This wiki has undergone a migration to Confluence found Here
Difference between revisions of "201609 Attachments"
Jump to navigation
Jump to search
| Line 1: | Line 1: | ||
| − | [[Category:201609_FHIR_Connectathon_Track_Proposals| | + | [[Category:201609_FHIR_Connectathon_Track_Proposals|September 2016 Proposals]] |
__NOTOC__ | __NOTOC__ | ||
=Attachments= | =Attachments= | ||
Revision as of 17:10, 17 June 2016
Attachments
Submitting WG/Project/Implementer Group
Attachments Work Group (AWG)
Justification
Electronic attachments are a high priority for processing claims and other payer/provider interactions. Current thinking has attachment submissions occurring via X12 messaging. However, there is substantial interest in experimenting with FHIR-based messaging for exchanging attachments. This track will explore the feasibility of this approach.
Proposed Track Lead
See Connectathon_Track_Lead_Responsibilities
- Rick Geimer
- Email: rick dot geimer at lantanagroup dot com
- Skype: rgeimer
- Co-leads, Paul Knapp, Durwin Day
Expected participants
- BCBS
- HCSC
- BCBSAL
- Anthem
- Optum
Roles
Please include information here regarding how much advance preparation will be required if creating a client and/or server.
Payer
Provider
Scenarios
For all scenarios below, the following types of attachments are allowed:
- PDF attachment
- Unstructured C-CDA attachment
- Structured C-CDA attachment
- C-CDA on FHIR attachment
Prior Authorization
- Action: Provider creates an attachment and sends it to the payer.
- Precondition: Prior authorization has occurred, and the provider has an id (i.e. electronic staple) to associate the attachment with the claim.
- Success Criteria: Payer receives the attachment and is able to view it.
- Bonus point:
Solicited
- Action: Payor sends an attachment request to the provider. Onus is on the payer to create the staple between the request and the attachment. Provider must return the payer's electronic staple (i.e. ID) with the attachment.
- Precondition: None
- Success Criteria: Provider receives the request, responds with the attachment, payer receives the attachment and is able to view it in their system.
- Bonus point:
Unsolicited
- Action: Provider sends an attachment to the payer in support of a claim without a request. Onus on the provider to create the electronic staple (i.e. matching IDs) between the claim and the attachment.
- Precondition: Prior agreement in place between payer and provider.
- Success Criteria: Payer receives the attachment and is able to view it in their system.
- Bonus point:
