PSS for CARIN IG for Digital Insurance Card

1a. Project Name CARIN IG for Digital Insurance Card 1b. Project ID 1697 1c. Is Your Project an Investigative Project (aka PSS-Lite)? No 1d. Is your Project Artifact being Reaffirmed or proceeding to Normative directly after being either Informative or STU? No 1e. Today's Date 1f. Name of standard being reaffirmed 1g. Project Artifact Information 1h. ISO/IEC Standard to Adopt 1i. Does the standard include excerpted text from one or more ISO, IEC or ISO/IEC standards, but is not an identical or modified adoption? 1j. Unit of Measure 2a. Primary/Sponsor WG Payer/Provider Information Exchange 2b. Co-Sponsor WG Financial Management 2c. Co-Sponsor Level of Involvement Request formal content review prior to ballot 2d. Project Facilitator Mark Roberts, Adam Culbertson, Cille Kissel 2e. Other Interested Parties (and roles) Vocabulary 2f. Modeling Facilitator 2g. Publishing Facilitator Mark Roberts, Adam Culbertson, Cille Kissel 2h. Vocabulary Facilitator Cille Kissel, Mark Roberts, Adam Culbertson 2i. Domain Expert Representative 2j. Business Requirements Analyst 2k. Conformance Facilitator Mark Roberts, Adam Culbertson, Cille Kissel 2l. Other Facilitators 2m. Implementers Humana, Cambia Health 3a. Project Scope This project is intended to develop artifacts (FHIR implementation guides, code mappings, reference implementations, etc) to retrieve proof of insurance coverage information via FHIR when requested or shared by a Patient in order to create an electronic rendering of the insurance membership card within a digital application. The information returned must meet the following requirements: - Maintains parity with other FHIR resource that utilize similar data (Coverage, Patient, InsurancePlan, etc) - Consistent with regulatory requirements for Patient Access, etc - May be accessed in a synchronous workflow - Meets practical business needs of providers/vendors that use this data in their workflows The existing Coverage FHIR resource enables some of the insurance coverage information relevant to the member to be exchanged, but there are gaps which prevent the possibility of displaying a full digital rendering of the insurance card. The implementation guide for this project will include instructions, reference mappings, and sample implementations to enable insurers to express additional information such as Group ID, Network Name, Plan Logo, RxBIN, etc. The IG may incorporate elements from the WEDI Health ID IG where appropriate. This FHIR implementation guide will use the US Core profiles. If this FHIR implementation guide is unable to use a US Core profile, we will request approval from the US Realm Steering Committee, and provide the US Realm Steering Committee an approved rationale for deviation in the implementation guide where applicable Attachments 3b. Project Need We believe there are app developers who are interested in developing a digital rendering of the physical insurance card mapped via FHIR. 3c. Security Risk No 3d. External Drivers 3e. Objectives/Deliverables and Target Dates 5/2021 - Draft implementation guide published 5/2021 - Connectathon 6/2021 - Development and Connectathon outcomes documented and presented to PIE Work Group 7/2021 - Ballot material approved by PIE Work Group 9/2021 - STU Ballot 1/2022 - Publish 2023 Re-Ballot 3f. Common Names / Keywords / Aliases: CARIN, Digital Membership ID, Digital Insurance Card 3g. Lineage 3h. Project Dependencies None. 3i. HL7-Managed Project Document Repository URL: https://confluence.hl7.org/display/CAR/CARIN+IG+for+Digital+Membership+ID 3j. Backwards Compatibility N/A 3k. Additional Backwards Compatibility Information (if applicable) 3l. Using Current V3 Data Types? N/A 3l. Reason for not using current V3 data types? 3m. External Vocabularies N/A 3n. List of Vocabularies 3o. Earliest prior release and/or version to which the compatibility applies None. 4a. Products Electronic Health Record (EHR) Functional Profile, FHIR Extensions, FHIR Implementation Guide, FHIR Resources, Guidance (e.g. Companion Guide, Cookbook, etc) 4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to? R4 4c. FHIR Profiles Version 4d. Please define your New Product Definition 4d. Please define your New Product Family 5a. Project Intent Supplement to a current standard 5a. White Paper Type 5a. Is the project adopting/endorsing an externally developed IG? 5a. Externally developed IG is to be (select one) 5a. Specify external organization 5a. Revising Current Standard Info 5b. Project Ballot Type STU to Normative 5c. Additional Ballot Info 5d. Joint Copyright No 5e. I understand I must submit a Joint Copyright Letter of Agreement to the TSC in order for the PSS to receive TSC approval. no 6a. External Project Collaboration CARIN Alliance 6b. Content Already Developed 10% 6c. Content externally developed? Yes 6d. List Developers of Externally Developed Content Adam Culbertson and Cille Kissel 6e. Is this a hosted (externally funded) project? Yes 6f. Stakeholders Payors, Other 6f. Other Stakeholders Patients, Providers, Insurance companies, App developers 6g. Vendors EHR, PHR, Equipment, Health Care IT 6g. Other Vendors 6h. Providers Healthcare Institutions (hospitals, long term care, home care, mental health) 6h. Other Providers 6i. Realm U.S. Realm Specific 7d. US Realm Approval Date Apr 06, 2021 7a. Management Group(s) to Review PSS FHIR 7b. Sponsoring WG Approval Date Mar 30, 2021 7c. Co-Sponsor Approval Date Apr 06, 2021 7c. Co-Sponsor 2 Approval Date 7c. Co-Sponsor 3 Approval Date 7c. Co-Sponsor 4 Approval Date 7c. Co-Sponsor 5 Approval Date 7c. Co-Sponsor 6 Approval Date 7c. Co-Sponsor 7 Approval Date 7c. Co-Sponsor 8 Approval Date 7c. Co-Sponsor 9 Approval Date 7c. Co-Sponsor 10 Approval Date 7e. CDA MG Approval Date 7f. FMG Approval Date Apr 07, 2021 7g. V2 MG Approval Date 7h. Architecture Review Board Approval Date 7i. Steering Division Approval Date Apr 19, 2021 7j. TSC Approval Date May 03, 2021