Stream: CARIN BB ExplanationOfBenefit
Topic: Pharmacy vs Medical EOB
Bapi Behera (Jan 12 2021 at 23:45):
When the 3rd party mobile App sends the request for EOB, the client need to send both Medical & Pharmacy. But Athe data received from 2 different sources, one from the Med Provider and the other from Pharmacy Provider.
What is CARIN BB recommendation combining the Pharmacy and Medical EoB profiles to send to requester? The reason is, Pharmacy EOB data format different format than the Medical EOB data.
How the data can be combined (or you have different solution) to send to the requester?
Thanks for your help
Cooper Thompson (Jan 13 2021 at 15:19):
One approach I've seen is that organizations will be providing multiple resource servers (likely under a single auth server). This approach is aligned with the ONC rule (even though the data is governed by the CMS rule) because the ONC mandates token introspection for the express purpose of using an auth server of a certified HIT system to manage access to multiple resource servers. With this approach, there would be two different endpoints, one for pharmacy claims, and one for medical claims, and both endpoints would accept the same access token issued by the auth server.
Bapi Behera (Jan 13 2021 at 15:44):
Cooper Thompson said:
One approach I've seen is that organizations will be providing multiple resource servers (likely under a single auth server). This approach is aligned with the ONC rule (even though the data is governed by the CMS rule) because the ONC mandates token introspection for the express purpose of using an auth server of a certified HIT system to manage access to multiple resource servers. With this approach, there would be two different endpoints, one for pharmacy claims, and one for medical claims, and both endpoints would accept the same access token issued by the auth server.
Thanks Cooper. The data received from 2 end points medical and Pharmacy will have 2 different data sets. how that will be send to the 3rd party mobile app requester? Do we need to combine the data or any other solution ?
Cooper Thompson (Jan 13 2021 at 20:23):
The 3rd party app would make two different requests to two different endpoints. When you publish your FHIR URLs, you'd publish two endpoints.
Bapi Behera (Jan 14 2021 at 18:45):
Bapi Behera said:
When the 3rd party mobile App sends the request for EOB, the client need to send both Medical & Pharmacy. But Athe data received from 2 different sources, one from the Med Provider and the other from Pharmacy Provider.
What is CARIN BB recommendation combining the Pharmacy and Medical EoB profiles to send to requester? The reason is, Pharmacy EOB data format different format than the Medical EOB data.
How the data can be combined (or you have different solution) to send to the requester?
Thanks for your help
@Saul Kravitz @Ryan Howells @Josh Lamb @Mark Roberts @Igor Sirkovich - Any suggestions
Last updated: Apr 12 2022 at 19:14 UTC
