Provider prior authorization API – documentation templates and rules

The health IT developer demonstrates the Health IT Module supports the following capabilities as a “Full DTR EHR” in accordance with an implementation specification at § 170.215(j)(2):

1. DTR-1: Registration with a “DTR Payer Service” to enable the required client capabilities with the “DTR Payer Service” including authentication, authorization, and FHIR operations as described in the “Full DTR EHR Capability Statement.”
2. DTR-2: Authentication and authorization as a client with a “DTR Payer Service” using “Backend Services” in accordance with an implementation specification at § 170.215(c).
3. DTR-3: Population of “Standard Questionnaires” received from a “DTR Payer Service” including support for the “$questionnaire-package” operation.
4. DTR-4: Population of “Adaptive Questionnaires” received from a “DTR Payer Service” including support for the ”$questionnaire-package” and “$next-question” operations.
5. DTR-5: Value set expansion for questionnaires in accordance with the “$expand” operation.
6. DTR-6: Execution of Clinical Quality Language (CQL) to support pre-population of questionnaires.
7. DTR-7: Display of pre-populated questionnaires to the user for review and completion.
8. DTR-8: Storage of completed questionnaires in the Health IT Module.

The tester verifies the Health IT Module supports the following capabilities as a “Full DTR EHR” in accordance with an implementation specification at § 170.215(j)(2):

1. DTR-1: Registration with a “DTR Payer Service” to enable the required client capabilities with the “DTR Payer Service” including authentication, authorization, and FHIR operations as described in the “Full DTR EHR Capability Statement.”
2. DTR-2: Authentication and authorization as a client with a “DTR Payer Service” using “Backend Services” in accordance with an implementation specification at § 170.215(c).
3. DTR-3: Population of “Standard Questionnaires” received from a “DTR Payer Service” including support for the “$questionnaire-package” operation.
4. DTR-4: Population of “Adaptive Questionnaires” received from a “DTR Payer Service” including support for the ”$questionnaire-package” and “$next-question” operations.
5. DTR-5: Value set expansion for questionnaires in accordance with the “$expand” operation.
6. DTR-6: Execution of Clinical Quality Language (CQL) to support pre-population of questionnaires.
7. DTR-7: Display of pre-populated questionnaires to the user for review and completion.
8. DTR-8: Storage of completed questionnaires in the Health IT Module.