Goal: Develop a standard data exchange in support of patient cost transparency for devices, services and collection of services using FHIR APIs for exchange of data.
Phase 2 Goal Summary: Support Good Faith Estimate data exchange via FHIR APIs when multiple providers are involved
Objectives: Italicized is phase 2
- Define standard FHIR-based methodology (data input, data output and format) to support requests and responses for patient cost
- Ability to communicate good faith estimates (GFE) for single service, collection of services, and items from provider to payer
- Ability to communicate Advanced Explanation of Benefits (AEOB) in advance of scheduled service or upon request to patient and optionally, to provider.
Ability for convening provider to notify co-providers and request data to inform good faith estimates (GFE) for expected service(s) and item(s)
Ability for co-providers to respond to a request for data back to convenor (convening provider, third party, or payer) with cost and planned service(s) or item(s) information.
Ability for Coordination Platform to communicate GFE to Patient (leveraging existing FHIR API), payer (leveraging existing PCT IG workflow,) and to other providers in the care team, prior to scheduled service or upon request
Project Scope Statement: HL7 Project Scope Statement (PSS) for Patient Cost Transparency
Sponsoring Workgroup: Financial Management
Co-Sponsoring Workgroup: Payer/Provider Information Exchange (PPIE) (formerly Attachments)
PCT Implementation Guide:
STU1 Ballot Reconciliation:
Reference Implementation:
Server
Endpoint for testing: https://pct-payer.davinci.hl7.org/fhir
- Client
- https://github.com/HL7-DaVinci/pct-client
- Endpoint for testing: https://pct-client.davinci.hl7.org
- Test EHR (Provides data to client RI)
- https://github.com/HL7-DaVinci/test-pct-ehr
- Endpoint for testing: https://pct-ehr.davinci.hl7.org/fhir
Test Scripts: Touchstone Da Vinci PCT Test Scripts
Zulip Channel: https://chat.fhir.org/#narrow/stream/301151-Da-Vinci.20PCT
Project Milestones - Phase 2
Milestone | Timeframe |
---|---|
Requirements | Feb - June 2023 |
FHIR Gap Analysis | June - July 2023 |
Profile and Operation Development | July - Nov 2023 |
Test Case Development | Aug - Dec 2023 |
Connectathon | Jan 2024, May 2024 |
Reference Implementation (Updates) | Dec 2023 - Jan 2024 |
STU Ballot | May 2024 (Goal) |
Conference Call Schedule & Dial-Ins
NEW Day/Time as of 9/2023! Occurs weekly on Wednesday from 12:00 Noon PM to 1:00 PM ET
(Same Link)
Join Zoom Meeting: https://hl7-org.zoom.us/j/93358035002?pwd=MmJQc096bHBqdXFOaUlnTFpwc2wzZz09
Meeting ID: 933 5803 5002
Passcode: 8675309
One tap mobile
+13126266799,,93358035002# US (Chicago)
+16465588656,,93358035002# US (New York)
Ballot Milestone Goals:
Milestone | Ballot Deadlines |
---|---|
Notice of Intent to Ballot (NIB) | |
Ballot Signup Starts | |
Initial IG Content | |
Ballot QA Period | |
Final IG Content | |
Ballot Voting Starts | |
Ballot Voting Ends | |
Ballot Reconciliation Starts |
Patient Cost Transparency Team
Role | Name | Organization | |
Project Co-Lead (PMO/SME) | Point-of-Care Partners | vanessa.candelora@pocp.com | |
Project Co-Lead (Payer) | FL Blue | ||
Project Co-Lead (Provider) | Rev Cycle Leads | Providence St. Joseph | |
Project Co-Lead (Vendor) | Jacob Woodford | Epic | jwoodfor@epic.com |
IG Development Co-Lead | Lantana | ||
RI Development Co-Lead | Lantana | sean.mcilvenna@lantanagroup.com | |
Testing Lead | Ryan Moehrke | Aegis | ryan.moehrke@aegis.net |
Policy SME | Global Alliant, Inc. | denise.s@globalalliantinc.com | |
PMO/Technical Director | Stratametrics | ||
PMO/Program Manager | Point of Care Partners | jocelyn.keegan@pocp.com |
Links to Other Resources