Project Scope Statement 

FHIR IG Proposal

  • This implementation guide is intended to define exchange methods that support communication of risk based coding gaps among different stakeholders such as payers, providers, and government managed care programs. The focus of this IG is to drive accurate and complete documentation of health conditions for members/patients that would lead to improved quality of care, follow up and outcomes, in addition to more accurate risk-adjusted payment calculations and reduced administrative burdens. 
  • STU1 focused on exchanging risk adjustment coding gap reports from payers to providers.
  • STU2 focuses on exchanging risk adjustment coding gap reports from providers back to certified coders and to payers.

Sponsoring Workgroup: Clinical Quality Information (CQI)

RA Implementation Guide:

STU Ballot Reconciliation and IG Jira Trackers:

Reference Implementation:

Test Scripts: Touchstone Da Vinci RA Test Scripts

Zulip Channel: 

Phase One Introduction and Scope

Phase Two Introduction and Scope

Project Milestones




April-May 2021
FHIR Gap AnalysisMay-June 2021
FHIR IG DevelopmentMay- November 2021

Test Case Development

June-October 2021
ConnectathonSeptember 2021
Reference ImplementationJuly 2021-
STU1 BallotJanuary 2022
STU1 Publication June 16th,  2022
STU2 BallotMay 2023

Conference Call Schedule & Dial-Ins

Thursdays at 3pm ET

See: Da Vinci Use Cases#WeeklyMeetingSchedule

May2023 Ballot Milestones


Ballot Deadlines 

Ballot Signup Ends


Ballot Voting Starts


Ballot Voting Ends


Risk Adjustment Team :

RoleName OrganizationEmail 
Project Co-LeadOptimum 
Project Co-LeadStratametrics 
Project Co-LeadProvidence St.
Project Co-LeadNovillus

Implementation Guide

Implementation Guide Co-Lead

Optimum eHealth 

Reference Implementation LeadSmile
Project ManagementTeresa Younkin Point of Care
PMO/Program ManagerPoint of Care 

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