CMS Interoperability and Prior Authorization Rule: Payer FHIR APIs
The CMS rules requiring payers to expose Patient Access, Provider Access, Payer-to-Payer and Prior Authorization APIs, and the Da Vinci guides behind them.
CMS Interoperability and Prior Authorization Rule: Payer FHIR APIs
Coming soon. This post is a placeholder in the US Healthcare learning path. The outline below is what it will cover.
What this post will cover
- The 21st Century Cures Act and information blocking
- CMS-9115-F and CMS-0057-F
- The four APIs: Patient Access, Provider Access, Payer-to-Payer, Prior Authorization
- Compliance deadlines and prior auth decision timeframes
- Da Vinci implementation guides: CRD, DTR and PAS
- How FHIR PAS maps to the X12 278, and TEFCA
Further watching
From the HealthTech Decoded channel:
Where this fits
Level 3 · Health data exchange › Clinical interoperability (HL7, FHIR, DICOM)
This post is licensed under CC BY 4.0 by the author.