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  1. FHIR Specification Feedback
  2. FHIR-36587

revise list of methods to submit additional information

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Highest Highest
    • US Da Vinci PAS (FHIR)
    • 1.2.0-ballot [deprecated]
    • Financial Mgmt
    • STU
    • Use Cases and Overview
    • 2.3.7
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      Change this section to read as follows:

      If additional information is needed, the provider can satisfy the request for additional information in one of the following ways:

      1. Via a CDex Submit-Attachment operation based on the X12 278 request for additional information
      2. Via a CDex Submit-Attachment operation where the LOINC code indicated a specific Questionnaire exists on the Payers Operation endpoint using the tracing ID as the business identifier
      3. An X12 275 response (by provider) to a X12 278 response (as represented in the response FHIR bundle)

      Here is a diagram that shows the workflow associated with a request for additional information:

      (need to update the drawing)

      Show
      Change this section to read as follows: If additional information is needed, the provider can satisfy the request for additional information in one of the following ways: Via a CDex Submit-Attachment operation based on the X12 278 request for additional information Via a CDex Submit-Attachment operation where the LOINC code indicated a specific Questionnaire exists on the Payers Operation endpoint using the tracing ID as the business identifier An X12 275 response (by provider) to a X12 278 response (as represented in the response FHIR bundle) Here is a diagram that shows the workflow associated with a request for additional information: (need to update the drawing)
    • Bob Dieterle / Rachael Foerster : 10-0-1
    • Clarification
    • Non-substantive

    Description

      See list in section 2.3.7

      #1 should not be an option. It is worrisome that a payer would be deem conformant with this IG by requesting additional information via FAX.

      #4 is not clear – how would the provider know to resubmit? You need to spell out how the payer is going to tell the provider to resubmit and what additional info is needed.

      To be conformant with the IG the supporting information SHOULD be requested in an automated way and within the same workflow (i.e. no fax/mail/proprietary solutions like portals).

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            celine_lefebvre Celine Lefebvre
            Celine Lefebvre
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              Updated:
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