HL7 FHIR Implementation Guide: Simplify Health Equity Application Reviews IG Release 1 - US Realm | STU1 - Local Development build (v0.1.0). See the Directory of published versions

Introduction

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SHEAR utilizes existing FHIR Implementation Guides that have been recommended for implementation by Payers as part of the CMS Interoperability and Patient Access Rule (9115-F) and the CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule (CMS-0057-P).

This Implementation Guide makes available:

• information about the Health Equity-related services and products a Health Plan makes available to members. The product or service information also provides a link to the assessment screening questionnaire that is required when applying for a given service. The products and services and their associated questionnaires can be presented via the open Da Vinci Plan-Net (Provider Directory) API.
• A Health Plan member’s Advance Directive instructions. By linking the Advance Directive to the Member’s coverage their instructions and wishes are more likely to be available to a Provider at the point of care. The Advance Directive extension is based upon requirements defined in the PACIO Advance Directive Interoperability IG.

This IG adds two Extensions to the Coverage resource:

• SHEAR-InsuranceProduct-extension
• SHEAR-AdvanceDirective-extension

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