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Publication Request

Publication Request

1. Published Name of the Standard for which request is being made

Da Vinci - Coverage Requirements Discovery

2. Standards Material/Document


3. Date of Request

Dec 01, 2020

4. Use Period

2 years

5. Reason for extension, timeline, and actions

6. Original Publication Date

7. End date of the current STU period

Dec 01, 2022

8. Length of the requested extension

9. Review Process

10. HL7 Work Group making this request and date

Financial Management

10a. Requesting WG Date

Dec 01, 2020

11. URL of approval minutes

12. HL7 Product Management Group


12a. Management Group Date of Approval

Dec 02, 2020

13. URL of approval minutes

14. Is the artifact ready for final publication?


15. If not ready, please describe remaining steps.

A snapshot must be made of the SDC specification that CRD can point to. (SDC will not be published until January.)

16. Tool name used to produce the machine processable artifacts in the IG

HL7 IG Publisher

17. The name of the “IG artifact” within the context of the above mentioned tool.

Da Vinci - Coverage Requirements Discovery

18. Balloted Name of the standard for which request is being made

Ballot name was HL7 FHIR® Implementation Guide: Coverage Requirements Discovery, Release 1 - US Realm

19. Requested name for published standard

Da Vinci - Coverage Requirements Discovery (CRD)

20. If CMET, list IDs balloted

21. Project Insight Number


22. Document Realm


23. Ballot cycle in which the document was successfully balloted


24. Results of that ballot (following reconciliation activities):

24. Results of that ballot (following reconciliation activities):

(not needed for errata, STU extension, or unballoted STU update)

25. Affirmative


26. Negative


27. Abstentions


28. Not Returned


29. Total in ballot pool


30. Date on which final document/standards material was supplied to HQ

Nov 25, 2020

31. URL of publication material/ SVN repository

32. Publishing Facilitator

Lloyd McKenzie

33. Special Publication Instructions

34. URL of ballot reconciliation document

35. Has the Work Group posted its consideration of all comments received in its reconciliation document on the ballot desktop?


36. Substantive Changes Since Last Ballot?


37. Product Brief Reviewed By

Financial Management

38. Date Product Brief Reviewed

Dec 01, 2020

39. Has the Product Brief changed?

Product Brief

Product Brief

40. Family


41. Section

Clinical and Administrative Domains

42. Topic

Financial Management

43. Please Describe the Topic

44. Product Type

Implementation Guide

45. Parent standard


46. Parent Standard Status


47. Update/replace standard


48. Common name/search keyword


49. Description

Provides a mechanism for healthcare providers to discover guidelines, pre-authorization requirements and other expectations from payor organizations related to a proposed medication, procedure or other service associated with a patient's insurance coverage. Supports both patient-specific and patient-independent information retrieval.



These are categories of potential users, implementers, or other interested parties such as those that are indicated on the Project Scope Statement under “Stakeholders/Vendors/Providers”. Select those that are applicable, or suggest others:

50. Stakeholders


51. Vendors


52. Providers

Emergency Services Healthcare Institutions (hospitals, long term care, home care, mental health) Other (specify in text box below)

53. Benefits

Ensures providers are aware of payer-specific requirements at the time of decision-making. Reduces provider burden by simplifying prior authorization processes. Allows awareness of coverage to be considered as part of planning patient care.

54. Implementations/Case Studies

Reference implementation created by MITRE.
Test implementation by Mettle Solutions

55. Development Background

This specification was created as part of the Da Vinci project with significant participation from the U.S. Payer community as well as several EHR software vendors.