HL7 Specifications
Financial Management
HL7 FHIR® Implementation Guide: Payer Data Exchange (PDex) Payer Network, Release 1.1 – US Realm
HL7 FHIR® Implementation Guide: Payer Data Exchange (PDex), Release 2 – US Realm
HL7 FHIR® Implementation Guide: Coverage Requirements Discovery, Release 2.0.1
This specification 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. It supports both patient-specific and patient-independent information retrieval.