Clinical Quality Framework Common FHIR Assets (US-Based), published by Clinical Quality Framework. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cqf-us/ and changes regularly. See the Directory of published versions

Table of Contents

0 Table of Contents

1 Home

2 Background

3 Use Cases

3.1 Prior Authorization Questionnaire Use Case

4 Architectural Guidance

5 Query Management

5.1 Authoring Documentation

5.2 Patterns

5.2.1 Condition Patterns

5.2.2 Coverage Patterns

5.2.3 Patient Patterns

5.3 Usage

6 Downloads

7 Tooling Support

8 Changes

9 Downloads

10 License

11 Artifacts Summary

11.1

11.2

11.3

11.4

11.5

11.6

11.7

11.8

11.9

11.10

11.11 Example Patient and Coverage Questionnaire

11.12 Genetic/Molecular testing preauthorization request

11.13 Medical Benefit Outpatient Drug Authorization Form

11.14 Medical Necessity For Authorization Of Catheters

11.15 Humana Uniform Pharmacy Prior Authorization Request Form

11.16 null (Bundle)

11.17 null (Bundle)

11.18 null (Bundle)

11.19 null (Bundle)

11.20 null (Bundle)

11.21