Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - 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 2.0.1 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 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 Submit a Claim resource for adjudication
.... 14.4 Submit a Claim resource for inquiry
.... 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 Attachment Request Codes
.... 14.78 Metric Data Source
.... 14.79 PAS Communication Medium Value Set
.... 14.80 PAS Information Change Mode Value Set
.... 14.81 PAS Supporting Info Type Value Set
.... 14.82 PAS Task Codes
.... 14.83 X12 278 CRC Condition Category
.... 14.84 X12 278 CRC Condition Code
.... 14.85 X12 278 Diagnosis Code Value Set
.... 14.86 X12 278 Diagnosis Information Type
.... 14.87 X12 278 Diagnosis Type Value Set
.... 14.88 X12 278 Follow Up Action Value Set
.... 14.89 X12 278 Health Care Service Location Type Value Set
.... 14.90 X12 278 Nutrition Enteral Formula Type
.... 14.91 X12 278 Nutrition Oral Diet Type
.... 14.92 X12 278 Reject Reason Value Set
.... 14.93 X12 278 Requested Service Modifier Type
.... 14.94 X12 278 Requested Service Type
.... 14.95 X12 278 Review Decision Reason Codes
.... 14.96 PAS Temporary Codes
.... 14.97 Additional Information Task Example
.... 14.98 Authorization Response with Practitioner Requestor Example
.... 14.99 Communication Request Example
.... 14.100 Device Request Example
.... 14.101 Encounter Example
.... 14.102 Error Response Bundle Example
.... 14.103 Error Response Example
.... 14.104 Homecare Authorization Bundle Example
.... 14.105 Homecare Authorization Differential Update Bundle Example
.... 14.106 Homecare Authorization Differential Update Example
.... 14.107 Homecare Authorization Example
.... 14.108 Homecare Authorization Update Bundle Example
.... 14.109 Homecare Authorization Update Example
.... 14.110 Medical Services Authorization Bundle Example
.... 14.111 Medical Services Authorization Example
.... 14.112 Medication Request Example
.... 14.113 Nutrition Order Example
.... 14.114 PAS Claim Inquiry Example
.... 14.115 PAS Claim Inquiry ResponseExample
.... 14.116 PAS Inquiry Request Bundle Example
.... 14.117 PAS Inquiry Response Bundle Example
.... 14.118 Referral Authorization Bundle Example
.... 14.119 Referral Authorization Example
.... 14.120 Referral Authorization Response Bundle Example
.... 14.121 Referral Authorization Response Example
.... 14.122 Submit Claim Beneficiary Example
.... 14.123 Submit Claim Insurance Example
.... 14.124 Submit Claim Insurer Example
.... 14.125 Submit Claim Referral Location Example
.... 14.126 Submit Claim Referral Practitioner Example
.... 14.127 Submit Claim Referral Practitioner Role Example
.... 14.128 Submit Claim Referral Request Example
.... 14.129 Submit Claim Requestor Example
.... 14.130 Submit Claim Subscriber Example
.... 14.131 Submit Claim Surgical Location Example
.... 14.132 Submit Claim Surgical Practitioner Example
.... 14.133 Submit Claim Surgical Practitioner Role Example
.... 14.134 Surgical Admission Request Bundle Example
.... 14.135 Surgical Request Authorization Example
.... 14.136 PAS Subscription