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TrackSummary - Description (Focus for Oct)Track LeadDayDa Vinci Community Ask

List your name if planning on participating

Burden Reduction 

Our Goal is to test CRD/DTR/PAS interoperability with as many interested parties as possible. e.g. EHR vendors, Providers, Payers, and others. The Da Vinci Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Auth Support (PAS) Implementation Guides (IGs) together support an integrated workflow to enable automated submission of required documentation and/or prior authorization from EHR and payer systems respectively. The use of these IGs is likely to be mandated as part of regulation. We have had past connectathon testing of CRD, DTR, and PAS. This track will ensure that the IGs work appropriately, independently, as well as in concert.

TBD

Tues 10/27
  1. Additional Testers
MITRE, Mettle Solutions, MCG
PDex Payer to Payer

Testing of changes to the Payer Data Exchange IG that are being incorporated into the STU2 version of the guide.  There will be an opportunity for payers to test their exchange solutions with other payers, and for apps to test against Patient Access API servers.  This track will also test the HRex changes to member match and the mutual TLS and authorization with consent process.

PDex: 

  • Mapping for Dental and Vision
  • The EOB format for Prior Authorization status and information in PDex. 
  • Payer Data Exchange Business To Business Flow using MemberMatch/MemberAccess
Mark Scrimshire Tues 10/26 and Wed 10/27
  1. Additional Testers
ZeOmega
PDex Formulary and PlanNet

This Da Vinci track brings together the Drug Formulary and Plan-Net IGs that are cited by CMS to enable payers to comply with the Patient Access API rule. For payers this is an opportunity to test out their APIs with reference applications. For Consumer applications this is an opportunity to connect with payers and test your apps against the Drug Formulary and Plan-Net Patient Access APIs.

Formulary - testing the whole IG with relationship changes, but also specific testing needs: 

    1. Testing QuantityLimitDetail extension
    2. More robust (real world scenario) search testing
    3. Additional Testers

Plan Net:

1) Testing more than the previous "snapshot" of active providers, need to test the status and active dates for providers getting added and ended (contract periods.) to support enrollment period changes and the CAA requirement for notification of changes within 48hours. 

Tues 10/26 and Wed 10/27
  1. Additional Testers

Risk Adjustment

This is the second testing event to test the new Da Vinci Risk Adjustment Implementation Guide that is currently under active development. The STU1 of this IG is targeted for the January 2022 Ballot Cycle. 

  • Test the $report operation specified in the implementation guide 
  • Test the profiles specified in the IG
  • Test the results of the $report operation
Yan Heras Tues 10/26 (may extend)
  1. Additional Testers

Alphora 

PJM Consulting LLC

Novillus 

Optum


Patient Cost Transparency (PCT)

This is the first Testing event to test the new Da Vinci PCT Implementation Guide that is currently under active development. The STU1 of this IG is targeted for the January 2022 Ballot Cycle. 

  • Test the AEOB request/response
Wed 10/27
  1. Additional Testers
MITRE, SmileCDR
CDex

This track will continue the work of several past connectathon tracks testing out the HRex and CDex implementation guides.  (CDex depends on components defined in HRex.)

NOTE: Unlike past connectathons, this track will not incorporate the PCDE implementation guide as PCDE development work is on hold until Jan. 2022.

 The specific aspects of the IGs that will be a focus of this track include:

  • Testing the subscription/notification messaging approach for CDex.
  • Time allowing, experiment with mechanisms for asynchronous delivery of information
Eric Haas 

Cancelled.

Cancelled.
Member Attribution

The Testing event will exercise the Risk Based Contract Member Attribution List FHIR IG. The Phase 2 work we are looking to test with partners are:

  • Scenario 5: Consumer creates PATIENT, PRACTITIONER and ORGANIZATION resources
  • Scenario 6: Consumer creates Group resource:
  • Scenario 7: Consumer modifies Group resource
  • Scenario 8: Consumer modifies Group resource

  1. Additional Testers = Providers using DPC. 
Cancelled.

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