FHIR IG analytics| Package | hl7.ehrs.us.dhfpr2 |
| Resource Type | Requirements |
| Id | Requirements-DHFPR2-AS.8.3.json |
| FHIR Version | R5 |
| Source | https://build.fhir.org/ig/HL7/dhfp-ig/Requirements-DHFPR2-AS.8.3.html |
| URL | http://hl7.org/ehrs/us/dhfpr2/Requirements/DHFPR2-AS.8.3 |
| Version | 2.0.0-ballot |
| Status | active |
| Date | 2025-12-19T08:44:27+00:00 |
| Name | AS_8_3_Support_Integration_of_Cost_Financial_information_into_Patient_Care |
| Title | AS.8.3 Support Integration of Cost/Financial information into Patient Care (Function) |
| Realm | us |
| Authority | hl7 |
| Description | Support interactions with other systems, applications, and modules to enable the use of cost management information required to guide users and workflows. |
| Purpose | The provider is alerted or presented with the most cost-effective services, referrals, devices, etc., to recommend to the patient. This may be tailored to the patient's health insurance/plan coverage rules. Medications may be presented in order of cost, or the cost of specific interventions may be presented at the time of ordering. |
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Note: links and images are rebased to the (stated) source
The provider is alerted or presented with the most cost-effective services, referrals, devices, etc., to recommend to the patient. This may be tailored to the patient's health insurance/plan coverage rules. Medications may be presented in order of cost, or the cost of specific interventions may be presented at the time of ordering.
| AS.8.3#01 | MAY |
The system MAY provide the ability to extract formularies, preferred providers, and other information, from internal or external sources, that are associated with a patient's health care plan and coverage so that the provider can offer cost effective alternatives to patients. |
| AS.8.3#02 | MAY |
The system MAY provide the ability to extract information about exemptions on coverage limitations and guidelines. |
| AS.8.3#03 | MAY |
The system MAY provide the ability to capture or transmit the request for information about exemptions on coverage limitations and guidelines. |
| AS.8.3#04 | MAY |
The system MAY provide the ability to render expected patient out-of- pocket cost information for medications, diagnostic testing, and procedures, from internal or external sources, that are associated with a patients health care plan and coverage. |
| AS.8.3#05 | MAY |
The system MAY provide the ability to render a notification of an alert to the provider of care where formularies, preferred provider and other information indicate the health plan requires an alternative. |
| AS.8.3#06 | SHOULD |
The system SHOULD conform to function AS.9.3 (Support Service Authorizations) to integrate support of prior authorization processes. |
FHIR
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"version": "2.0.0-ballot",
"name": "AS_8_3_Support_Integration_of_Cost_Financial_information_into_Patient_Care",
"title": "AS.8.3 Support Integration of Cost/Financial information into Patient Care (Function)",
"status": "active",
"date": "2025-12-19T08:44:27+00:00",
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"conditionality": false,
"requirement": "The system SHOULD conform to function [AS.9.3](Requirements-DHFPR2-AS.9.3.html) (Support Service Authorizations) to integrate support of prior authorization processes.",
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