FHIR IG Statistics: Requirements/EHRSFMR2-AS.8.3

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{
  "resourceType": "Requirements",
  "id": "EHRSFMR2-AS.8.3",
  "meta": {
    "profile": [
      "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/FMFunction"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "ehr"
    }
  ],
  "url": "http://hl7.org/ehrs/uv/ehrsfmr2/Requirements/EHRSFMR2-AS.8.3",
  "version": "2.1.1-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": "2025-05-13T15:11:00+00:00",
  "publisher": "HL7 International / Electronic Health Records",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/ehr"
        }
      ]
    }
  ],
  "description": "Support interactions with other systems, applications, and modules to enable the use of cost management information required to guide users and workflows.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "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.",
  "statement": [
    {
      "extension": [
        {
          "url": "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean": false
        }
      ],
      "key": "EHRSFMR2-AS.8.3-01",
      "label": "AS.8.3#01",
      "conformance": [
        "MAY"
      ],
      "conditionality": false,
      "requirement": "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.",
      "derivedFrom": "EHR-S_FM_R1.1 S.3.2.3#1"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean": false
        }
      ],
      "key": "EHRSFMR2-AS.8.3-02",
      "label": "AS.8.3#02",
      "conformance": [
        "MAY"
      ],
      "conditionality": false,
      "requirement": "The system MAY provide the ability to extract information about exemptions on coverage limitations and guidelines.",
      "derivedFrom": "EHR-S_FM_R1.1 S.3.2.3#2"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean": false
        }
      ],
      "key": "EHRSFMR2-AS.8.3-03",
      "label": "AS.8.3#03",
      "conformance": [
        "MAY"
      ],
      "conditionality": false,
      "requirement": "The system MAY provide the ability to capture or transmit the request for information about exemptions on coverage limitations and guidelines."
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean": false
        }
      ],
      "key": "EHRSFMR2-AS.8.3-04",
      "label": "AS.8.3#04",
      "conformance": [
        "MAY"
      ],
      "conditionality": false,
      "requirement": "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.",
      "derivedFrom": "EHR-S_FM_R1.1 S.3.2.3#3"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean": false
        }
      ],
      "key": "EHRSFMR2-AS.8.3-05",
      "label": "AS.8.3#05",
      "conformance": [
        "MAY"
      ],
      "conditionality": false,
      "requirement": "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.",
      "derivedFrom": "EHR-S_FM_R1.1 S.3.2.3#4"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean": false
        }
      ],
      "key": "EHRSFMR2-AS.8.3-06",
      "label": "AS.8.3#06",
      "conformance": [
        "SHOULD"
      ],
      "conditionality": false,
      "requirement": "The system SHOULD conform to function [AS.9.3](Requirements-EHRSFMR2-AS.9.3.html) (Support Service Authorizations) to integrate support of prior authorization processes.",
      "derivedFrom": "EHR-S_FM_R1.1 S.3.2.3#5"
    }
  ]
}