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Section 1c: FHIR®
Section 3: Implementation Guides

HL7 FHIR® Implementation Guide: Da Vinci - Coverage Requirements Discovery (CRD) Edition 2.2.1 - US Realm

DESCRIPTION

Provides a mechanism for healthcare providers to discover guidelines, pre-authorization requirements and other expectations from payor organizations related to a proposed medication, procedure or other service associated with a patient's insurance coverage. Supports both patient-specific and patient-independent information retrieval.

 

See the specification at http://hl7.org/fhir/us/davinci-crd/2.2.1

ALTERNATIVE NAMES

HL7 FHIR® Implementation Guide: Da Vinci - Coverage Requirements Discovery (CRD) Edition 2.2.1 - US Realm may also go by the following names or acronyms:

"HL7 FHIR® IG: Coverage Requirements Discovery, R1",CRD, Payer requirements, US Da Vinci CRD

BENEFITS

  • Ensures providers are aware of payer-specific requirements at the time of decision-making.
  • Reduces provider burden by simplifying prior authorization processes.
  • Allows awareness of coverage to be considered as part of planning patient care.

IMPLEMENTATIONS/CASE STUDIES

  • Reference implementation created by MITRE.
  • Lantana Test implementation by Mettle Solutions, Epic and others

DEVELOPMENT BACKGROUND

This specification was created as part of the Da Vinci project with significant participation from the U.S. Payer community as well as several EHR software vendors.

RELATED DOCUMENTS

HL7 FHIR® Implementation Guide: Da Vinci - Coverage Requirements Discovery (CRD) Edition 2.2.1 - US Realm

STU DOCUMENTS

HL7 FHIR® Implementation Guide: Coverage Requirements Discovery (CRD), Edition 2.2.1 - US Realm See the standard at '>http://hl7.org/fhir/us/davinci-crd/2.2.1'>. (Submit Feedback on STU)
HL7 FHIR® Implementation Guide: Da Vinci - Coverage Requirements Discovery Edition 2.1, US Realm See the standard at http://hl7.org/fhir/us/davinci-crd/STU2.1. Expiration Apr 2026
HL7 FHIR® Implementation Guide: Coverage Requirements Discovery (CRD), Release 1 - US Realm http://hl7.org/fhir/us/davinci-crd/STU1/index.html Expiration Dec 2023

TOPIC

  • Financial Management

BALLOT TYPE

  • STU

STATUS DATE

2023-10-20

RESPONSIBLE WORK GROUP

Financial Management

PRODUCT TYPE

  • Implementation Guide

STAKEHOLDERS

  • EHR, PHR Vendors
  • Emergency Services Providers
  • Healthcare Institutions
  • HIS Vendors
  • Medical Imaging Service Providers
  • Payors

FAMILY

  • FHIR

CURRENT STATE

  • Active

REALM

  • US Realm