Payer Data Exchange (PDex) is preparing an STU2 version of the IG. This will incorporate changes to support anticipated regulatory changes related to Burden Reduction. This track will be testing out the changes to the IG made for the STU2 Early May Ballot Submission.
Testing of changes to the Payer Data Exchange IG that have been incorporated into the balloted STU2 version of the guide. With an impending NPRM that may address Payer-to-Payer Exchange this will be an opportunity for payers to test their exchange solutions with other payers. There will also be the opportunity for apps to test the Prior Authorization Profile that was added to the IG to support regulatory changes related to Burden Reduction.
Test an Implementation Guide
Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group
Mark Scrimshire <firstname.lastname@example.org>; Bob Dieterle <email@example.com>; Co-lead : Ezequiel (EZ) Morales <firstname.lastname@example.org>
Track Lead Email(s)
Payer Data Exchange is aligned with PDex Plan-Net (Provider Directory) and PDex US Drug Formulary. There may also be overlap with the CARIN Blue Button IG. PDex also leverages profiles and operations from the Health Record Exchange (HRex) IG. The Prior Authorization profile is based on data elements from the CARIN Blue Button IG and the Da Vinci Prior Authorization Support (PAS) IG.
Specification(s) this track uses
Artifacts of focus
Addition of a Profile in support of the exchange of Prior Authorization documentation. Payer-to-Payer Business to Business Exchange.
Payers and Technology Vendors will be the primary attendees for the PDex Track.
Track Kick Off Call
April 22, 2022 12:00pm Eastern
PDex Track Orientation Recording_2022_04_22
Patient Access API
Scenarios to be tested:
This sub-track will test a modified Member-Match Operation that has an added Consent resource.
Scenarios to be tested:
The Track will also feature an evaluation of the pre-requisites required to perform Payer-to-Payer Exchange using the Patient Access APIs. We welcome Payers wishing to test these scenarios.
PDex STU2 Additions
This sub-track will test the addition of content to PDex to support Prior Authorization requirements for sharing of data with members
Scenarios and profiles to be tested:
Stretch Goals for Track:
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