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:

Test Scripts: Touchstone Da Vinci PCT Test Scripts

Zulip Channel: https://chat.fhir.org/#narrow/stream/301151-Da-Vinci.20PCT

Project Milestones - Phase 2




Feb - June 2023
FHIR Gap AnalysisJune - July 2023
Profile and Operation DevelopmentJuly - Nov 2023

Test Case Development

Aug - Dec 2023
ConnectathonJan 2024, May 2024
Reference Implementation  (Updates)Dec 2023 - Jan 2024
STU BallotMay 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:


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

RoleName OrganizationEmail 
Project Co-Lead (PMO/SME)Point-of-Care Partnersvanessa.candelora@pocp.com  
Project Co-Lead (Payer)

FL Blue


Project Co-Lead (Provider)Rev Cycle LeadsProvidence St. Joseph

Project Co-Lead (Vendor)Jacob WoodfordEpicjwoodfor@epic.com
IG Development Co-Lead Lantana


RI Development Co-LeadLantanasean.mcilvenna@lantanagroup.com
Testing LeadRyan Moehrke Aegisryan.moehrke@aegis.net
Policy SMEGlobal Alliant, Inc.denise.s@globalalliantinc.com 
PMO/Technical DirectorStratametrics


PMO/Program ManagerPoint of Care Partnersjocelyn.keegan@pocp.com 

  • No labels