4 Submit a Prior Authorization Request for adjudication
.... 14.5 PAS Metric Data
.... 14.6 PAS Claim Base
.... 14.7 PAS Claim Response Base
.... 14.8 PAS Organization Base Profile
.... 14.9 PAS Beneficiary Patient
.... 14.10 PAS Claim
.... 14.11 PAS Claim Inquiry
.... 14.12 PAS Claim Inquiry Response
.... 14.13 PAS Claim Response
.... 14.14 PAS Claim Update
.... 14.15 PAS CommunicationRequest
.... 14.16 PAS Coverage
.... 14.17 PAS Device Request
.... 14.18 PAS Encounter
.... 14.19 PAS Inquiry Request Bundle
.... 14.20 PAS Inquiry Response Bundle
.... 14.21 PAS Insurer Organization
.... 14.22 PAS Location Profile
.... 14.23 PAS Medication Request
.... 14.24 PAS Nutrition Order
.... 14.25 PAS Practitioner
.... 14.26 PAS PractitionerRole
.... 14.27 PAS Request Bundle
.... 14.28 PAS Requestor Organization
.... 14.29 PAS Response Bundle
.... 14.30 PAS Service Request
.... 14.31 PAS Subscriber Patient
.... 14.32 PAS Task
.... 14.33 PAS Identifier
.... 14.34 PAS Timing
.... 14.35 AdministrationReferenceNumber
.... 14.36 AuthorizationNumber
.... 14.37 CalendarPattern
.... 14.38 CareTeamClaimScope
.... 14.39 CertificationEffectiveDate
.... 14.40 CertificationExpirationDate
.... 14.41 CertificationIssueDate
.... 14.42 CertificationType
.... 14.43 CommunicatedDiagnosis
.... 14.44 ConditionCode
.... 14.45 ContentModifier
.... 14.46 DeliveryPattern
.... 14.47 DiagnosisRecordedDate
.... 14.48 EPSDTIndicator
.... 14.49 ErrorElement
.... 14.50 ErrorFollowupAction
.... 14.51 ErrorPath
.... 14.52 HomeHealthCareInformation
.... 14.53 IdentifierJurisdiction
.... 14.54 IdentifierSubDepartment
.... 14.55 InfoCancelledFlag
.... 14.56 InfoChanged
.... 14.57 ItemAuthorizedDetail
.... 14.58 ItemAuthorizedProvider
.... 14.59 ItemPreAuthIssueDate
.... 14.60 ItemPreAuthPeriod
.... 14.61 ItemRequestedServiceDate
.... 14.62 ItemTraceNumber
.... 14.63 LevelOfServiceCode
.... 14.64 MilitaryStatus
.... 14.65 NursingHomeLevelOfCare
.... 14.66 NursingHomeResidentialStatus
.... 14.67 PALineNumber
.... 14.68 PatientStatus
.... 14.69 ProductOrServiceCodeEnd
.... 14.70 RequestedService
.... 14.71 RevenueUnitRateLimit
.... 14.72 ReviewAction
.... 14.73 ReviewActionCode
.... 14.74 ServiceItemRequestType
.... 14.75 ServiceLineNumber
.... 14.76 AHA NUBC Revenue Value Set
.... 14.77 Metric Data Source
.... 14.78 PAS Communication Medium Value Set
.... 14.79 PAS Information Change Mode Value Set
.... 14.80 PAS LOINC Attachment Codes Value Set
.... 14.81 PAS PWK01 Attachment Report Type Code Value Set
.... 14.82 PAS Supporting Info Type Value Set
.... 14.83 PAS Task Codes
.... 14.84 X12 278 CRC Condition Category
.... 14.85 X12 278 CRC Condition Code
.... 14.86 X12 278 Diagnosis Code Value Set
.... 14.87 X12 278 Diagnosis Information Type
.... 14.88 X12 278 Diagnosis Type Value Set
.... 14.89 X12 278 Follow Up Action Value Set
.... 14.90 X12 278 Health Care Service Location Type Value Set
.... 14.91 X12 278 Nutrition Enteral Formula Type
.... 14.92 X12 278 Nutrition Oral Diet Type
.... 14.93 X12 278 Reject Reason Value Set
.... 14.94 X12 278 Requested Service Modifier Type
.... 14.95 X12 278 Requested Service Type
.... 14.96 X12 278 Review Decision Reason Codes
.... 14.97 PAS Temporary Codes
.... 14.98 Additional Information Task Example
.... 14.99 Authorization Response with Practitioner Requestor Example
.... 14.100 Communication Request Example
.... 14.101 Device Request Example
.... 14.102 Encounter Example
.... 14.103 Error Response Bundle Example
.... 14.104 Error Response Example
.... 14.105 Homecare Authorization Bundle Example
.... 14.106 Homecare Authorization Differential Update Bundle Example
.... 14.107 Homecare Authorization Differential Update Example
.... 14.108 Homecare Authorization Example
.... 14.109 Homecare Authorization Update Bundle Example
.... 14.110 Homecare Authorization Update Example
.... 14.111 Medical Services Authorization Bundle Example
.... 14.112 Medical Services Authorization Example
.... 14.113 Medication Request Example
.... 14.114 Nutrition Order Example
.... 14.115 PAS Claim Inquiry Example
.... 14.116 PAS Claim Inquiry ResponseExample
.... 14.117 PAS Inquiry Request Bundle Example
.... 14.118 PAS Inquiry Response Bundle Example
.... 14.119 PAS Subscription example for a specific provider
.... 14.120 PAS Subscription Notification example
.... 14.121 PAS Subscription Notification Parameters
.... 14.122 Pending Authorization Response with Practitioner Requestor Example
.... 14.123 Referral Authorization Bundle Example
.... 14.124 Referral Authorization Example
.... 14.125 Referral Authorization Response Bundle Example
.... 14.126 Referral Pending Authorization Response Bundle Example
.... 14.127 Rejection Response Bundle Example
.... 14.128 Rejection Response Example
.... 14.129 Submit Claim Beneficiary Example
.... 14.130 Submit Claim Insurance Example
.... 14.131 Submit Claim Insurer Example
.... 14.132 Submit Claim Referral Location Example
.... 14.133 Submit Claim Referral Practitioner Example
.... 14.134 Submit Claim Referral Practitioner Role Example
.... 14.135 Submit Claim Referral Request Example
.... 14.136 Submit Claim Requestor Example
.... 14.137 Submit Claim Subscriber Example
.... 14.138 Submit Claim Surgical Location Example
.... 14.139 Submit Claim Surgical Practitioner Example
.... 14.140 Submit Claim Surgical Practitioner Role Example
.... 14.141 Surgical Admission Request Bundle Example
.... 14.142 Surgical Request Authorization Example
.... 14.143 PAS Subscription