CDSO-FHIR Pilot without QHIN
- Olena Honchar
- Feb 13
- 1 min read
Updated: Mar 6
Combs-Dyer Consulting is working with several clients to create a FHIR based mechanism – without a QHIN – to move the clinical documentation supporting an order (CDSO) from the ordering clinician to the DME supplier and then onto the payer.
Background
CMS regulation 0057 requires most health plans to develop a FHIR based mechanism to allow an ordering clinician to receive – – right in their EHR – – an electronic clinical template of all the data elements that health plan requires to make a prior authorization decision. DME suppliers need to receive a copy of that completed template, the CDSO FHIR bundle, to ensure their claims to the health plan will be paid. Currently there is no FHIR standard for how this FHIR bundle should move from the ordering clinician to the DME supplier.
Goal
The goal of this pilot is to:
1. Develop a CDSO/CDEX companion, guide and
2. Test it in the real world between several ordering clinicians several DME suppliers and several payers.
Comments