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Objective:

Define FHIR based services to enable provider, at point of service, to request authorization (including all necessary clinical information to support the request)  and receive immediate authorization. 

Sponsoring Workgroup: Financial Management

Prior Authorization Support Implementation Guide:

Project Milestones

Milestone

Timeframe

Requirements

March 2019
FHIR Gap AnalysisMarch 2019
Profile and Operation DevelopmentMarch 2019
Connectathon Scenario Definition and PlanningMarch/ April 2019

Test Case Development

May 2019
ConnectathonMay 2019
Reference ImplementationJune 2019
STU BallotSept 2019

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Conference Call Schedule & Dial-Ins

Fridays at 3pm Eastern

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September Ballot Milestones

Milestone

September Ballot Deadlines (2019)

Notice of Intent to Ballot

June 30, 2019
Ballot Signup StartsJuly 8, 2019

Initial IG Content

July 14, 2019
Ballot QA PeriodJuly 21, 2019

Final IG Content

August 4, 2019

Ballot Voting Starts

August 9, 2019

Ballot Voting Ends

September 9, 2019

Ballot Reconciliation Starts

September 2019

Prior Authorization Support Team:

RoleName OrganizationEmail 
Project Co-LeadBob DieterleEnablecarerdieterle@enablecare.us
Project Co-LeadAnupam GoelUnited Healthcare
Implementation Guide LeadLloyd McKenzieGevitylloyd@lmckenzie.com
Reference Implementation LeadGary GryanMitreggryan@mitre.org
Program ManagerJocelyn KeeganPoint of Care Partnersjocelyn.keegan@pocp.com
Technical DirectorDr. Viet NguyenStratametrics vietnguyen@stratametrics.com 
Project ManagerDana MarcelonisPoint of Care Partnersdana.marcelonis@pocp.com


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