Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Advanced Authorization

Overview

TBD

Workflow

1. The HIC or TPA sends an Advance Authorization Message to the provider via nphies system to advise that a prior message from that system contained errors.
2. nphies validates the message and returns an Acknowledgement Message with a status of OK if the message is valid otherwise the acknowlegement contains an OperationOutcome resource indicating errors in the Advance Authorization Message.
3. nphies stores the message if valid for return to the provider via Polling.

Message Structures

Advanced Authorization Message

The key resources for the message are provided below and all require nphies-profiled resources as provided in the Artifacts. Note: the MessageHeader resource must be the first .entry in the bundle and any other resources may follow in any order.

Nphies Bundle (.type = message )
  Nphies MessageHeader (.eventCoding = advanced-authorization)
  Nphies Advanced Authorization
  Nphies Coverage
  Nphies Patient
  Nphies Organization (Provider)
  Nphies Organization (Insurer)
  [Nphies CommunicationRequest]
  [any additional resources]

Acknowledgement Message

See Acknowledgement Message.

Guidance

TBD

Full Message Examples

Key Extensions

TBD

Error Handling

If nphies detects errors in the request message such that the request cannot be processed then the response message will contain an OperationOutcome resource rather than a business-level Status Response resource. Otherwise if nphies detects errors within the request it will return a Status Response with errors (Task.output.type = ‘error’) and an extension indicating where the error occurred.

Like all other response messages the provider receives from nphies, if there are other messages queued at nphies which have not been delivered to the provider then this will be reflected in the presence of a MessageHeader.meta.tag.