Stream: Da Vinci
Topic: CMS elements to Claim Resource Object
padma prabhavathi (Aug 20 2019 at 19:00):
Hi Everyone,
We are trying to mapping CMS Prior Authorization(PA) request elements to claim resource.
As part of CMS PA request we needs to provide details about attending provider, referring provider, facility provider, ordering provider, service provider, operating provider.
Can we use careteam elements in claim resource for sending these details or do you suggest any other elements in claim resource
Thank you so much for the support
Lloyd McKenzie (Aug 20 2019 at 21:10):
@Jean Duteau
Jean Duteau (Aug 20 2019 at 23:49):
Not sure lloyd pinged me on this other than I did an X12 mapping to the Claim resource for Prior Authorizations. :) Yes, I would use the careTeam elements to describe the various provider details, if that was essential to understanding what is being asked for authorization. Otherwise only the party responsible for the claim would go in the provider element.
Last updated: Apr 12 2022 at 19:14 UTC
