The role of HL7® FHIR® in patient cost transparency
summary
Da Vinci builds a FHIR implementation guide that turns a provider’s good faith estimate bundle into a payer-side pre-adjudicated claim and returns an advanced explanation of benefits the patient can receive via the Patient Access API. A reference implementation (edifx) already ingests the GFE and emits an AEOB at connectathons, coverage matches about 85% of Blue Button fields, and the IG is in ballot reconciliation aiming for publication later this year.
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chapters (15)
- 0:00Introduction and speaker intro
- 1:03Da Vinci project overview
- 3:55Patient cost transparency goals
- 6:01Problem of surprise medical bills
- 8:29No Surprises Act and FHIR response
- 12:30Need for cost transparency
- 13:12Good Faith Estimate workflow
- 19:37Good Faith Estimate details
- 24:34Example workflow demo
- 25:36Implementation guide resources
- 26:39Testing and connectathons
- 27:21Collaboration with X12
- 29:49Q&A on Advanced EOB
- 35:13Q&A on provider accountability
- 39:55Closing remarks
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