2021-05-07 PDex Meeting

Da Vinci Implementer Support Page

Implementers can take advantage of tools: See the Reference links on the Payer Data Exchange (PDex) page to access links for Reference Implementations, sandboxes, test scripts, and more!

Da Vinci PDex for Patient Access API Frequently Asked Questions (FAQs)

CMS Final Rule Questions and Answers log

NEW link: ONC FAST National Healthcare Directory (including end points) solution page that includes links to everything (solution doc, Connectathon, HL7 workgroup, etc.): https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/National+Healthcare+Directory

Call to All Implementers: We learn as a community and iterate on the IGs through real world experience, so your contributions are welcome! Please come with your questions. Options:

1) Send them to us on Zulip: 

• PDex: https://chat.fhir.org/#narrow/stream/235286-Da-Vinci.20PDex - may be updated. Mark Scrimshire
• Formulary:  https://chat.fhir.org/#narrow/stream/197730-Da-Vinci.20PDex.20Drug.20Formulary
• Plan Net/ Directory: https://chat.fhir.org/#narrow/stream/229922-Da.2BVinci.2BPDex.2BPlan-Net
• tag Vanessa Candelorato make sure they get to this agenda if not answered. 

2) Ask questions live on the call

3) Edit and add your question to this page (in this box under "Question")

Share Proposed Resolution for   FHIR-28293 - Getting issue details... STATUS  

Reviewed 018 Proposed Response. 

Two separate questions: Can we get this data?  Can we publish that data? 

• Trying to encourage providers to add digital end points into the NPI record.  As we see more adoption, we will see more end points information available to share.  
• Now, you just need to prove you share it, if you have it. 
• CMS - need to share if you have it. 
• CAQH national FHIR end point directory - ONC FAST team focused on Payers, but will likely extend into the future for provider end points as well.  

Question on #017

• Can publish additional values from within the guide. e.g. drug tier.
• • has own plan-specific value set. 
  • how do we add a drug tier so the consumer understands it and can validate it. 
• There is a drug tier value set, but it's extensible. 
• Deductible - could be zero or could have a maintenance drug that is covered before the deductible, but others go through the deductible. 
• Value that is missing is a charge value - drug not subject to deductible, but there is a deductible otherwise. (not free, but not subject to deductible)
  • "Charge" isn't clear - so something like "excluded from deductible" or "outside of.."
  • "not subject to deductible" - people liked this. 
• Let's harmonize with the EOB. 
• This is in the drug tier definition extension. 
• Two uses: co-pay and co-insurance. 

David Hill- create a ticket and propose an update on this for next week.  

Adjourned at 12:51pm EST.

Source PowerPoint: PDEXandUSCoreRelationship.pptx

Source code is here: https://github.com/HL7/davinci-epdx

• Other Spreadsheets used to support tables in PDEX IG:

• PDEX-USCore3-1-1-2020-10-20-v5.xlsx
• PDEX-Plannet-formulary-2020-10-20-v3.xlsx
• Observation-FHIR_R4 v1.4.xlsx

HL7 FM PDEX What to Review 2020-10-20-v1.pptx