Da Vinci Prior Authorization Support FHIR Implementation Guide
PAS defines a FHIR R4 mechanism for submitting prior authorization requests, responses, status, updates, and supporting context in a way designed to map to applicable X12 transactions. It is one part of the Da Vinci burden-reduction workflow.
What the authority record establishes
PAS defines a FHIR R4 mechanism for submitting prior authorization requests, responses, status, updates, and supporting context in a way designed to map to applicable X12 transactions. It is one part of the Da Vinci burden-reduction workflow.
Technical specification; becomes required where adopted by regulation, contract, program, or trading-partner agreement
The exact official title, issuing body, jurisdiction, version or application record, and linked source define the scope of this page. Readers should not transfer the authority's status to a commercial product or infer transaction-, patient-, system-, site-, or organization-specific applicability from this summary.
Why it matters to this market
PAS governs the request-and-response exchange after requirement discovery and documentation preparation. Claiming FHIR support without specifying PAS version, trading-partner workflow, X12 handling, and testing evidence is insufficient.
Affected operating stages
- Request Submission
- Supporting Information Exchange
- Determination Response
- Status Inquiry
- Request Update Or Cancellation
Capabilities to examine
Clinical Documentation Assembly
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for clinical documentation assembly.
Medical-Service Electronic Submission
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for medical-service electronic submission.
Authorization Status Tracking
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for authorization status tracking.
FHIR CRD, DTR, And PAS Interoperability
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for FHIR CRD, DTR, and PAS interoperability.
X12 278 And Attachment Exchange
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for X12 278 and attachment exchange.
Audit Trail And Decision Provenance
Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for audit trail and decision provenance.
Affected buyer audiences
- payers and delegated UM organizations
- EHR and provider workflow vendors
- clearinghouses and ePA coordinators
- FHIR platform and integration teams
- conformance and testing teams
Implementation questions
- Which entities, products, populations, transactions, systems, sites, or jurisdictions are actually within scope?
- What is binding, what is guidance, and what is a technical or consensus standard?
- Which publication, adoption, effective, application, transition, and enforcement dates differ?
- Who owns legal, clinical, quality, regulatory, policy, or operational interpretation?
- How will a source revision affect open work and historical decisions?
Interpretation boundary
Prior Auth Monitor does not provide patient-specific medical advice, determine coverage, authorize care, or establish final payment. Its records support organizational research and operating review.